jueves, 27 de junio de 2013

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet -- Manichanh et al. -- Gut

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet -- Manichanh et al. -- Gut

Gut doi:10.1136/gutjnl-2012-303013
  • Gut microbiota
  • Original article

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet

Open Access
  1. Fernando Azpiroz1
+ Author Affiliations
  1. 1Digestive System Research Unit, Departament de Medicina, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Universitat Autònoma de Barcelona, Barcelona, Spain
  2. 2Molecular Biology Institute of Barcelona, Consejo Superior de Investigaciones Cientificas, Barcelona, Spain
  3. 3Department of Chemistry and Biochemistry, University of Colorado at Boulder, and Howard Hughes Medical Institute, Boulder, Colorado, USA
  4. 4Digestive Health Department, Danone Research, Palaiseau, France
  1. Correspondence to Professor Fernando Azpiroz, Digestive System Research Unit, Hospital General Vall d'Hebron, Barcelona 08035, Spain; azpiroz.fernando@gmail.com
  • Received 1 June 2012
  • Revised 7 May 2013
  • Accepted 14 May 2013
  • Published Online First 13 June 2013


Objective To characterise the influence of diet on abdominal symptoms, anal gas evacuation, intestinal gas distribution and colonic microbiota in patients complaining of flatulence.
Design Patients complaining of flatulence (n=30) and healthy subjects (n=20) were instructed to follow their usual diet for 3 days (basal phase) and to consume a high-flatulogenic diet for another 3 days (challenge phase).
Results During basal phase, patients recorded more abdominal symptoms than healthy subjects in daily questionnaires (5.8±0.3 vs 0.4±0.2 mean discomfort/pain score, respectively; p=< 0.0001) and more gas evacuations by an event marker (21.9±2.8 vs 7.4±1.0 daytime evacuations, respectively; p=0.0001), without differences in the volume of gas evacuated after a standard meal (262±22 and 265±25 mL, respectively). On flatulogenic diet, both groups recorded more abdominal symptoms (7.9±0.3 and 2.8±0.4 discomfort/pain, respectively), number of gas evacuations (44.4±5.3 and 21.7±2.9 daytime evacuations, respectively) and had more gas production (656±52 and 673±78 mL, respectively; p< 0.05 vs basal diet for all). When challenged with flatulogenic diet, patients’ microbiota developed instability in composition, exhibiting variations in the main phyla and reduction of microbial diversity, whereas healthy subjects’ microbiota were stable. Taxa from Bacteroides fragilis or Bilophila wadsworthia correlated with number of gas evacuations or volume of gas evacuated, respectively.
Conclusions Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode

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