Development and validation of a novel scoring system for bloating and distension: The Mayo Bloating Questionnaire

Neurogastroenterol Motil. 2022 Aug;34(8):e14330. doi: 10.1111/nmo.14330. Epub 2022 Feb 24.


Background: Abdominal bloating and distension are prevalent gastrointestinal symptoms. Our aim was to design and validate a questionnaire to reliably measure the multiple symptom components of bloating and distension in the outpatient setting.

Methods: A 45-item questionnaire was developed after an extensive literature review. Face and content validity were established through expert review and a focus group. Validation was achieved by administering an identical questionnaire 1 week apart. Data were assessed using standard methods.

Key results: Forty one patients returned both questionnaires (85% women; mean age = 44 years). Respondents reported a variety of diagnoses, including irritable bowel syndrome (63%), gastroesophageal reflux disease (54%), functional dyspepsia (27%), small intestinal bacterial overgrowth (22%), and gastroparesis (17%). Test-retest reliability revealed excellent agreement (k ≥ 0.81) and substantial agreement (0.61 ≤ k < 0.81) for 29% and 43% of categorical questions, respectively. Alternate-parallel form reliability was supported by association between responses for questions that evaluated missing school/work and questions that evaluated symptom impact on daily activities (p < 0.05). Patients who missed school/work due to bloating symptoms were more likely to report a severe impact on their ability to enjoy life (p < 0.05) and their overall well-being (p < 0.01). Contingency analyses revealed an association between overall 7-day symptom severity and impact on daily activities (p < 0.001), enjoying life (p < 0.001), and overall well-being (p < 0.001).

Conclusions and inferences: This novel questionnaire demonstrated good validity and reliability in patients with symptoms of bloating and distension. The questionnaire was easy to use and score, making it a potentially useful tool for both research studies and clinical purposes.

Keywords: abdominal bloating; distension; irritable bowel syndrome; quality of life; questionnaire.

MeSH terms

  • Adult
  • Dilatation, Pathologic
  • Dyspepsia* / diagnosis
  • Female
  • Flatulence
  • Gastrointestinal Diseases*
  • Humans
  • Irritable Bowel Syndrome*
  • Male
  • Reproducibility of Results
  • Surveys and Questionnaires