Harder H, Serra J, Azpiroz F, Passos M C, Aguadé S, Malagelada J-R
Digestive System Research Unit, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
Gut. 2003 Dec;52(12):1708-13. doi: 10.1136/gut.52.12.1708.
Patients with functional gut disorders manifest poor tolerance to intestinal gas loads but the mechanism of this dysfunction is unknown.
Our aims were firstly, to explore the relative importance of the amount of intestinal gas versus its distribution on symptom production, and secondly, to correlate gut motility and perception of gas loads.
Fourteen healthy subjects with no gastrointestinal symptoms.
In each subject a gas mixture was infused (12 ml/min) either into the jejunum or rectum for one hour during blocked rectal gas outflow, and subsequently gas clearance was measured over one hour of free rectal evacuation. We measured abdominal perception, distension, and gut tone by duodenal and rectal barostats.
Similar magnitude of gas retention (720 ml) produced significantly more abdominal symptoms with jejunal compared with rectal infusion (perception score 4.4 (0.4) v 1.5 (0.5), respectively; p<0.01) whereas abdominal distension was similar (15 (2) mm and 14 (1) mm girth increment, respectively). Jejunal gas loads were associated with proximal contraction (by 57 (5)%) and colonic loads with distal relaxation (by 99 (20)%).
The volume of gas within the gut determines abdominal distension whereas symptom perception depends on intraluminal gas distribution and possibly also on the gut motor response to gas loads.
功能性肠道疾病患者对肠道气体负荷的耐受性较差，但这种功能障碍的机制尚不清楚。
我们的目的一是探讨肠道气体量与其分布对症状产生的相对重要性，二是关联肠道动力与对气体负荷的感知。
14名无胃肠道症状的健康受试者。
在每个受试者中，在直肠气体流出受阻期间，将一种气体混合物（12毫升/分钟）注入空肠或直肠1小时，随后在直肠自由排空1小时期间测量气体清除情况。我们通过十二指肠和直肠压力传感器测量腹部感知、腹胀和肠道张力。
与直肠注入相比，空肠注入产生相似量的气体潴留（720毫升）时，腹部症状明显更多（感知评分分别为4.4（0.4）和1.5（0.5）；p<0.01），而腹胀相似（腹围增加分别为15（2）毫米和14（1）毫米）。空肠气体负荷与近端收缩相关（增加57（5）%），结肠负荷与远端松弛相关（增加99（20）%）。
肠道内气体的量决定腹胀，而症状感知取决于肠腔内气体分布，也可能取决于肠道对气体负荷的运动反应。
