bloating, fullness, AND ABDOMINAL DISCOMFORT
Bloating, fullness, and abdominal discomfort are nonspecific symptoms that may be encountered in both organic and “functional” (e.g., irritable bowel syndrome, disorders characterized by deranged motility) digestive tract disorders.
These syndromes do not seem to occur as commonly in animals as they do in humans. Although in human medicine they have been presumed over the years to be associated with a central problem of increased gaseousness, it is now known that most of these patients' symptoms do not originate in excessive intestinal gas. Rather, the responsible mechanisms appear to involve disordered intestinal motility and a heightened pain response to intestinal distention. It is now thought that gas, even in small volumes, may trigger symptoms even though the total quantity of gas in the intestinal tract is not greater than in asymptomatic subjects. Patients with these problems may be symptomatic more often if they tend to be aerophagic as well.The symptom complex of bloating, fullness, and abdominal discomfort certainly is recognized to occur in dogs but can be difficult to detect unless the owner is an astute observer. Clinicians are cautioned to not overlook the possibility that patients with these vague symptoms have a significant disorder, not in terms of being life-threatening, because this is rarely the case, but rather in terms of causing significant discomfort.
Disorders that tend to cause these symptoms in dogs include gastric and/or intestinal motility derangement and inflammatory bowel disease. Diagnostic tests that should be considered include survey abdominal radiographs to examine for presence of excessive bowel gas (rarely positive), radiographic studies to evaluate intestinal motility (e.g., BIPS, nuclear scintigraphy), and both upper and lower GI endoscopy to obtain small and large bowel biopsy samples. Normal intestinal biopsy results support a diagnosis of dys- motility (irritable bowel syndrome), whereas abnormal biopsy results are generally consistent with some degree of inflammatory bowel disease.
Treatment is often based on biopsy results and clinical interpretation of the symptom complex exhibited by the patient. Dietary manipulation, including use of high-fiber diets for irritable bowel syndrome, and various types of pharmacologic management are usually employed. Inflammatory bowel disease is discussed in Chapter 7. Irritable bowel syndrome is discussed in Chapter 8.