Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
Am J Gastroenterol. 2011 May;106(5):815-9. doi: 10.1038/ajg.2010.408.
The abdomen normally accommodates intra-abdominal volume increments. Patients complaining of abdominal distension exhibit abnormal accommodation of colonic gas loads (defective contraction and excessive protrusion of the anterior wall). However, abdominal imaging demonstrated diaphragmatic descent during spontaneous episodes of bloating in patients with functional gut disorders. We aimed to establish the role of the diaphragm in abdominal distension.
In 20 patients complaining of abdominal bloating and 15 healthy subjects, we increased the volume of the abdominal cavity with a colonic gas load, while measuring abdominal girth and electromyographic activity of the anterior abdominal muscles and of the diaphragm.
In healthy subjects, the colonic gas load increased girth, relaxed the diaphragm, and increased anterior wall tone. With the same gas load, patients developed significantly more abdominal distension; this was associated with paradoxical contraction of the diaphragm and relaxation of the internal oblique muscle.
In this experimental provocation model, abnormal accommodation of the diaphragm is involved in abdominal distension.
腹部通常能容纳腹腔内体积的增加。有腹部膨胀感的患者表现出结肠气体负荷的异常容纳（收缩功能缺陷和前壁过度突出）。然而，在功能性肠道疾病患者的自发性腹胀发作期间，腹部影像学显示膈肌下降。我们旨在确定膈肌在腹胀中的作用。
在 20 名有腹部膨隆感的患者和 15 名健康受试者中，我们通过结肠气体负荷增加腹腔体积，同时测量腹围和前腹壁肌肉及膈肌的肌电图活动。
在健康受试者中，结肠气体负荷增加了腹围，使膈肌松弛，并增加了前壁张力。在相同的气体负荷下，患者出现了明显更多的腹部膨隆；这与膈肌的反常收缩和内斜肌的松弛有关。
在这个实验性激发模型中，膈肌的异常容纳参与了腹胀。
