Intestinal Gas

肠气
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    随着营养学研究的深入,膳食纤维(DF)在动物日粮中的重要性日益增加。DF由肠道微生物群发酵产生代谢产物,这对改善肠道健康很重要。本综述是使用体外和体内模型对DF在猪营养中的作用进行的系统综述。在体外模型中总结了DF的发酵特性及其代谢产物的代谢机制。并指出SCFA和气体是连接DF的重要代谢产物,肠道菌群,和肠道健康,它们在肠道健康中起着关键作用。同时,一些关于宿主-微生物相互作用的信息可以通过传统的动物体内模型得到改善,产生了对营养素最直接的反馈,证实了DF对母猪繁殖性能的有益作用,仔猪肠道健康,和种植猪肉的质量。最后,比较了不同发酵模式的优缺点。在未来的研究中,有必要灵活结合体内外发酵模型,深入研究DF对生物体的作用机理,以促进精准营养工具的发展,为DF在畜牧业中的深入、合理利用提供科学依据。要点:•综述了膳食纤维体外模型的发酵特性。•综述了代谢物的代谢途径及其在肠道中的作用。•综述了膳食纤维在猪不同阶段的作用。
    The importance of dietary fiber (DF) in animal diets is increasing with the advancement of nutritional research. DF is fermented by gut microbiota to produce metabolites, which are important in improving intestinal health. This review is a systematic review of DF in pig nutrition using in vitro and in vivo models. The fermentation characteristics of DF and the metabolic mechanisms of its metabolites were summarized in an in vitro model, and it was pointed out that SCFAs and gases are the important metabolites connecting DF, gut microbiota, and intestinal health, and they play a key role in intestinal health. At the same time, some information about host-microbe interactions could have been improved through traditional animal in vivo models, and the most direct feedback on nutrients was generated, confirming the beneficial effects of DF on sow reproductive performance, piglet intestinal health, and growing pork quality. Finally, the advantages and disadvantages of different fermentation models were compared. In future studies, it is necessary to flexibly combine in vivo and in vitro fermentation models to profoundly investigate the mechanism of DF on the organism in order to promote the development of precision nutrition tools and to provide a scientific basis for the in-depth and rational utilization of DF in animal husbandry. KEY POINTS: • The fermentation characteristics of dietary fiber in vitro models were reviewed. • Metabolic pathways of metabolites and their roles in the intestine were reviewed. • The role of dietary fiber in pigs at different stages was reviewed.
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  • 文章类型: Journal Article
    目的:腹胀导致腹肌协同失调(即,the肌收缩和腹壁松弛)患有肠-脑相互作用障碍的患者。本研究旨在验证一个简单的生物反馈程序,由腹胸壁运动引导,用于治疗腹胀.
    方法:在本随机分组中,平行,安慰剂对照试验,招募了42名连续患者(36名女性和6名男性;年龄17-64岁),这些患者均患有膳食引发的明显腹胀。通过自适应带使用电感体积描记术获得腹部和胸壁运动的记录。该信号显示给生物反馈组的患者,他们被教导动员隔膜。相比之下,安慰剂组的患者没有得到信号,给他们服用了安慰剂胶囊。在为期4周的干预期内进行了三次会议,指示进行锻炼(生物反馈组)或每天服用安慰剂3次(对照组)在家。通过对不良膳食的反应(腹胸电活动和周长的变化)和使用每日量表测量的临床症状持续7天,来评估结果。
    结果:生物反馈组(n=19)的患者学会了纠正由进餐引起的腹肌协同失调(肋间活动平均降低了82%±10%,前壁活动增加了97%±6%的平均±SE,周长的增加平均±SE减少了108%±4%),并且临床症状得到改善(腹胀评分降低了66%±5%的平均±SE)。在安慰剂组中未观察到这些效果(所有,P<.002)。
    结论:腹胸壁运动可作为一种有效的生物反馈信号,用于纠正肠-脑相互作用障碍患者的腹肌协同失调和腹胀。ClincialTrials.gov,编号:NCT04043208。
    OBJECTIVE: Abdominal distention results from abdominophrenic dyssynergia (ie, diaphragmatic contraction and abdominal wall relaxation) in patients with disorders of gut-brain interaction. This study aimed to validate a simple biofeedback procedure, guided by abdominothoracic wall motion, for treating abdominal distension.
    METHODS: In this randomized, parallel, placebo-controlled trial, 42 consecutive patients (36 women and 6 men; ages 17-64 years) with meal-triggered visible abdominal distension were recruited. Recordings of abdominal and thoracic wall motion were obtained using inductance plethysmography via adaptable belts. The signal was shown to patients in the biofeedback group, who were taught to mobilize the diaphragm. In contrast, the signal was not shown to the patients in the placebo group, who were given a placebo capsule. Three sessions were performed over a 4-week intervention period, with instructions to perform exercises (biofeedback group) or to take placebo 3 times per day (control group) at home. Outcomes were assessed through response to an offending meal (changes in abdominothoracic electromyographic activity and girth) and clinical symptoms measured using daily scales for 7 days.
    RESULTS: Patients in the biofeedback group (n = 19) learned to correct abdominophrenic dyssynergia triggered by the offending meal (intercostal activity decreased by a mean ± SE of 82% ± 10%, anterior wall activity increased by a mean ± SE of 97% ± 6%, and increase in girth was a mean ± SE of 108% ± 4% smaller) and experienced improved clinical symptoms (abdominal distension scores decreased by a mean ± SE of 66% ± 5%). These effects were not observed in the placebo group (all, P < .002).
    CONCLUSIONS: Abdominothoracic wall movements serve as an effective biofeedback signal for correcting abdominophrenic dyssynergia and abdominal distention in patients with disorders of gut-brain interaction. ClincialTrials.gov, Number: NCT04043208.
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  • 文章类型: Journal Article
    结肠内容物的分析是胃肠病学家的宝贵工具,在临床常规中具有多种应用。当考虑磁共振成像(MRI)模式时,T2加权图像能够分割结肠腔,而粪便和气体含量只能在T1加权图像中区分。在本文中,我们提出了一个端到端准自动框架,该框架包括在T2和T1图像中准确分割结肠以及提取结肠内容和形态数据以提供结肠内容和形态数据的量化所需的所有步骤.因此,医生对饮食的影响和腹胀的机制有了新的见解。
    The analysis of colonic contents is a valuable tool for the gastroenterologist and has multiple applications in clinical routine. When considering magnetic resonance imaging (MRI) modalities, T2 weighted images are capable of segmenting the colonic lumen, whereas fecal and gas contents can only be distinguished in T1 weighted images. In this paper, we present an end-to-end quasi-automatic framework that comprises all the steps needed to accurately segment the colon in T2 and T1 images and to extract colonic content and morphology data to provide the quantification of colonic content and morphology data. As a consequence, physicians have gained new insights into the effects of diets and the mechanisms of abdominal distension.
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  • 文章类型: Journal Article
    先前的研究表明,抗性糊精可溶性纤维具有益生元特性,对血糖管理和饱腹感具有相关的健康益处。我们的目的是证明持续施用抗性糊精对肠道气体产生的影响,消化的感觉,和肠道菌群代谢和组成。健康受试者(n=20)给予抗性糊精(14g/dNUTRIOSE®,RoquetteFrères,Lestrem,法国)四个星期。结果是以前测量过的,一开始,结束,给药后两周:白天肛门排空气体;消化感知,腰围,和响应标准膳食的气体产生;对舒适膳食的感觉和消化反应;磁共振结肠生物量的体积;通过鸟枪测序的粪便微生物群的分类学和代谢功能;尿液中的代谢组学。右旋糖酐给药产生了肠道气体产生和气体相关感觉的初始增加,随后下降,停药后放大了。糊精增加了结肠生物量的体积,随着产生短链脂肪酸的种类的增加以及胆汁酸和生物素代谢的调节,诱导微生物代谢和组成的变化。这些数据表明,可溶性纤维的消耗会诱导肠道微生物群对发酵途径的适应性反应,而气体产量较低。
    Previous studies have shown that a resistant dextrin soluble fibre has prebiotic properties with related health benefits on blood glucose management and satiety. Our aim was to demonstrate the effects of continuous administration of resistant dextrin on intestinal gas production, digestive sensations, and gut microbiota metabolism and composition. Healthy subjects (n = 20) were given resistant dextrin (14 g/d NUTRIOSE®, Roquette Frères, Lestrem, France) for four weeks. Outcomes were measured before, at the beginning, end, and two weeks after administration: anal evacuations of gas during daytime; digestive perception, girth, and gas production in response to a standard meal; sensory and digestive responses to a comfort meal; volume of colonic biomass by magnetic resonance; taxonomy and metabolic functions of fecal microbiota by shotgun sequencing; metabolomics in urine. Dextrin administration produced an initial increase in intestinal gas production and gas-related sensations, followed by a subsequent decrease, which magnified after discontinuation. Dextrin enlarged the volume of colonic biomass, inducing changes in microbial metabolism and composition with an increase in short chain fatty acids-producing species and modulation of bile acids and biotin metabolism. These data indicate that consumption of a soluble fibre induces an adaptative response of gut microbiota towards fermentative pathways with lower gas production.
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  • 文章类型: Journal Article
    Our aim was to determine the reliability of plain abdominal radiographs for the evaluation of abdominal gas content in patients with functional digestive symptoms.
    Abdominal CT scan scout views, mimicking a conventional plain abdominal radiograph, were obtained from 30 patients both during episodes of abdominal distension and basal conditions. Physicians (n = 50) were instructed to rate the estimated volume of gas in the 60 images presented in random sequence using a scale graded from 0 to ≥600 ml.
    The gas volumes estimated in the scout views differed from those measured by CT by a median of 90 (95% CI 70-102) ml, and the misestimation was not related to the absolute volume in the image. The accuracy of the observers, measured by their mean misestimation, was not related to their specialty or the training status (misestimation by 96 (95% CI 85-104) ml in staff vs 78 (70-106) ml in residents; p = 0.297). The accuracy was independent of the order of presentation of the images. Gas volume measured by CT in the images obtained during episodes of abdominal distension differed by a median of 39 (95% CI 29-66) ml from those during basal conditions, and this difference was misestimated by a median of 107 (95% CI 94-119) ml. The accuracy of these estimations was not related to the absolute gas volumes (R = -0.352; p < 0.001) or the magnitude of the differences.
    Plain abdominal radiographs have limited value for the evaluation of abdominal gas volume in patients with functional gut disorders.
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  • 文章类型: Journal Article
    背景:可见的腹胀归因于:(A)扭曲的感知,(B)肠道气体积聚,或(C)腹肌协同失调(diaphragm肌推动和前壁松弛)。
    方法:分析了先前研究(n=139)中连续出现功能性肠道疾病和可见腹胀的患者。患者(61例功能性腹胀,对74例便秘型肠易激综合征和4例交替排便习惯)进行了两次评估,在基础条件下和自我报告的可见腹胀发作期间;104例患者的静态腹部CT图像,76例腹壁动态肌电图记录,35例膈肌活动可用于分析。
    结果:(A)通过卷尺测量获得了腹胀的客观证据(139例患者中有138例患者的周长增加),通过CT成像(104例患者中有96例腹部周长增加)和腹部肌电图(活动减少,即,放松,76例患者中的73例)。(B)在99例患者中,肠道气体量在基础值的±300ml范围内,在5名患者中,尽管如此,他还是表现出了膈肌下降。(C)通过EMG(活动增加)在35例患者中的34例和通过CT(膈下降)在103例患者中的82例中检测到膈肌收缩。
    结论:在大多数抱怨可见腹胀发作的患者中:(A)主观主张由客观证据证实;(B)肠道气体的增加不能证明可见腹胀是合理的;(C)动态肌电图记录一致证明了腹肌协同失调,但静态CT成像灵敏度较低。
    Visible abdominal distension has been attributed to: (A) distorted perception, (B) intestinal gas accumulation, or (C) abdominophrenic dyssynergia (diaphragmatic push and anterior wall relaxation).
    A pool of consecutive patients with functional gut disorders and visible abdominal distension included in previous studies (n = 139) was analyzed. Patients (61 functional bloating, 74 constipation-predominant irritable bowel syndrome and 4 with alternating bowel habit) were evaluated twice, under basal conditions and during a self-reported episode of visible abdominal distension; static abdominal CT images were taken in 104 patients, and dynamic EMG recordings of the abdominal walls in 76, with diaphragmatic activity valid for analysis in 35.
    (A) Objective evidence of abdominal distension was obtained by tape measure (increase in girth in 138 of 139 patients), by CT imaging (increased abdominal perimeter in 96 of 104 patients) and by abdominal EMG (reduced activity, i.e., relaxation, in 73 of 76 patients). (B) Intestinal gas volume was within ±300 ml from the basal value in 99 patients, and above in 5 patients, who nevertheless exhibited a diaphragmatic descent. (C) Diaphragmatic contraction was detected in 34 of 35 patients by EMG (increased activity) and in 82 of 103 patients by CT (diaphragmatic descent).
    In most patients complaining of episodes of visible abdominal distention: (A) the subjective claim is substantiated by objective evidence; (B) an increase in intestinal gas does not justify visible abdominal distention; (C) abdominophrenic dyssynergia is consistently evidenced by dynamic EMG recording, but static CT imaging has less sensitivity.
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  • 文章类型: Journal Article
    肠道刺激之间的相互作用可能会导致功能性胃肠病患者的症状重叠。目的是确定结肠内容物增加对便秘型肠易激综合征(IBS-C)和消化不良症状重叠患者的胃感觉/运动反应和饱腹感的影响。和一群健康的受试者。
    在15例IBS-C患者和10例健康受试者中,真实与假结肠充气(1080毫升)对胃敏感性的影响(通过胃的逐步扩张来测量),胃顺应性,腹部感知,并在不同的日子研究了营养饮料的耐受性。
    在健康的受试者中,结肠充气引起胃对扩张的敏感性增加(前平均评分2.0±0.2,和后3.0±0.4;p=0.038)。在IBS中,结肠充气后的基础敏感性更高,并且保持不变(评分分别为4.0±0.1和3.8±0.3;p<0.001vs.健康基础)。IBS-C(评分2.6±0.1)的结肠气体输注引起的腹部症状明显高于健康(评分1.7±0.4;p=0.027),随着胃张力的微小变化,两组的胃顺应性均无变化。结肠填充导致IBS的营养饮料耐受性大大降低(791±87ml假填充,491±58毫升气体填充;p<0.001),但健康状况仅略有下降(940±70毫升假填充,860±94毫升气体填充;p=0.223)。
    结肠内容物的体积调节IBS-C患者的饱腹感,由于一般的内脏泛过敏。在选择这些患者的便秘治疗方法时应考虑这些影响。
    Interaction between gut stimuli may induce symptom overlap in patients with functional gastrointestinal disorders. The aim is to determine the effect of increased volumes of colonic contents on gastric sensory/motor responses and satiety in patients with constipation-predominant irritable bowel syndrome (IBS-C) and overlapping dyspeptic symptoms, and a cohort of healthy subjects.
    In 15 patients with IBS-C and 10 healthy subjects, the effect of real versus sham colonic filling with gas (1080 ml) on gastric sensitivity (measured by stepwise distensions of the stomach), gastric compliance, abdominal perception, and nutrient drink tolerance was studied on separate days.
    In healthy subjects, colonic gas filling induced an increment in gastric sensitivity to distension (mean score 2.0 ± 0.2 before, and 3.0 ± 0.4 after; p = 0.038). In IBS, basal sensitivity was greater and remained unchanged after colonic gas filling (score 4.0 ± 0.1 and 3.8 ± 0.3, respectively; p < 0.001 vs. basal in health). Colonic gas infusion induced abdominal symptoms that were significantly greater in IBS-C (score 2.6 ± 0.1) than in health (score 1.7 ± 0.4; p = 0.027), with minor changes in gastric tone, and no changes in gastric compliance in both groups. Colonic filling produced a profound reduction in nutrient drink tolerance in IBS (791 ± 87 ml sham filling, 491 ± 58 ml gas filling; p < 0.001) but only a minor reduction in health (940 ± 70 ml sham filling, 860 ± 94 ml gas filling; p = 0.223).
    The volume of the colonic contents modulates satiety in patients with IBS-C, due to a general visceral pan-hypersensitivity. These effects should be considered in the choice of treatment for constipation in these patients.
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  • 文章类型: Journal Article
    一项针对8例患者的随机交叉研究(6F,年龄57±13)与重叠GERD-IBS(非便秘)进行,以评估米粉与餐后TLESR早餐和午餐的小麦面条餐,肠道产气,和GERD/GI症状。结果:与大米相比,午餐后摄入小麦与更频繁的TLESR显着相关(5.0±0.7vs.1.9±0.3次/2小时,p=0.01)。午饭后,与水稻摄食相比,小麦摄食与较高的H2和CH4水平显着相关(p<0.05),而午餐前H2和CH4水平相似(p>0.05)。直到午餐后2小时的H2浓度曲线下面积与TLESR数显着相关(r=0.69,p=0.04)。餐后反流(2.9±1.2vs.0.4±0.2),腹胀(7.0±0.4与3.1±0.9),饱腹感(7.7±0.4vs.3.5±0.9),打气(3.8±1.2vs.与米粉摄入后相比,小麦摄入后1.1±0.6)症状评分明显更高(p<0.05)。结论:小麦面餐,高FODMAP饮食的一部分,诱导了更高的TLESR频率,更高的GERD,上消化道症状评分高于米粉,低FODMAP饮食的一部分,IBS-GERD重叠患者。这些影响与更多的肠道气体产生有关。因此,低FODMAP饮食可以缓解合并IBS的GERD患者的GERD症状.
    A randomized crossover study in eight patients (6 F, age 57 ± 13) with overlapping GERD-IBS (non-constipation) was conducted to evaluate the effects of rice noodle vs. wheat noodle meals for breakfast and lunch on postprandial TLESR, intestinal gas production, and GERD/GI symptoms. Results: Wheat ingestion was significantly associated with more frequent TLESR after lunch than rice (5.0 ± 0.7 vs. 1.9 ± 0.3 times/2 h, p = 0.01). After lunch, wheat ingestion was significantly associated with higher H2 and CH4 levels compared to rice ingestion (p < 0.05), while H2 and CH4 levels before lunch were similar (p > 0.05). The area under curve of H2 concentration until 2 h after lunch significantly correlated with the TLESR number (r = 0.69, p = 0.04). Postprandial regurgitation (2.9 ± 1.2 vs. 0.4 ± 0.2), bloating (7.0 ± 0.4 vs. 3.1 ± 0.9), satiety (7.7 ± 0.4 vs. 3.5 ± 0.9), and belching (3.8 ± 1.2 vs. 1.1 ± 0.6) symptom scores were significantly greater after wheat compared to rice noodle ingestion (p < 0.05). Conclusion: Wheat noodle meals, part of a high FODMAP diet, induced a higher frequency of TLESRs, a higher GERD, and higher upper-GI symptom scores than rice noodle meals, part of a low FODMAP diet, in patients with overlapping IBS-GERD. These effects were associated with more intestinal gas production. Thus, a low FODMAP diet may relieve GERD symptoms in GERD patients with overlapping IBS.
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  • 文章类型: Journal Article
    富含可发酵残留物的健康植物性饮食可能会诱发与气体有关的症状,可能是由肠道微生物群介导的。我们以前表明,食用含有动物双歧杆菌亚种的发酵乳制品(FMP)。乳酸CNCMI-2494和乳酸菌改善了胃肠道(GI)舒适度,以应对健康个体的肠胃性饮食挑战。为了研究FMP对这些参与者肠道微生物活性的影响,我们对粪便样本(n=262)进行了代谢组学分析,它们是在摄入习惯性饮食和两个为期3天的高残留挑战饮食期间收集的,在FMP消耗28天之前和之后。大多数FMP物种在消耗产品时被检测到或发现富集。FMP以几种方式减轻了气胀性饮食对气体相关症状的影响。首先,FMP消耗与产气细菌的消耗和氢向甲烷转化的增加有关。它还导致活动的上调,例如复制和与运动性和趋化性相关的功能的下调。此外,在FMP摄入时,代谢活动,如碳水化合物代谢,归因于动物芽孢杆菌和嗜热链球菌,丰富;这些活动被偶然发现与几种胃肠道症状呈负相关。最后,在FMP干预的应答者中发现了更紧密的微生物生态系统或微生物之间的相互关系。一起来看,这些发现表明,FMP的摄入通过与常驻肠道微生物群的积极相互作用,提高了对放气饮食的耐受性.
    Healthy plant-based diets rich in fermentable residues may induce gas-related symptoms, possibly mediated by the gut microbiota. We previously showed that consumption of a fermented milk product (FMP) containing Bifidobacterium animalis subsp. lactis CNCM I-2494 and lactic acid bacteria improved gastrointestinal (GI) comfort in response to a flatulogenic dietary challenge in healthy individuals. To study the effects of the FMP on gut microbiota activity from those participants, we conducted a metatranscriptomic analysis of fecal samples (n = 262), which were collected during the ingestion of a habitual diet and two series of a 3-day high-residue challenge diet, before and following 28-days of FMP consumption. Most of the FMP species were detected or found enriched upon consumption of the product. FMP mitigated the effect of a flatulogenic diet on gas-related symptoms in several ways. First, FMP consumption was associated with the depletion of gas-producing bacteria and increased hydrogen to methane conversion. It also led to the upregulation of activities such as replication and downregulation of functions related to motility and chemotaxis. Furthermore, upon FMP intake, metabolic activities such as carbohydrate metabolism, attributed to B. animalis and S. thermophilus, were enriched; these activities were coincidentally found to be negatively associated with several GI symptoms. Finally, a more connected microbial ecosystem or mutualistic relationship among microbes was found in responders to the FMP intervention. Taken together, these findings suggest that consumption of the FMP improved the tolerance of a flatulogenic diet through active interactions with the resident gut microbiota.
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