Intestinal gas and its associated symptoms (eg, bloating, distension, and flatulence) have long been trivialized and dismissed by many medical practitioners. Recent studies examining the relationship between these symptoms and the quality of life of patients with irritable bowel syndrome (IBS) report, however, that patients experience substantial distress because of these symptoms. In fact, patients with IBS often report that, even though they may be able to cope with the abdominal pain, they cannot tolerate the bloating and distension.
In an article in the December 2003 issue of Gut, Eamonn Quigley, MD, discusses the role of intestinal gas in IBS and its relationship to IBS symptoms. Patients with IBS do not appear to produce more gas than do individuals not suffering from IBS. They do appear, however, to suffer from abnormal gas transit, which result in gas retention in the small intestine. This gas retention, combined with visceral hypersensitivity, is likely to cause symptoms (ie, gas retention causes bloating and distension, whereas hypersensitivity causes patients with IBS to experience greater discomfort than is experienced by persons without IBS at the same level of retention). Gas content and transit appear to conspire with the motor and sensory responses of the gut to produce gas-related symptoms in patients with IBS as well as in individuals not suffering from IBS, according to Dr. Quigley.