{
  "abstract": "Introduction Excess visceral adiposity has been proposed as a potential mechanism for gastrointestinal bloating, particularly in patients with visible abdominal distension compared with those experiencing bloating without objective swelling (sensory bloating). Using MRI, we compared abdominal fat distribution between bloating subtypes and controls and explored whether extreme visceral adiposity phenotypes are over-represented in bloating.Methods Fifty-one age/sex-matched participants were included: visible bloating (n=23), sensory bloating (n=19), and controls (n=9). All underwent MRI enterography with axial T2-weighted imaging at L3. Abdominal fat segmentation (Entrolytics, Motilent) derived visceral (VAT), subcutaneous (SAT), and total adipose volumes; VAT/SAT ratio and adipose index (total adipose/height 2) were calculated. Groups were compared using ANOVA or Kruskal–Wallis tests as appropriate, with ANCOVA adjusting for BMI. VAT/SAT centile thresholds were derived from controls, with values >90th centile classified as disproportionately high visceral adiposity.Results VAT, SAT, VAT/SAT ratio, and adipose index showed substantial overlap with no significant group differences (VAT H=0.71, p=0.70; SAT H=3.13, p=0.21; VAT/SAT H=2.55, p=0.28; adipose index H=0.63, p=0.73). BMI correlated with VAT and SAT (r=0.59 and r=0.80; both p<0.001) and remained the only significant predictor of VAT after adjustment. However, 17/42 (40%) of patients with bloating had VAT/SAT ratios above the control 90th centile, compared with just one (11%) control participant, with no difference between the sensory vs visible bloating subgroupsConclusion While overall fat burden does not explain bloating at a group level, centile-based analysis identifies a subgroup of patients with disproportionately high visceral adiposity, suggesting a potential contributory mechanism in selected patients. Increased BMI was a good predictor of increased visceral adiposity, suggesting an important reversible cause for symptom persistence. Future studies are needed to reassess this prospectively and to investigate the impact of weight modification on bloating symptoms.Abstract O56 Figure 1",
  "authors": [
    {
      "affiliations": [
        "University College London, London, United Kingdom"
      ],
      "name": "Chloe Dennis"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Asma Fikree"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Natalia Zarate"
    },
    {
      "affiliations": [
        "Motilent, London, United Kingdom"
      ],
      "name": "Iyad Naim"
    },
    {
      "affiliations": [
        "University College London, London, United Kingdom"
      ],
      "name": "Sarah Ehisan Mohamed"
    },
    {
      "affiliations": [
        "University College London, London, United Kingdom"
      ],
      "name": "Yuija Gao"
    },
    {
      "affiliations": [
        "University College London, London, United Kingdom"
      ],
      "name": "Stuart Taylor"
    }
  ],
  "title": "O56 Bloating may be caused by disproportionate visceral fat deposition in a subgroup of patients – an MRI study",
  "uid": "bbaa2b23-d2e6-5eca-ae9a-4bb4d0af59a1"
}