Abdomino-phrenic dyssynergia in patients with abdominal bloating and distension

Albert Villoria, Fernando Azpiroz, Emanuel Burri, Daniel Cisternas, Alfredo Soldevilla, Juan R. Malagelada

Research output: Contribution to journalArticleResearchpeer-review

41 Citations (Scopus)


Objectives: The abdomen normally accommodates intra-abdominal volume increments. Patients complaining of abdominal distension exhibit abnormal accommodation of colonic gas loads (defective contraction and excessive protrusion of the anterior wall). However, abdominal imaging demonstrated diaphragmatic descent during spontaneous episodes of bloating in patients with functional gut disorders. We aimed to establish the role of the diaphragm in abdominal distension.METHODS:In 20 patients complaining of abdominal bloating and 15 healthy subjects, we increased the volume of the abdominal cavity with a colonic gas load, while measuring abdominal girth and electromyographic activity of the anterior abdominal muscles and of the diaphragm.RESULTS:In healthy subjects, the colonic gas load increased girth, relaxed the diaphragm, and increased anterior wall tone. With the same gas load, patients developed significantly more abdominal distension; this was associated with paradoxical contraction of the diaphragm and relaxation of the internal oblique muscle. Conclusions: In this experimental provocation model, abnormal accommodation of the diaphragm is involved in abdominal distension. © 2011 by the American College of Gastroenterology.
Original languageEnglish
Pages (from-to)815-819
JournalAmerican Journal of Gastroenterology
Issue number5
Publication statusPublished - 1 Jan 2011


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