Flatulence: symptoms, causes and treatment of flatulence

Flatulence is a condition in which bloating is observed. With this complaint, doctors of various specialties may encounter.

This condition can be clinically manifested in different ways. In addition, it leaves an imprint on the ongoing instrumental research, sharply limiting their value.

However, in order to solve this problem, the doctor must know the reason for its development and mechanism. Only in this case it will be possible to purposely eliminate the effect of the causal factor.

The causes of meteorism

The basis for the development of flatulence is the imbalance of the process of formation of intestinal gases and their removal, which is realized by means of evacuation and absorption.

Violation of this process is very often observed in patients with gastroenterological profile, and can also occasionally occur in completely healthy people, while delivering them enormous discomfort. Normally, intestinal gases are represented by foam, which is covered with mucus, which facilitates the process of their transportation and further removal from the intestine. With meteorism, this process is significantly impaired.

The physiological causes that lead to increased intake of gastrointestinal gases and are the basis of flatulence are:

• conversation during a meal;
  
• reading and watching TV at this time followed by a discussion;
  
• fast food intake;
  
• frequent drinking;
  
• frequent swallowing of saliva.

The main gastroenterological diseases that lead to flatulence are:

• gastritis;
  
• pancreatitis;
  
• cholecystitis;
  
• enteritis
  
• colitis and others.

Given the various causes that lead to flatulence, it is proposed to classify it into the following types:

1. 1) Alimentary - when consuming products that split only in the large intestine
   
2. 2) Dysbiotic - is associated with a violation of the qualitative and quantitative composition of the microflora of the large intestine( oftenarises against the background of uncontrolled intake of antibiotics, glucocorticoids, as well as a decrease in the acidity of gastric juice)
   
3. 3) Digestive, due to enzyme deficiency at the level of thin
   
4. intestine 4) Mechanical - occurs as a result of impaired gas flow through the intestines against the background of internal or external intrusion
   
5. 5) Circulatory, developing against a background of venous stasis associated with portal hypertension, circulatory insufficiency, and also due to lymphostasis( Whipple's disease)
   
6. 6) Dynamic, based on functional impairment of intestinal peristalsis
   
7. 7) Altitudinal - develops as a result of ascent to altitude when atmospheric pressure decreases
   
8. 8) Psychogenic.

Symptoms of flatulence

Typically, flatulence manifests itself as a characteristic symptom that is familiar to every person who has had excessive gas formation. So, for meteorism, there are such signs in adults and children:

• abdominal enlargement in volume;
  
• rumbling;
  
• the emission of gases that have an unpleasant odor;
  
• pain cramp character;
  
• mental disorders and discomfort arising on this background.

Diagnosis

Diagnostic search for flatulence includes the following studies:

• coprogram - a study of stool for the presence of undigested food residues and their nature;
  
• determination of enzyme activity in duodenal contents;
  
• ultrasound examination of liver function;
  
• biochemical study of triglyceride levels;
  
• bacteriological study of feces, including the definition of lactoflora.

With the help of these methods it is possible to establish the true cause of meteorism, as well as to determine the nature of the therapeutic actions carried out. Especially it concerns the restoration of the intestinal microflora and replacement of the enzymatic function of the pancreas, if necessary.

Treatment of flatulence

Treatment of meteorism is complex. It should be aimed at the following objectives:

• the organization of dietary nutrition, the nature of which depends on the specific type of dyspeptic disorder;
  
• treatment of the background pathological process;
  
• pharmacological correction of disorders of exocrine function;
  
• restoration of the qualitative and quantitative composition of the microbial flora of the large intestine;
  
• normalization of gastrointestinal motility;
  
• removal of excess gaseous substances from the intestine.

The main principles of proper nutrition with flatulence are:

1. 1) Exclusion of milk and dairy products, if there is lactase deficiency.
   
2. 2) If the meteorism is fermenting, then it is necessary to exclude products containing coarse plant fibers, as well as legumes and beverages such as kvass, beer and juices. In such a situation, it is recommended to increase foods high in protein( meat, cottage cheese, fish) in the diet.
   
3. 3) If flatulence is putrefactive, then on the contrary, protein products should be removed from the diet. Such patients are recommended to consume carbohydrate products( cereals, bread), boiled vegetables and apples.

Before the appointment of enzyme treatment for meteorism, it is necessary to examine the stool for undigested food residues. This will allow us to assess the insufficiency of which enzyme is present. Depending on the type of enzyme deficiency the doctor will select the necessary drug.

Struggle with an increased amount of gas in the intestine can be carried out by pharmacological preparations from two main groups:

• adsorbents( enterosorbents).
  
• defoamers.

Enterosorbents have a unique composition, which allows them to sorb on their surface gaseous substances. This is the most extensive group of pharmacological drugs, which allows you to cope with flatulence. It is represented by the following medicines:

1. 1) Activated charcoal - is given twice or thrice a day for 10-14 tablets, depending on the weight of the patient.
   
2. 2) Microbes are a paste-like preparation.
   
3. 3) Ваулен possesses high adsorptive ability, as it consists of the smallest pores.
   
4. 4) Polypheps are prescribed on a tablespoon three times a day for half an hour before meals.
   
5. 5) Smecta is a modern sorbent based on aluminum and magnesium silicate. Assign one packet three times a day, previously dissolving it in half a glass of water at room temperature. One of its side effects is the strengthening of constipation. The drug has not only a high sorption ability, but also has a protective effect on the intestinal cells, increases their resistance, enhances the hemostatic effect, as it affects the coagulation factors.
   
6. 6) Cholestyramine is the drug of choice for those patients who have a disorder of fat metabolism. In the intestine, it forms complexes with bile acids, which are insoluble in water, and also excretes various toxins and gaseous substances well. It is prescribed three times a day, the single dosage ranges from 2 to 5 g.
   
7. 7) Entegnin, the active ingredient of which is lignin. Molecules with medium and low mass produce more efficiently than activated carbon. It is prescribed three times a day, a single dose - 2 tablets. In addition to the sorption effect, it has antioxidant and immunomodulating properties, as well as the ability to reduce the prothrombin index.

Defoamers are an insignificant group of drugs that include:

• espumizan;
  
• diflatil( can not be used for various obstructive diseases of the digestive system);
  
• is a meteorospasm consisting of alverine and simethicone.

How does Espumizan work? The drug reduces the surface tension, against the background of which the formation of gas bubbles is difficult and there is an increased destruction of those already formed.

The excretion of these tiny gas particles is carried out either by intestinal peristalsis or by absorption through the intestinal wall. Assign after eating each time, as well as before bedtime. A single dose is from 1 to 2 capsules.

Meteopazmil has a complex effect. On the one hand, it blocks the penetration of calcium ions into the smooth muscle cell, so it exhibits spasmolytic effects( spasmodic pains are often observed against the background of flatulence).On the other hand, it reduces the sensitivity of nerve endings to different stimuli, which is an additional factor that has an analgesic effect.

All these effects are realized by means of alverine. Due to simethicone, which is part of Meteopazmil, foaming of intestinal gases is prevented and the process of their excretion is accelerated. In addition, the drug has a beneficial effect on the motility of the gastrointestinal tract, normalizing the stool. Treatment of meteorism with folk remedies can supplement the basic therapy.

Prevention

Prophylaxis of flatulence should be based on the following principles:

• timely treatment of cause-related diseases;
  
• normalization of nutrition, taking into account the nature of possible dyspepsia;
  
• elimination of overeating;
  
• rational intake of food( silently, without frequent drinking and swallowing saliva, etc.).

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