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This article explores the research behind diverticular disease and its dietary management, with a focus on dietary fibre. Diverticula, saclike protrusions in the colonic wall, are extremely prevalent in older people living in Western countries and range from asymptomatic (diverticulosis) to moderately symptomatic (diverticular disease) to severely symptomatic (diverticulitis). Diet and lifestyle are implicated in the development of these conditions, as demonstrated by the vast increase in prevalence as countries become more industrialised and follow a Western dietary pattern. Dietary fibre is a particular nutrient of interest. Contrary to prior dogma, research suggests that individuals with diverticular disease should actually strive for a high fibre diet to reduce the risk of developing further diverticula and prevent progression to diverticulitis. The dietary management of the symptoms of diverticular disease is not well understood. Vigorous physical activity may reduce the risk of diverticulitis. Community nurses can help their patients to avoid harmful and unnecessary dietary restrictions by using the information in this article. [ABSTRACT FROM AUTHOR]

Background: Abdominal pain is stressful, accounting for a large proportion of emergency and primary care visits. Clinical workups for irritable bowel syndrome (IBS) are often without abnormal findings and symptoms can be severe, diminishing patients’ IBS-related quality of life (IBS-QOL). Purpose: The efficacy of stress-relieving therapies to manage IBS symptoms was explored. Methods: Participants were randomly assigned to standard care or an intervention group (ie, walking, music, and essential oils). The IBS-QOL, gastrointestinal (GI) distress, and general health questionnaires were completed at baseline and 6-week visits. Results: The intervention explained 20% of the variance for IBS-QOL, 19% for GI distress, and 27% for general health, after controlling for baseline scores. IBS-QOL and general health were improved, with GI distress minimized for the walking and essential oils groups. Conclusions: Adding walking and essential oils to an established IBS treatment regimen can positively impact health and well-being. [ABSTRACT FROM AUTHOR]

This meta-analysis was conducted to analyze the effect of abdominal massage on gastrointestinal functions in the elderly. This literature search was conducted using the ClinicalKey, Scopus, PubMed, Web of Science, and Google Scholar databases to cover studies up to June 2022. The abdominal massage group had a large effect on reducing constipation severity and abdomen circumference. The abdominal massage had no effect on stool classification. The results indicated that abdominal massage for older people appears to be effective in reducing the severity of constipation and decreasing the abdominal circumference. These results can determine that abdominal massage can be used to reduce the severity of constipation and abdominal circumference. [ABSTRACT FROM AUTHOR]

Some probiotics may be beneficial in irritable bowel syndrome (IBS), but differences in species and strains used, as well as endpoints reported, have hampered attempts to make specific recommendations as to which should be preferred. We updated our previous meta-analysis examining this issue. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (up to March 2023). Randomized controlled trials (RCTs) recruiting adults with IBS, comparing probiotics with placebo were eligible. Dichotomous symptom data were pooled to obtain a relative risk of global symptoms, abdominal pain, or abdominal bloating or distension persisting after therapy, with a 95% confidence interval (CI). Continuous data were pooled using a standardized mean difference with a 95% CI. Adverse events data were also pooled. We identified 82 eligible trials, containing 10,332 patients. Only 24 RCTs were at low risk of bias across all domains. For global symptoms, there was moderate certainty in the evidence for a benefit of Escherichia strains, low certainty for Lactobacillus strains and Lactobacillus plantarum 299V, and very low certainty for combination probiotics, LacClean Gold S, Duolac 7s, and Bacillus strains. For abdominal pain, there was low certainty in the evidence for a benefit of Saccharomyces cerevisae I-3856 and Bifidobacterium strains, and very low certainty for combination probiotics, Lactobacillus , Saccharomyces , and Bacillus strains. For abdominal bloating or distension there was very low certainty in the evidence for a benefit of combination probiotics and Bacillus strains. The relative risk of experiencing any adverse event, in 55 trials, including more than 7000 patients, was not significantly higher with probiotics. Some combinations of probiotics or strains may be beneficial in IBS. However, certainty in the evidence for efficacy by GRADE criteria was low to very low across almost all of our analyses. We studied the efficacy of probiotics for irritable bowel syndrome. There was some evidence of efficacy, but the quality of the trials included makes it hard to draw definitive conclusions. Future trials should be more rigorous and could focus on potentially effective strains or species from this meta-analysis. [ABSTRACT FROM AUTHOR]

Benign mesothelial cysts are rare, and to our knowledge there are no reported cases of benign mesothelial cysts in patients with a history of gastroschisis. A 15-year-old girl with a history of complicated gastroschisis and multiple operations as a child presented to the emergency department with back pain and abdominal bloating that worsened over the course of a year. At the time of presentation, she was febrile, but her basic blood tests were within normal limits. Imaging studies including an abdominal ultrasound, a computed tomography of the abdomen, and a magnetic resonance imagining of the abdomen demonstrated a 31× 21 × 11cm cystic abdominopelvic lesion, the origin of which was unclear. Tumor markers including alpha fetoprotein, CA 125, CA 19–9, beta HCG, carcinoembryonic antigen, inhibin A/B, and lactate dehydrogenase were normal. The fluid was sampled by needle aspiration. Amber fluid with mostly macrophages (72 %) and was obtained. A pigtail catheter was placed, and 2500 ml of clear yellow/brown fluid were drained. She was sent home with the drain and was scheduled for an elective cyst excision but presented to the hospital with a bowel obstruction a few days later. She underwent an extensive laparoscopic lysis of adhesions, drain removal, and partial excision of the cyst wall. The pathology analysis was consistent with a benign mesothelial cyst. No new drains were placed. She recovered well from the operation. At 3 months of follow up she is doing well and has no recurrence of the cyst by ultrasound. She will continue to be monitored with periodic ultrasounds. While rare, benign mesothelial cysts should be on the differential diagnosis of patients with large abdominal cysts, particularly if they have a history of prior abdominal operations. [ABSTRACT FROM AUTHOR]

Abdominal distention results from abdominophrenic dyssynergia (ie, diaphragmatic contraction and abdominal wall relaxation) in patients with disorders of gut–brain interaction. This study aimed to validate a simple biofeedback procedure, guided by abdominothoracic wall motion, for treating abdominal distention. In this randomized, parallel, placebo-controlled trial, 42 consecutive patients (36 women and 6 men; ages 17–64 years) with meal-triggered visible abdominal distention were recruited. Recordings of abdominal and thoracic wall motion were obtained using inductance plethysmography via adaptable belts. The signal was shown to patients in the biofeedback group, who were taught to mobilize the diaphragm. In contrast, the signal was not shown to the patients in the placebo group, who were given a placebo capsule. Three sessions were performed over a 4-week intervention period, with instructions to perform exercises (biofeedback group) or to take placebo 3 times per day (control group) at home. Outcomes were assessed through response to an offending meal (changes in abdominothoracic electromyographic activity and girth) and clinical symptoms measured using daily scales for 7 days. Patients in the biofeedback group (n = 19) learned to correct abdominophrenic dyssynergia triggered by the offending meal (intercostal activity decreased by a mean ± SE of 82% ± 10%, anterior wall activity increased by a mean ± SE of 97% ± 6%, and increase in girth was a mean ± SE of 108% ± 4% smaller) and experienced improved clinical symptoms (abdominal distention scores decreased by a mean ± SE of 66% ± 5%). These effects were not observed in the placebo group (all, P <.002). Abdominothoracic wall movements serve as an effective biofeedback signal for correcting abdominophrenic dyssynergia and abdominal distention in patients with disorders of gut–brain interaction. ClincialTrials.gov , Number: NCT04043208. [Display omitted] A simple and effective biofeedback technique, guided by the motion of the abdominal and thoracic walls, is introduced to treat abdominal distention in patients with digestive disorders. [ABSTRACT FROM AUTHOR]

H-type anorectal malformation (ARM) is a rare type defined as a congenital ano-recto-urogenital communication with an external anal opening in a normal or ectopic position. The management of male H-type ARM is controversial because of its rarity and diverse phenotypes. Excision or ligation of the fistula using the anterior perineal approach has mostly been selected for treatment in previous reports, but recurrence of the fistula is not uncommon. An 18-day-old boy presented to our hospital with abdominal bloating and bilious emesis. Anal stenosis was detected on examination. Dilatations by bougienage and enemas were initiated. He experienced urinary infections twice at within the following month. At seven months of age, his mother noticed gas and fecal discharge from his urethral opening. Retrograde cystourethrography and contrast enema revealed a rectourethral fistula, leading to the diagnosis of an H-type ARM. We did a rectal pull-through using the posterior sagittal anorectoplasty (PSARP) approach, with a sigmoid colostomy to minimize the risk of recurrence. The postoperative course was uneventful and there were no complications. The patient had good urinary function and defecation without fistula recurrence. Rectal pull-through with a PSARP seems to be an effective procedure for the management of male H-type ARM. [ABSTRACT FROM AUTHOR]

Galactose intolerance, associated with bloating and abdominal pain, is similar to lactose intolerance. Congenital galactose malabsorption in a child can lead to severe diarrhea. To avoid the consequences of galactose malabsorption, we obtained a galactose decomposition strain of Lactiplantibacillus plantarum MWLp-4 from human milk. Importantly, this strain had almost overlapping dynamics of galactose and lactose utilization, showing a great galactose catabolic ability. In this paper, we studied safety evaluation including hemolysis test, drug sensitivity test, and determination of amine in vitro of L. plantarum MWLp-4. In addition, we evaluated the probiotic function such as antimicrobial properties, adhesion, acid resistance, and bile salt resistance, etc. Meanwhile, we have analyzed the key genes on function and safety. As a conclusion, this strain possess great safety and probiotic function. The genes related to galactose metabolism, bacteriocin synthesis, surface protein synthesis, bile salt hydrolysis and stress response are found in L. plantarum MWLp-4. Analysis of the consistency of the phenotype with its genotype via whole genome sequencing showed that the phenotype of its physiological function is due to the large number of related genes existing in it. Therefore, this study would provide potential degrading galactose probiotics for producing special functional food. [Display omitted] • A galactose decomposition strain of Lactiplantibacillus plantarum MWLp- 4 from human milk. • Combination genotypic and phenotypic analyses to assess strain's functions. • Potential probiotics for avoid ting the consequences of galactose malabsorption. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) (also known as spastic colon) is a chronic condition that affects the large intestine (colon) and seems to be more prevalent among women. It is often associated with cramping, abdominal pain, bloating, flatulence, diarrhoea and/or constipation (depending on which sub-type the patient suffers from). Certain alarm features (e.g. rectal bleeding, nocturnal symptoms and family history of colorectal cancer or inflammatory bowel disease) should be ruled out first before IBS can be diagnosed, following an approach of exclusion. The exact pathogenesis of IBS is not clear, but psychosocial factors, abnormal gastrointestinal motility and visceral hypersensitivity play an important role. Psychological distress such as anxiety and depression have also been linked to IBS and are potentially exacerbated by the patients' impaired quality of life whilst living with the condition. Treatment of IBS is directed towards encouraging physical exercise, advising the patient on dietary modification, providing psychosocial support and alleviating the patients' symptoms. [ABSTRACT FROM AUTHOR]

High strength or construction bloating clay is widely used in construction operations especially in construction of roads, bridges, airfield pavement. It replaces crushed stone as an aggregate. Technology of high strength bloating clay requires essential changes in its stoving curve in comparison with the production of light bloating clay. It is shown that in order to solve an urgent construction problem of bloating clay release it is necessary to conduct monitoring of temperature pattern in a rotary kiln in several distinctive cross sections and conduct management of a kiln as an object with distributed constants with the use of several, especially three, concentrated control actions. The developed mathematical model of stoving process and methodology of computing experiment, exemplified by the 40×2,5м kiln, allowed to find operating areas of condition and management of an automated object, focused on bloating clay release with assigned strength. [ABSTRACT FROM AUTHOR]

Background & Aims In patients with functional gut disorders, abdominal distension has been associated with descent of the diaphragm and protrusion of the anterior abdominal wall. We investigated mechanisms of abdominal distension in these patients. Methods We performed a prospective study of 45 patients (42 women, 24–71 years old) with functional intestinal disorders (27 with irritable bowel syndrome with constipation, 15 with functional bloating, and 3 with irritable bowel syndrome with alternating bowel habits) and discrete episodes of visible abdominal distension. Subjects were assessed by abdominothoracic computed tomography (n = 39) and electromyography (EMG) of the abdominothoracic wall (n = 32) during basal conditions (without abdominal distension) and during episodes of severe abdominal distension. Fifteen patients received a median of 2 sessions (range, 1–3 sessions) of EMG-guided, respiratory-targeted biofeedback treatment; 11 received 1 control session before treatment. Results Episodes of abdominal distension were associated with diaphragm contraction (19% ± 3% increase in EMG score and 12 ± 2 mm descent; P < .001 vs basal values) and intercostal contraction (14% ± 3% increase in EMG scores and 6 ± 1 mm increase in thoracic antero-posterior diameter; P < .001 vs basal values). They were also associated with increases in lung volume (501 ± 93 mL; P < .001 vs basal value) and anterior abdominal wall protrusion (32 ± 3 mm increase in girth; P < .001 vs basal). Biofeedback treatment, but not control sessions, reduced the activity of the intercostal muscles (by 19% ± 2%) and the diaphragm (by 18% ± 4%), activated the internal oblique muscles (by 52% ± 13%), and reduced girth (by 25 ± 3 mm) ( P ≤ .009 vs pretreatment for all). Conclusions In patients with functional gut disorders, abdominal distension is a behavioral response that involves activity of the abdominothoracic wall. This distension can be reduced with EMG-guided, respiratory-targeted biofeedback therapy. [ABSTRACT FROM AUTHOR]

Although belching and hiccups are regarded as normal behaviors, they can occur at high frequency or become persistent, becoming bothersome and requiring medical care. Patients with excessive belching frequently have supragastric belches. Excessive belching should be treated as a behavioral disorder. Persistent hiccups, however, can be the first presentation of a serious disorder that requires extensive diagnostic testing. When no cause is found, only the symptoms can be treated. Aerophagia is an episodic or chronic disorder in which patients (children and adults) swallow large quantities of air, which accumulate in the gastrointestinal tract to cause abdominal distention and bloating. These patients should not undergo explorative laparotomy because they do not have ileus. New treatment approaches are needed for patients with aerophagia. [ABSTRACT FROM AUTHOR]

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INTRODUCTION: Previous surveys of gastrointestinal symptoms after spinal cord injury have not used validated questionnaires and have not focused on the full spectrum of such symptoms and their relationship to factors, such as level of spinal cord injury and psychologic dysfunction. This study was designed to detail the spectrum and prevalence of gastrointestinal symptoms in spinal cord injury and to determine clinical and psychologic factors associated with such symptoms. METHODS: Established spinal cord injury patients (>12 months) randomly selected from a spinal cord injury database completed the following three questionnaires: 1) Rome II Integrative Questionnaire, 2) Hospital Anxiety and Depression Scale, and 3) Burwood Bowel Dysfunction after spinal cord injury. RESULTS: A total of 110 patients participated. The prevalence of abdominal bloating and constipation were 22 and 46 percent, respectively. Bloating was associated with cervical (odds ratio = 9.5) and lumbar (odds ratio = 12.1) level but not with thoracic level of injury. Constipation was associated with a higher level of injury (cervical odds ratio = 5.6 vs. lumbar) but not with psychologic factors. In contrast, abdominal pain (33 percent) and fecal incontinence (41 percent) were associated with higher levels of anxiety (odds ratio = 6.8, and odds ratio = 2.4) but not with the level of injury. CONCLUSIONS: There is a high prevalence and wide spectrum of gastrointestinal symptoms in spinal cord injury. Abdominal bloating and constipation are primarily related to specific spinal cord levels of injury, whereas abdominal pain and fecal incontinence are primarily associated with higher levels of anxiety. Based on our findings, further physiologic and psychologic research studies in spinal cord injury patients should lead to more rational management strategies for the common gastrointestinal symptoms in spinal cord injury. [ABSTRACT FROM AUTHOR]

Wandering spleen is a rare entity and can be a great imitator. Varied presentations have been described. We a present a case, the first in our center, with pelvic spleen associated with splenic vein torsion and secondary gastric varices. Presentation of our patient was with haematemesis which settled after splenectomy. [ABSTRACT FROM AUTHOR]

Abstract: The present report describes an 8-year-old gelding presenting with signs of severe abdominal pain. After performing a thorough physical examination, including rectal palpation and additional diagnostic tests, an exploratory laparotomy was recommended. The jejunum was found herniated through the gastrosplenic ligament, and the stomach was severely distended with gas. Given a poor prognosis, the horse was euthanized on the table. At necropsy, the stomach appeared dilated, with an 180° horizontal gastric torsion, from left (lateral) to right (medial), dividing the organ into dorsal and ventral compartments. We believe that the chronic traction exerted by an incarcerated and distended loop of jejunum, in the dorsal aspect of the gastrosplenic ligament, associated with trauma during episodes of intense rolling, enlarged the rent until it ruptured. Because of this rupture, the lateral dorsal aspect of the stomach became unattached, predisposing it to the torsion. [Copyright &y& Elsevier]

The article offers information related to dyspepsia, which is characterized by the feeling discomfort, fullness and bloating. It mentions various causes of dyspepsia including heartburn, hiatus hernia, and gallstones. It suggests the use of several over-the-counter (OTC) drugs for treating dyspepsia including antacids, alginates, and histamine-2 receptor antagonists.

Abstract: INTRODUCTION: Intraabdominal bands of the vitelline vessel remnant are the rarest form of congenital mesodiverticluar bands which may or may not be associated with Meckel''s diverticulum. In the majority of cases they cause an acute abdominal disease such as intestinal obstruction, especially in children. PRESENTATION OF CASE: We report a case of a 64 year old gentleman who experienced recurrent episodes of abdominal distension and bloating over two years. Computed tomography of his abdomen, colonoscopy, and barium follow through were all normal. Diagnostic laparoscopy revealed a single band adhesion stretching between the distal ileal mesentery and the anterior abdominal wall near the umbilicus. DISCUSSION: Congenital vascular bands are established causes of acute intestinal obstruction especially in children but are relatively uncommon. Their role in chronic abdominal pain is rare and diagnosis is difficult preoperatively. Pain in the patient was most likely due to recurrent partial twisting and untwisting of the bowel around the band. CONCLUSION: This case not only highlights an unusual cause of chronic abdominal pain, but also the effectiveness of laparoscopy as a diagnostic tool in such patients. [Copyright &y& Elsevier]

Soap bubbles, rubber balloons, and distended bellies have been seen and experienced by men over centuries giving them the idea of tension and eventually the feeling of blowing out, until someone found a physicomathematical explanation to close the loop from practical to theoretical knowledge and so making a few guys happy, which does not mean at all that the inflated sensation will not show up again and that cattle in the country will not be treated with a stab in the tummy by a would-be-veterinary-doctor to relieve bloat (see “Bloat”). [ABSTRACT FROM PUBLISHER]