Bloating( flatulence) - Causes, symptoms and treatment. MF.

Bloating( synonyms: flatulence, whipping, tympania) is a condition in which the gastrointestinal tract accumulates excess gases, which may be a result of increased formation or inadequate excretion from the body.

A healthy person in the gastrointestinal tract contains a certain volume of gases, the nature and quantity of which depends on age, lifestyle, nutrition. Normally, in humans, more gas accumulates in the stomach and colon( mainly in the right and left bends).Significantly less of them are contained in the small intestine, sigmoid and colon.

Causes of bloating or meteorism

There are several ways of forming gases in the body:

- aerophagia - ingestion of air, mainly during eating of food, drinks;

- secretion of gases during digestion due to neutralization of gastric and pancreatic juices by bicarbonates;

- a small amount of intestinal gases comes from the blood;

- the formation of gases due to the vital activity of the intestinal microflora( during the cleavage of various nutrients( proteins, sugars) methane, hydrogen, carbon dioxide, hydrogen sulphide) is released.

Increased gas production in the absence of pathology can be observed in the following cases:

1. Swallowing large portions of air in the process of eating, drinking strong drinks, fast food( "on the run") - all this leads to excess intake of gases from food into the stomach,secretion of gastric and pancreatic juices, necessary for digestion. Food is not split up into proteins, fats, carbohydrates, large slags are formed, they are fermented and rotted in the intestines, instead of being digested, which leads to the production of excess gases and weighting of the flow of flatulence.

2. Excessive consumption of food, causing the formation of gases( beans, cabbage, apples).

3. Eating foods that enhance fermentation processes( black bread, kvass, beer, tea mushroom).

4. In people with lactose intolerance - the use of dairy products.

5. Meteorism in pregnant women due to compression of the intestine by a pregnant uterus: the food masses and nutrient absorption processes slow down.

Diseases accompanied by bloating

In diseases of the gastrointestinal tract, flatulence is most often combined with other symptoms: nausea, unpleasant taste in the mouth, diarrhea or constipation, anorexia, belching, abdominal pain without clear localization.

There are several causes of meteorism associated with pathological conditions of the digestive system:

1. Disturbance of digestive processes in enzymatic insufficiency, impaired absorption, pathology of formation and release of bile acids. In this case, a large portion of the food enters the undigested form into the intestine, where it is split by the intestinal microflora with the formation of a large number of gases.

2. Mechanical flatulence - in the presence of a mechanical obstacle in the gastrointestinal tract( stenosis, adhesions, tumors).

3. Dynamic flatulence occurs when the motor function of the gastrointestinal tract( peritonitis, severe infections and intoxications, infringement of the mesentery) is disturbed.

4. Inflammatory bowel or digestive system diseases( pancreatitis, colitis, Crohn's disease, etc.).

5. Non-inflammatory diseases of the intestines or organs of the digestive tract( dysbacteriosis, intolerance of nutrients( eg, lactulose and maltose, etc.), which are often found in childhood( flatulence in newborns and infants));

6. Circulatory flatulence can be associated with general or local circulatory disturbances( stagnant blood in the veins of the intestine reduces the absorption of gases from the intestine into the blood and increases their intake from the blood into the intestine, which is observed, for example, with cirrhosis of the liver).

7. Psychogenic( hysteria, frequent stressful situations): overexcitation of the nervous system can be accompanied by a spasm of smooth muscles of the intestine, therefore, leads to a slowing of peristalsis. The accumulating gases overstretch the gut and cause pain.

With various diseases of the gastrointestinal tract, flatulence is combined with different symptoms of these diseases. With cirrhosis of the liver of any etiology, in addition to jaundice of varying intensity, patients complain of a feeling of heaviness or pain in the right hypochondrium, nausea, bitterness in the mouth, belching, bloating, general weakness, decreased efficiency.

Chronic cholecystitis( calculous and tubeless) is accompanied by flatulence and eructation. If there is a violation of the diet there are complaints of dull aching pain or heaviness, discomfort in the right hypochondrium, epigastric region, sometimes under the right scapula, nausea, bloating.

Meteorism is an almost constant symptom for chronic intestinal pathology. Chronic enteritis is accompanied by a swelling of the abdomen, a sensation of its extension, pains in the peri-pooch area, which subsides with the appearance of a loud rumbling. Stool - 6 times a day, abundant, light yellow color, without any admixture of blood, mucus or pus.

Crohn's disease( terminal ileitis), in addition to pronounced flatulence, is characterized by constant pains in various places of the abdomen, diarrhea with the discharge of a semi-liquid stool with a small admixture of blood and mucus, swelling and rumbling in the stomach, and weight loss.

Flatulence often occurs with intestinal dysbacteriosis - patients complain of decreased appetite, unpleasant aftertaste and smell from the mouth, nausea, bloating, diarrhea, lethargy, general malaise. Often, the phenomena of flatulence can occur with severe symptoms from other organs and systems, while the high standing of the diaphragm and the psychogenic factors are important.

Diagnosis of the causes of bloating.

With spasm of the large intestine, the leakage of gases is disturbed and a significant increase in the abdomen, which is due to swelling of the intestine, comes to the fore. Patients complain of discomfort, raspiranie stomach, pain. Another manifestation of the disease can be a constant rapid separation of gases from the intestine, which significantly worsens the quality of life of the patient. At the same time, the pain syndrome is weak or absent, complaints of "rumbling", bursting and "transfusion" in the abdomen prevail. Extraintestinal symptoms may appear. For example, from the side of the cardiovascular system - violation of the heart rate, burning in the heart, decreased mood, sleep disturbance, general weakness, pain in the muscles.

When examining a patient, pay attention to:

• complaints that can indicate not only the flatulence itself, but also the disease that caused it: diarrhea in irritable bowel syndrome;abdominal pain, fever, joint pain, decreased appetite in Whipple's disease;weight loss, blood and mucus admixture in feces with Crohn's disease, etc.;

• examination - bloating, palpatory abdominal tenderness in the near-umbilical region, tympanic percussion sound, with auscultation( listening) - amplification, weakening or absence of intestinal noises.

Laboratory tests:

• general blood test - signs of iron deficiency anemia( decrease in hemoglobin, erythrocytes), moderately expressed leukocytosis are characteristic for inflammatory diseases of the digestive system;

• general urine analysis - without pathological changes;

• total protein and protein fractions - hypoalbuminemia( Whipple's disease, ulcerative colitis, etc.);

• blood sugar - within normal limits;

• coprogram - polyphecal, admixture of blood and mucus;

• analysis of feces for elastase-1 - to exclude pancreatic diarrhea;

• biochemical indicators of pancreatic function: enzyme alpha-amylase, enzyme lipase;

• repeated planting of feces for pathogenic microflora and examination of the egg worm( to eliminate infectious or parasitic nature);

• electrolytes of blood - electrolyte imbalance.

However, the main survey method is an overview of the radiography of the abdominal cavity( pneumatosis of the intestine, Clauber's bowl with intestinal obstruction, etc.).

Treatment for bloating

Treatment of bloating should take into account its cause.

Flatulence caused by swallowing large amounts of air requires a correction of the culture of eating, refusal of chewing gum, carbonated drinks.

If you frequently eat foods that cause excessive formation of gases( beans, cabbage, apples) or enhance fermentation processes( black bread, kvass, beer, tea mushroom), you should adjust the diet by reducing the amount of these products in it.

Foods that are not recommended for bloating : coffee, chocolate, milk, fat, tea, very cold food, too hot food, honey, seeds, nuts, yeast, oats, cabbage, omelette with cheese, beans, chewing gum, candy, meat( fried), carbonated drinks, apples, raisins, cocktails, cereals, onions( and onions, and green), radish.

If flatulence develops as a consequence of chronic pancreatitis( the diagnosis is established as a result of the examination), and specifically because of a lack of pancreatic enzymes, the treatment includes medications containing such enzymes( Mezim forte, Creon, Pancreatin, Smecta, etc.).

Treatment of bloating caused by intestinal dysbiosis, peptic ulcer, gastritis, enterocolitis, is the treatment of the disease itself, which caused flatulence.

Meteorism caused by mechanical causes( tumors, stenoses, etc.) requires surgical treatment.

Drug therapy is directed at:

1. treatment of the underlying disease that caused flatulence;

2. Restoration of normal intestinal microflora;

3. removal of accumulated gases from the lumen of the gut: prokinetics, adsorbents( activated carbon, bismuth preparations), defoamers( espumizan, semiticon).

For the treatment of flatulence, you can also try folk remedies.

If simultaneously with increased gas formation observed increased heart rate, you can use tea from peppermint. Drink it is recommended during the day, until the overall well-being is improved.

With colic and spasms with flatulence: a pinch of chamomile pharmacy pour 3 cups of boiling water, insist 30-40 minutes, then strain;take half a cup of infusion during the day until the symptoms disappear completely.

In the absence of appetite and a large accumulation of gases in the intestine, dried ginger( dried in powder and taken at the tip of a teaspoon 2-4 times a day 15 minutes after eating, drinking 1/3 cup of water) is helpful.

For infants with meteorism, dill water is useful. For the preparation of dill tea, one tablespoon of finely chopped green must be filled with a half cup of boiling water. Drink it should be chilled during the day after eating.

Meteorism, chronic constipation and colitis can also be treated with spinach leaves. This is especially useful for children and the elderly.

In addition, you can use the seeds of ordinary cumin. For children: 1 teaspoon of seeds pour 1 cup of boiling water. Boil for no more than 1-2 minutes, then insist 30 minutes, and before use, filter. Take necessarily with a small amount of honey in 1/4 cup 3 times a day for 15-20 minutes before meals. For adults: 1 tablespoon seeds of caraway seeds are poured with 1 glass of boiling water.

In all cases of prolonged or recurring flatulence, you should consult your doctor for the necessary examination to identify the disease that caused flatulence.

Despite the availability of folk remedies, their use may not always be safe and effective. Folk remedies can cause allergic reactions and do not solve the main cause of permanent bloating - dysbiosis. Combat dysbiosis should be complex. The removal of decay products from the intestine must be combined with the use of products rich in lacto- and bifidobacteria or components that promote their growth. For example, with dysbacteriosis, the use of a double-acting drug - Liquid Coal - helps. On the one hand sorbent pectin cleanses the digestive system from toxins and toxins, eliminating harmful substances. On the other hand, the prebiotic Inulin creates a favorable environment on the inside of the intestine for the reproduction of bacteria - digestive assistants. The solution of these two tasks helps to quickly and safely get rid of dysbacteriosis and its symptoms.

To which doctors should be treated with bloating:

Gastroenterologist, therapist. You may need the help of an infectious disease specialist, oncologist or neurologist.