Volume 130, Issue 4, Pages 1062-1068 (April 2006) Impaired Viscerosomatic Reflexes and Abdominal-Wall Dystony Associated With Bloating  Fabrizio Tremolaterra, Albert Villoria, Fernando Azpiroz, Jordi Serra, Santiago Aguadé, Juan–R. Malagelada  Gastroenterology  Volume 130, Issue 4, Pages 1062-1068 (April 2006) DOI: 10.1053/j.gastro.2005.12.036 Copyright © 2006 American Gastroenterological Association Institute Terms and Conditions

Figure 1 Abdominal EMG recording. The EMG activities of various components of the abdominal wall were measured by means of bipolar surface electrodes at both sides of the abdomen. Gastroenterology 2006 130, 1062-1068DOI: (10.1053/j.gastro.2005.12.036) Copyright © 2006 American Gastroenterological Association Institute Terms and Conditions

Figure 2 Example of abdominal EMG activity. A voluntary abdominal contraction induced a marked increment in the activity of all muscular components of the abdominal wall. Gastroenterology 2006 130, 1062-1068DOI: (10.1053/j.gastro.2005.12.036) Copyright © 2006 American Gastroenterological Association Institute Terms and Conditions

Figure 3 Postural adaptation. The erect position increased the basal activity of the internal oblique to a similar level in patients and healthy controls. □, Patients; •, healthy controls; *, P < .05 vs supine. Gastroenterology 2006 130, 1062-1068DOI: (10.1053/j.gastro.2005.12.036) Copyright © 2006 American Gastroenterological Association Institute Terms and Conditions

Figure 4 Responses of abdominal muscles to standard intra-abdominal volume load. In healthy controls the volume load induced significant contraction of all abdominal muscles, except the internal oblique. Patients showed an abnormal adaptive response with impaired contraction of the lower rectus and external oblique, and paradoxic relaxation of the internal oblique. □, Patients; ■, healthy controls; *, P < .05 vs basal. Gastroenterology 2006 130, 1062-1068DOI: (10.1053/j.gastro.2005.12.036) Copyright © 2006 American Gastroenterological Association Institute Terms and Conditions

Figure 5 Relationship between relaxation of the internal oblique and abdominal distention in response to colonic gas load. Gastroenterology 2006 130, 1062-1068DOI: (10.1053/j.gastro.2005.12.036) Copyright © 2006 American Gastroenterological Association Institute Terms and Conditions