Ballonnements : du diagnostic à la prise en charge.

Bloating is a feeling of abdominal fullness and discomfort; abdominal distension is increasing in abdominal girth. Abdominal bloating is among the most commonly reported and bothersome gastrointestinal symptoms and could be associated with many disorders such as irritable bowel syndrome. According to the Rome IV criteria, the prevalence of functional bloating is 3.5 % (after exclusion of other disorders of the gut-brain interaction) but is much higher when associated with irritable bowel syndrome (up to 80%). The pathophysiology of functional bloating is multifactorial and includes among others constipation, pelvic floor dysfunction, visceral hypersensitivity, abdomino-phrenic dyssynergia, and carbohydrates intolerance. The treatments target the main mechanisms and include diet, medication and biofeedback. Transit disorders can be treated respectively by secretagogues and rifaximin but are not available in France. Biofeedback is useful in case of pelvic floor dysfunction and abdomino-phrenic dyssynergia. Low FODMAP diet is useful in patients with food-related bloating and distension but need to be proposed in selected patients. Neuromodulators help to decrease the sensation of bloating and the viscero-somatic reflex associated with abdominal distension. Both of them are available in France. Probiotics and antibiotics targeting small intestinal bacterial overgrowth cannot be recommended in this indication. [ABSTRACT FROM AUTHOR]