{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:21:04Z","timestamp":1789172464208,"version":"build-2803163510"},"reference-count":71,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8]]},"DOI":"10.1038\/ajg.2017.129","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T08:01:17Z","timestamp":1494921677000},"page":"1221-1231","source":"Crossref","is-referenced-by-count":81,"title":["Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge"],"prefix":"10.14309","volume":"112","author":[{"given":"Juan R","family":"Malagelada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Accarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Azpiroz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-9-20210219","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1053\/j.gastro.2006.07.015","article-title":"Relationship of abdominal bloating to distension in irritable bowel syndrome and effect of bowel habit.","volume":"131","author":"Houghton","year":"2006","journal-title":"Gastroenterology"},{"key":"R3-9-20210219","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1053\/j.gastro.2016.02.032","article-title":"Functional gastrointestinal disorders: history, pathophysiology, clinical features, and rome IV.","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"R4-9-20210219","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1111\/j.1572-0241.2007.01755.x","article-title":"Abdominal bloating in employed adults: prevalence, risk factors, and association with other bowel disorders.","volume":"103","author":"Tuteja","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"R5-9-20210219","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1111\/j.1572-0241.1999.01009.x","article-title":"Symptoms and visceral perception in patients with pain-predominant irritable bowel syndrome.","volume":"94","author":"Lembo","year":"1999","journal-title":"Am J Gastroenterol"},{"key":"R6-9-20210219","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1136\/bmj.299.6708.1138","article-title":"Ranking of symptoms by patients with the irritable bowel syndrome.","volume":"299","author":"Maxton","year":"1989","journal-title":"BMJ"},{"key":"R7-9-20210219","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1023\/A:1005554103531","article-title":"Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact.","volume":"45","author":"Sandler","year":"2000","journal-title":"Dig Dis Sci"},{"key":"R8-9-20210219","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1136\/gut.32.6.662","article-title":"Abdominal distension in female patients with irritable bowel syndrome: exploration of possible mechanisms.","volume":"32","author":"Maxton","year":"1991","journal-title":"Gut"},{"key":"R9-9-20210219","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1007\/BF02087912","article-title":"Factors influencing frequency of flatus emission by healthy subjects.","volume":"41","author":"Furne","year":"1996","journal-title":"Dig Dis Sci"},{"key":"R10-9-20210219","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1053\/j.gastro.2005.11.061","article-title":"Functional bowel disorders.","volume":"130","author":"Longstreth","year":"2006","journal-title":"Gastroenterology"},{"key":"R11-9-20210219","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1038\/ajg.2013.211","article-title":"Clinical data support that psyllium is not fermented in the gut.","volume":"108","author":"McRorie","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"R12-9-20210219","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/S0016-5085(98)70133-7","article-title":"Intestinal gas dynamics and tolerance in humans.","volume":"115","author":"Serra","year":"1998","journal-title":"Gastroenterology"},{"key":"R13-9-20210219","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1136\/gut.48.1.14","article-title":"Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome.","volume":"48","author":"Serra","year":"2001","journal-title":"Gut"},{"key":"R14-9-20210219","first-page":"G138","article-title":"Mechanisms of intestinal gas retention in humans:impaired propulsion versus obstructed evacuation.","volume":"281","author":"Serra","year":"2001","journal-title":"Am J Physiol"},{"key":"R15-9-20210219","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1053\/gast.2002.35394","article-title":"Lipid-induced intestinal gas retention in the irritable bowel syndrome.","volume":"123","author":"Serra","year":"2002","journal-title":"Gastroenterology"},{"key":"R17-9-20210219","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1038\/ajg.2013.386","article-title":"Differential effects of FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) on small and large intestinal contents in healthy subjects shown by MRI.","volume":"109","author":"Murray","year":"2014","journal-title":"Am J Gastroenterol"},{"key":"R18-9-20210219","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/S0140-6736(03)12489-0","article-title":"Gut flora in health and disease.","volume":"361","author":"Guarner","year":"2003","journal-title":"Lancet"},{"key":"R19-9-20210219","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/nmo.12498","article-title":"Intestinal gas homeostasis: disposal pathways.","volume":"27","author":"Mego","year":"2015","journal-title":"Neurogastroenterol Motil"},{"key":"R20-9-20210219","first-page":"82","article-title":"Invited review article: a review of gastrointestinal physiology and the mechanisms underlying the health benefits of dietary fiber: matching an effective fiber with specific patients needs.","volume":"1","author":"Mc Rorie","year":"2017","journal-title":"Clin Nurs Stud"},{"key":"R21-9-20210219","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.amjmed.2003.12.018","article-title":"Effect of physical activity on intestinal gas transit and evacuation in healthy subjects.","volume":"116","author":"Dainese","year":"2004","journal-title":"Am J Med"},{"key":"R23-9-20210219","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/gutjnl-2012-303013","article-title":"Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet.","volume":"63","author":"Manichanh","year":"2014","journal-title":"Gut"},{"key":"R24-9-20210219","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1111\/nmo.12324","article-title":"Effect of a low-flatulogenic diet in patients with flatulence and functional digestive symptoms.","volume":"26","author":"Azpiroz","year":"2014","journal-title":"Neurogastroenterol Motil"},{"key":"R25-9-20210219","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1111\/nmo.12662","article-title":"Accumulative effect of food residues on intestinal gas production.","volume":"27","author":"Mego","year":"2015","journal-title":"Neurogastroenterol Motil"},{"key":"R26-9-20210219","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1111\/nmo.12782","article-title":"Colonic content in health and its relation to functional gut symptoms.","volume":"28","author":"Bendezu","year":"2016","journal-title":"Neurogastroenterol Motil"},{"key":"R27-9-20210219","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1038\/ajg.2009.251","article-title":"Bloating and distension in irritable bowel syndrome: the role of gastrointestinal transit.","volume":"104","author":"Agrawal","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"R28-9-20210219","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/nmo.12243","article-title":"Fasting and postprandial volumes of the undisturbed colon: normal values and changes in diarrhea-predominant irritable bowel syndrome measured using serial MRI.","volume":"26","author":"Pritchard","year":"2014","journal-title":"Neurogastroenterol Motil"},{"key":"R29-9-20210219","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1136\/gutjnl-2012-302167","article-title":"Intestinal microbiota in functional bowel disorders: a Rome foundation report.","volume":"62","author":"Simren","year":"2013","journal-title":"Gut"},{"key":"R30-9-20210219","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1111\/j.1440-1746.2010.06370.x","article-title":"Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome.","volume":"25","author":"Ong","year":"2010","journal-title":"J Gastroenterol Hepatol"},{"key":"R32-9-20210219","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1111\/j.1572-0241.2007.01071.x","article-title":"Gas distribution within the human gut: effect of meals.","volume":"102","author":"Perez","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"R33-9-20210219","doi-asserted-by":"crossref","first-page":"e389","DOI":"10.1111\/nmo.12128","article-title":"Mechanisms of abdominal distension in severe intestinal dysmotility: abdomino-thoracic response to gut retention.","volume":"25","author":"Barba","year":"2013","journal-title":"Neurogastroenterol Motil"},{"key":"R34-9-20210219","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1053\/j.gastro.2008.02.096","article-title":"Bloating and distention in irritable bowel syndrome: the role of visceral sensation.","volume":"134","author":"Agrawal","year":"2008","journal-title":"Gastroenterology"},{"key":"R35-9-20210219","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/j.1469-7793.1998.579bw.x","article-title":"Modulation of gut perception in humans by spatial summation phenomena.","volume":"506","author":"Serra","year":"1998","journal-title":"J Physiol"},{"key":"R36-9-20210219","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1038\/ajg.2010.75","article-title":"Colonic responses to gas loads in subgroups of patients with abdominal bloating.","volume":"105","author":"Hernando-Harder","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"R37-9-20210219","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1136\/gut.51.5.701","article-title":"Visceral sensation and emotion: a study using hypnosis.","volume":"51","author":"Houghton","year":"2002","journal-title":"Gut"},{"key":"R38-9-20210219","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1053\/j.gastro.2004.08.057","article-title":"Effect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome.","volume":"127","author":"Murray","year":"2004","journal-title":"Gastroenterology"},{"key":"R39-9-20210219","first-page":"2209","article-title":"Impaired parasympathetic function increases susceptibility to inflammatory bowel disease in a mouse model of depression.","volume":"118","author":"Ghia","year":"2008","journal-title":"J Clin Invest"},{"key":"R40-9-20210219","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/apt.13738","article-title":"Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study.","volume":"44","author":"Koloski","year":"2016","journal-title":"Aliment Pharmacol Ther"},{"key":"R41-9-20210219","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1038\/nature05482","article-title":"Mechanisms linking obesity to insulin resistance and type 2 diabetes.","volume":"444","author":"Kahn","year":"2006","journal-title":"Nature"},{"key":"R42-9-20210219","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1053\/gast.1997.v113.pm9247458","article-title":"Attention and distraction: effects on gut perception.","volume":"113","author":"Accarino","year":"1997","journal-title":"Gastroenterology"},{"key":"R43-9-20210219","doi-asserted-by":"crossref","first-page":"3341","DOI":"10.1111\/j.1572-0241.2001.05336.x","article-title":"Sensation of bloating and visible abdominal distension in patients with irritable bowel syndrome.","volume":"96","author":"Chang","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"R44-9-20210219","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/00001610-200601000-00002","article-title":"Increased symptoms in female IBS patients with dysmenorrhea and PMS.","volume":"29","author":"Altman","year":"2006","journal-title":"Gastroenterol Nurs"},{"key":"R45-9-20210219","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1136\/gut.50.4.471","article-title":"The menstrual cycle affects rectal sensitivity in patients with irritable bowel syndrome but not healthy volunteers.","volume":"50","author":"Houghton","year":"2002","journal-title":"Gut"},{"key":"R46-9-20210219","first-page":"241","article-title":"Abdominal distension in irritable bowel syndrome: the patients perception.","volume":"4","author":"Maxton","year":"1992","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R47-9-20210219","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/jgh.13177","article-title":"Selective CCK receptor antagonism enhances accommodation and tolerance of intestinal gas in functional gut disorders.","volume":"31","author":"Lobo","year":"2015","journal-title":"J Gastroenterol Hepatol"},{"key":"R48-9-20210219","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1038\/ajg.2010.54","article-title":"Prolonged balloon expulsion is predictive of abdominal distension in bloating.","volume":"105","author":"Shim","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"R49-9-20210219","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1053\/j.gastro.2016.07.036","article-title":"Circadian rhythms in gastrointestinal health and diseases.","volume":"151","author":"Bishehsari","year":"2016","journal-title":"Gastroenterology"},{"key":"R50-9-20210219","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1136\/gut.48.2.216","article-title":"Ambulatory abdominal inductance plethysmography: towards objective assessment of abdominal distension in irritable bowel syndrome.","volume":"48","author":"Lewis","year":"2001","journal-title":"Gut"},{"key":"R51-9-20210219","doi-asserted-by":"crossref","first-page":"2807","DOI":"10.1111\/j.1572-0241.2008.02141.x","article-title":"Abdominal accommodation: a coordinated adaptation of the abdominal walls to its content.","volume":"103","author":"Villoria","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"R52-9-20210219","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1038\/ajg.2010.408","article-title":"Abdomino-phrenic dyssynergia in patients with abdominal bloating and distension.","volume":"106","author":"Villoria","year":"2011","journal-title":"Am J Gastroenterol"},{"key":"R53-9-20210219","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1053\/j.gastro.2009.01.067","article-title":"Abdominal distension results from caudo-ventral redistribution of contents.","volume":"136","author":"Accarino","year":"2009","journal-title":"Gastroenterology"},{"key":"R54-9-20210219","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1053\/j.gastro.2014.12.006","article-title":"Abdomino-thoracic mechanisms of functional abdominal distension and correction by biofeedback.","volume":"148","author":"Barba","year":"2015","journal-title":"Gastroenterology"},{"key":"R55-9-20210219","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1053\/j.gastro.2005.12.036","article-title":"Impaired viscerosomatic reflexes and abdominal wall dystony associated with bloating.","volume":"130","author":"Tremolaterra","year":"2006","journal-title":"Gastroenterology"},{"key":"R56-9-20210219","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1136\/gutjnl-2013-304574","article-title":"Mechanisms of postprandial abdominal bloating and distension in functional dyspepsia.","volume":"63","author":"Burri","year":"2014","journal-title":"Gut"},{"key":"R57-9-20210219","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1136\/gut.43.3.388","article-title":"Subtypes of constipation predominant irritable bowel syndrome based on rectal perception.","volume":"43","author":"Harraf","year":"1998","journal-title":"Gut"},{"key":"R58-9-20210219","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/apt.12006","article-title":"Is the subjective perception of lactose intolerance influenced by the psychological profile?","volume":"36","author":"Tomba","year":"2012","journal-title":"Aliment Pharmacol Ther"},{"key":"R59-9-20210219","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.cgh.2008.02.058","article-title":"Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence.","volume":"6","author":"Shepherd","year":"2008","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R60-9-20210219","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.gastro.2013.09.046","article-title":"A diet low in FODMAPs reduces symptoms of irritable bowel syndrome.","volume":"146","author":"Halmos","year":"2014","journal-title":"Gastroenterology"},{"key":"R61-9-20210219","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1172\/JCI115716","article-title":"Factors affecting hydrogen production and consumption by human fecal flora. The critical roles of hydrogen tension and methanogenesis.","volume":"89","author":"Strocchi","year":"1992","journal-title":"J Clin Invest"},{"key":"R62-9-20210219","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1056\/NEJMoa1004409","article-title":"Rifaximin therapy for patients with irritable bowel syndrome without constipation.","volume":"364","author":"Pimentel","year":"2011","journal-title":"N Engl J Med"},{"key":"R63-9-20210219","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1111\/j.1572-0241.2006.00734.x","article-title":"Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.","volume":"101","author":"Whorwell","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"R64-9-20210219","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1365-2036.2008.03853.x","article-title":"Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation.","volume":"29","author":"Agrawal","year":"2009","journal-title":"Aliment Pharmacol Ther"},{"key":"R66-9-20210219","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1111\/j.1572-0241.2002.05976.x","article-title":"Gastric distension and duodenal lipid infusion modulate intestinal gas transit and tolerance in humans.","volume":"97","author":"Serra","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"R67-9-20210219","first-page":"G89","article-title":"Reflex control of intestinal gas dynamics and tolerance in humans.","volume":"286","author":"Harder","year":"2004","journal-title":"Am J Physiol"},{"key":"R68-9-20210219","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1111\/j.1365-2982.2006.00809.x","article-title":"Intestinal tone and gas motion.","volume":"18","author":"Tremolaterra","year":"2006","journal-title":"Neurogastroenterol Mot"},{"key":"R69-9-20210219","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1053\/gast.2002.33658","article-title":"Prokinetic effects in patients with intestinal gas retention.","volume":"122","author":"Caldarella","year":"2002","journal-title":"Gastroenterology"},{"key":"R70-9-20210219","doi-asserted-by":"crossref","first-page":"2036","DOI":"10.1111\/j.1572-0241.2008.01866.x","article-title":"Intestinal gas and bloating: effect of prokinetic stimulation.","volume":"103","author":"Accarino","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"R71-9-20210219","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/nmo.12217","article-title":"Effect of prucalopride on symptoms of chronic constipation.","volume":"26","author":"Tack","year":"2014","journal-title":"Neurogastroenterol Motil"},{"key":"R72-9-20210219","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1023\/A:1005488705869","article-title":"Improved screening for intestinal villous atrophy by D-xylose breath test.","volume":"45","author":"Casellas","year":"2000","journal-title":"Dig Dis Sci"},{"key":"R73-9-20210219","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.cgh.2013.09.022","article-title":"Effect of linaclotide on severe abdominal symptoms in patients with irritable bowel syndrome with constipation.","volume":"12","author":"Rao","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R74-9-20210219","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/j.1365-2982.2009.01385.x","article-title":"Guanylate cyclase C-mediated antinociceptive effects of linaclotide in rodent models of visceral pain.","volume":"22","author":"Eutamene","year":"2010","journal-title":"Neurogastroenterol Motil"},{"key":"R75-9-20210219","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1136\/gut.2005.077503","article-title":"A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome.","volume":"55","author":"Tack","year":"2006","journal-title":"Gut"},{"key":"R76-9-20210219","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.pnpbp.2008.10.018","article-title":"Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis.","volume":"33","author":"Rahimi","year":"2009","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"}],"container-title":["American Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00000434-201708000-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:16:28Z","timestamp":1786547788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00000434-201708000-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":71,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1038\/ajg.2017.129","relation":{},"ISSN":["0002-9270"],"issn-type":[{"value":"0002-9270","type":"print"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}