Gastrointestinal Gas and Abdominal Fat Quantity Measured by Three-Dimensional Abdominal Computed Tomography in Patients with Functional Bloating

Hong Sub Lee; Jai Keun Kim; Joo Sung Sun; Kwang Jae Lee

doi:10.4166/kjg.2018.71.6.324

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Lee, Kim, Sun, and Lee: Gastrointestinal Gas and Abdominal Fat Quantity Measured by Three-Dimensional Abdominal Computed Tomography in Patients with Functional Bloating

Original Article

Korean J Gastroenterol 2018;71(6):324-331.

Published online: 4 October 2018

DOI: https://doi.org/10.4166/kjg.2018.71.6.324

Gastrointestinal Gas and Abdominal Fat Quantity Measured by Three-Dimensional Abdominal Computed Tomography in Patients with Functional Bloating

Hong Sub Lee^1,², Jai Keun Kim³, Joo Sung Sun³, Kwang Jae Lee¹

¹Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea

²Department of Gastroenterology, Myongji Hospital, Goyang, Korea

³Department of Radiology, Ajou University School of Medicine, Suwon, Korea

Correspondence to: Kwang Jae Lee, Department of Gastroenterology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea. Tel: +82-31-219-5102, Fax: +82-31-219-5999, E-mail: kjleemd@hotmail.com

Received 11 December 2017 Revised 2 March 2018 Accepted 25 March 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

The aim of this study was to assess whether increased intestinal gas or fat content in the abdominal cavity is related to abdominal bloating, using three-dimensional abdominal computed tomography scan.

Methods

Twenty-nine healthy individuals without abdominal bloating and organic disease (15 women; mean age, 49 years; range of age, 23–73 years) and 30 patients with chronic recurrent abdominal bloating-diagnosed with functional bloating (10 women; mean age, 53 years; range of age, 35–75 years) – participated in this study. The mean values of measured parameters were compared using independent sample t-test.

Results

The mean volume of total colon gas in bloated patients was similar to that in control subjects. The distribution of intraabdominal gas was also similar between the two groups. However, the amount of gas in the transverse colon tended to be significantly higher in patients with bloating than in controls (p=0.06). Body mass index was similar between the two groups (23.4±3.2 kg/m² and 22.3±3.1 kg/m², respectively). Moreover, no significant differences with respect to circumferential area, subcutaneous fat, visceral fat area, and total fat area were found between the two groups.

Conclusions

Bloating might not just be the result of gastrointestinal gas or intraabdominal fat. Other contributing factors, such as localized abnormality in gas distribution and visceral hypersensitivity, may be involved.

Keywords: Abdominal fat, Gastrointestinal contents, Gas bloat syndrome, Multidetector computed tomography, Irritable bowel syndrome

References

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Fig. 1.

Subcutaneous fat and visceral fat amount measurement by image processing workstation software.

Fig. 2.

Intra-abdominal gas measurements by image processing workstation software.

Fig. 3.

Abdominal gas distribution. (A) The amount of gas in the transverse colon tended to be significantly higher in patients with bloating than in controls (p=0.051). (B) The tendency to have increased amount of gas in the transverse colon was noted in male (p=0.058). (C) Total amount of stomach and colon gas was similar with control in female. A-colon, ascending clolon; T-colon, transverse colon; D-colon, descending colon; RS-colon, rectosigmoid colon.

Fig. 4.

Maximal diameter of intestinal segment. (A) The mean maximal diameter of A colon, T colon, D colon and RS colon in the patients with bloating was similar as in control subjects. (B) There is no significant mean diameter difference between patients and control in female. (C) In male, mean diameter of intestine was higher in patients, significantly in the jejunum (2.1±0.6 vs. 1.7±0.6 mm³; p=0.001) and ileum (2.0±1.2 vs. 1.6±0.7 mm³; p=0.020). A-colon, ascending clolon; T-colon, transverse colon; D-colon, descending colon; RS-colon, rectosigmoid colon.

Table 1.

Comparison of Body Mass Index and Fat Contents between Patients with Bloating and Control Subjects

Variables	Bloating (n=29)	Controls (n=30)	p-value	Subgroup
Variables	Bloating (n=29)	Controls (n=30)	p-value	Male (n=20)	p-value	Female (n=10)	p-value
Body mass index (kg/m²)	23.4 (3.2)	22.3 (3.1)	0.175	24.0 (3.1)	0.364	22.1 (3.1)	0.652
Circumferential area (mm²)	509.5 (113.0)	482.3 (120.2)	0.373	536.8 (110.2)	0.632	454.9 (102.5)	0.894
Subcutaneous fat (mm)	20.5 (6.5)	19.8 (6.6)	0.684	19.3 (5.8)	0.450	22.8 (7.5)	0.682
Visceral fat area (mm²)	76.5 (38.1)	62.6 (32.8)	0.136	85.4 (40.1)	0.483	58.7 (27.2)	0.430
Total fat area (mm²)	158.3 (96.3)	129.6 (57.9)	0.173	72.2 (16.1)	0.617	167.0 (136.9)	0.220

Values are presented as mean (standard deviation).

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