{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T19:07:23Z","timestamp":1769800043586,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,8,11]],"date-time":"2019-08-11T00:00:00Z","timestamp":1565481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["SAF 2016\u201076648\u2010R"],"award-info":[{"award-number":["SAF 2016\u201076648\u2010R"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some patients complain that eating lettuce, gives them gas and abdominal distention. Our aim was to determine to what extent the patients' assertion is sustained by evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An in vitro study measured the amount of gas produced during the process of fermentation by a preparation of human colonic microbiota (n\u00a0=\u00a03) of predigested lettuce, as compared to beans, a high gas\u2010releasing substrate, to meat, a low gas\u2010releasing substrate, and to a nutrient\u2010free negative control. A clinical study in patients complaining of abdominal distention after eating lettuce (n\u00a0=\u00a012) measured the amount of intestinal gas and the morphometric configuration of the abdominal cavity in abdominal CT scans during an episode of lettuce\u2010induced distension as compared to basal conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Gas production by microbiota fermentation of lettuce in vitro was similar to that of meat (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.44), lower than that of beans (by 78\u00a0\u00b1\u00a015%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and higher than with the nutrient\u2010free control (by 25\u00a0\u00b1\u00a019%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.05). Patients complaining of abdominal distension after eating lettuce exhibited an increase in girth (35\u00a0\u00b1\u00a03\u00a0mm larger than basal; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) without significant increase in colonic gas content (39\u00a0\u00b1\u00a04\u00a0mL increase; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.071); abdominal distension was related to a descent of the diaphragm (by 7\u00a0\u00b1\u00a03\u00a0mm; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.027) with redistribution of normal abdominal contents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Inferences<\/jats:title><jats:p>Lettuce is a low gas\u2010releasing substrate for microbiota fermentation and lettuce\u2010induced abdominal distension is produced by an uncoordinated activity of the abdominal walls. Correction of the somatic response might be more effective than the current dietary restriction strategy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13703","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T05:13:58Z","timestamp":1565586838000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Abdominal distension after eating lettuce: The role of intestinal gas evaluated in vitro and by abdominal CT imaging"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5986-6592","authenticated-orcid":false,"given":"Elizabeth","family":"Barba","sequence":"first","affiliation":[{"name":"Digestive System Research Unit University Hospital Vall d'Hebron, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (Ciberehd) Barcelona Spain"},{"name":"Departament de Medicina Universitat Aut\u00f2noma de Barcelona Bellaterra 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