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Abdominal distension: causes and treatment


Bloating Meteorism (Greek meteōrismos) refers to the delay and accumulation of gas in the intestine, manifested by a feeling of abdominal distention from the inside, an increase in its size, rumbling, episodes of flatulence - a pathological abundant discharge of digestive gases.

Among the population, this is a fairly common phenomenon that occurs in people regardless of their age. Flatulence - a purely medical term, in the common people such a condition is called abdominal distension. Such a dyspeptic disorder can be either one of the signs of a disease of the digestive system, or an independent response of the body to the use of poor-quality food, products that cause increased gas formation during their digestion, or other external stimuli.

The presence of gases in the intestines is the physiological norm. Air enters the digestive tract when food is swallowed. The process of digestion of the food lump is accompanied by the production of a certain amount of gases, they are also formed during the neutralization of pancreatic and gastric juice by natural bicarbonates. A small percentage of gases enter the intestines from the blood.

A characteristic place of localization of the main volume of gases are the bends of the colon and the stomach. The smallest number is in the sigmoid, colon and small intestine. The amount and nature of the gases produced depends on the microflora, which plays a large role in gas formation, a person's lifestyle, age, nutrition, climatic living conditions, the presence of hereditary or acquired during the life of diseases of the digestive system.

The accumulated gas is a foam of bubbles, each of which is covered with a thin layer of viscous mucus. Difficulty splitting, digestion and absorption of nutrients, as well as a decrease in the activity of enzymes occurs due to the coating of the intestinal walls of this foam.

Causes of bloating

The factors leading to flatulence are many. Excessive accumulation of gases may occur due to increased gas formation or untimely and insufficient removal of them from the body.

Causes of flatulence not related to disease:

  • The inclusion in the diet of products that increase gas formation . Alimentary meteorism occurs in healthy people when drinking carbonated drinks, eating foods rich in starch, carbohydrates, fiber. These include bread made from rye flour, potatoes, cabbage, beans. Abdominal distention is promoted by fruits or berries, which lead to fermentation in the intestines. These are grapes, apples, cherries, raisins.
  • Lactose intolerance . There is a category of people in whose intestines lactose is not absorbed due to the lack of an enzyme - lactase, which breaks down this milk sugar; therefore, the consumption of milk and dairy products causes flatulence and diarrhea.
  • Aerophagia . With haste during a meal with the rapid swallowing of large pieces of food, much more air gets into the stomach than with a measured, calm chewing of small portions of food.
  • Pregnancy Women complain of flatulence in the later stages of gestation. Their enlarged uterus presses against the intestines, reducing the intestinal tonus, slowing down peristalsis and promoting food masses.

Pathological conditions and diseases leading to bloating

  • Intestinal dysbiosis . The shift in the balance of "good" and "bad" microbes leads to digestive disorders.
  • Disruption of digestive processes caused by impaired absorption, lack of enzymes, hepato-intestinal circulation of bile acids. Food undigested in the upper sections of the tract enters the intestine, where the microflora produces a large amount of gases when it is cleaved.
  • Intestinal obstruction . Adhesions, tumors, stenosis and other mechanical obstacles lead to a violation of the evacuation function of different parts of the digestive tract. As a result, the food mass stagnates, fermentation and mechanical flatulence occur.
  • Introduction of complementary foods or transfer of a child to artificial nutrition . In babies born on time, and even more so in premature babies, due to imperfect functioning of the intestine, milk is poorly broken down and absorbed.
  • Inflammatory diseases of the digestive system :

- Crohn's disease;

- cholecystitis ;

- cirrhosis of the liver ;

- pancreatitis ;

- hepatitis;

- colitis and others.

With peritonitis, the timely discharge of gases does not occur due to intestinal atony, which causes a violation of its motility.

  • Acute intestinal infections , such as helminthiasis or salmonellosis, with severe intoxication disrupt the intestinal motor function.
  • Local and general circulatory disorders . Circulatory meteorism develops when blood stagnates in the intestinal veins. This is observed in liver cirrhosis, acute and chronic abdominal ischemia.
  • Neurogenic factor . Neuropsychiatric disorders, stress, hysteria, neurosis often lead to dyspeptic disorders. Frequent over-stimulation of the nervous system ends with spasm of the smooth muscles of the intestine, slowing down peristalsis.

Symptoms of bloating

Flatulence is manifested by seething, rumbling, heaviness and a feeling of fullness in the abdomen. Some may have dull aching pains without clear localization. Sometimes they are cramping in nature, subside after the discharge of gases or bowel movements. In severe flatulence, an increase in the size of the abdomen is noticeable. Flatulentsiya disturbed: delays alternate with abundant noisy emission of fetid gas. Indole, hydrogen sulfide and skatole impurities give a characteristic gas smell.

Abdominal distention is a sign of dyspepsia, in most cases it is accompanied by other dyspeptic symptoms - nausea, belching air, an unpleasant taste in the mouth, constipation or diarrhea, loss of appetite. On the part of the nervous system, sleep disturbance, irritability, weakness, and general weakness are possible. For extraintestinal symptoms include a burning sensation in the esophagus, tachycardia, and sometimes pain in the heart with a violation of its rhythm.

Flatulence is often observed in newborns and children under one year. It manifests intestinal colic. The baby is nervous during feeding, shouts a short time after it, presses the legs to the stomach.

Diagnosis with abdominal distension

With persistent flatulence, accompanied by pain of a different nature and not a corrective diet, you need to consult a doctor-gastroenterologist or therapist. To find out the reasons, he will draw up a plan of diagnostic measures. It is possible that consultation of a neurologist, an infectious disease specialist or an oncologist will be required.

At the first stage, a physical examination of the patient helps to obtain valuable information that would suggest the presence of a particular pathology. Anamnesis and patient complaints are collected, auscultation, percussion, external examination of the abdomen with palpation.

  1. Inspection . The contours of the abdomen during visual inspection will help determine the cause and nature of flatulence - general or local. For example, if the front wall of the abdomen is stretched in the shape of a dome, folds from intestinal loops are visible, then the probability of intestinal obstruction is high. The noticeable wavy contractions going from left to right, together with a seal in the epigastric region, suggest mechanical obstruction of the gastric sphincter. Redness (erythema) of the palms is a characteristic sign of latent cirrhosis.
  2. Percussion . When tapping the abdominal wall, a pronounced tympanic sound is heard. The accumulation of fluid in the abdominal cavity is manifested by a dull, oscillating sound in the flanks of the abdomen. When you change the body position of the subject, the nature of the sound changes.
  3. Auscultation . The bowel obstruction is indicated by whistling noises or a splashing sound made by accumulated fluid and / or gases. Intestinal noise can be amplified (before an obstacle), weakened, or completely absent.
  4. Palpation . With the accumulation of gases in the small intestine, the intense wall of the peritoneum and individual intestinal loops are palpated. Under the fingers, you can often feel the movement of gases. Sometimes probing helps to detect the presence of a tumor in the abdominal cavity.

The second stage consists of laboratory and instrumental diagnostics.

Laboratory research:

  1. Coprogram . It will help to identify fermentopathy, digestive disorders, the presence of worms, Giardia.
  2. Sowing feces for dysbiosis . To determine the ratio of beneficial, conditionally pathogenic and pathogenic bacteria.
  3. Feces on pancreatic elastase-1 . Required to study the state of the pancreas, which produces this proteolytic enzyme involved in the breakdown of elastin.
  4. Feces on carbohydrates . To identify pancreatic pathology, inflammatory bowel disease.
  5. Lipidogram feces . It is prescribed for suspected neoplasms, other diseases of the pancreas, enteritis, etc. It helps to reveal a violation of lipid breakdown and absorption.
  6. General blood test . Leukocytosis, an increase in ESR are characteristic of inflammatory processes in the digestive tract, a decrease in hemoglobin, erythrocytopenia - for anemia.
  7. Biochemical study of blood . An increase in bilirubin is observed with hepatitis, amylase - with pancreatitis, hypoalbuminemia - with non-specific ulcerative colitis.

Instrumental studies:

  1. Rectoromanoscopy with visual inspection of the rectal mucosa.
  2. Colonoscopy with inspection of the colon with a special probe inserted through the anus.
  3. Ultrasound of the internal organs . To assess the condition of organs, the detection of a possible inflammatory process or tumor formations.
  4. Intestinal ultrasonography - ultrasound examination of the intestine. Appointed to identify tumors free of fluid.
  5. Radiography of the intestine with contrast . The study of the passage of barium spreading through the small intestine helps to detect obturation, diverticula, ulceration and other bowel pathologies.
  6. Irrigoscopy is an x-ray examination of the large intestine in which contrast is injected.

Abdominal bloating treatment

No treatment will be effective without eliminating the etiological factors that provoke flatulence, therefore one of the main components is the elimination of the causes of pathology.

In healthy people, infrequent episodic bloating does not require treatment. Such a manifestation is eliminated independently. Some people only need to adjust their eating or diet culture, as well as diet. Eating without haste at the same time, with thorough chewing of each piece will help to eliminate aerophagy. To prevent fermentation and get rid of excessive production of gases in the process of splitting the food lump can limit or eliminate from the diet the following products: peas, beans, apples, grapes, potatoes, pastries, black bread, milk, kvass, carbonated drinks, etc.

The remaining cases require symptomatic medical treatment, a course of which is developed taking into account the impairment or illness, accompanied by flatulence.

Stages of treatment:

  • Diet with the exception of products that increase gas formation. If cholecystitis, pancreatitis, cholangitis, hepatitis or other inflammatory diseases of the digestive tract are diagnosed, then spices, smoked meats, lard, chocolate, coffee, fatty and fried foods should be excluded from the diet.
  • Treatment of the underlying disease. Enzyme deficiency is eliminated by taking the enzyme in exchange (creon, mezim forte, panzinorm). Symptoms of cholecystitis are stopped by antibiotics, choleretic agents and antispasmodics.
  • Normalization of peristalsis . To restore the intestinal motor function, a drug from the prokinetic group is prescribed, for example, motilium.
  • Restore normal intestinal biocinosis . To normalize the intestinal microflora, Maksilak, Linex, Acopolis, Bifiform and other probiotics and prebiotics are prescribed.
  • Removal of accumulated gases is carried out with the help of enterosorbents, the most common of which are activated carbon, polyphepan, smecta, filter, polysorb. They help eliminate toxins and gases from the body. To eliminate bloating in infants, they use dill water.

| 19 July 2015 | | 1 345 | Diseases of the digestive tract
Leave your feedback

William Hunt: Ok so: Beans, Veggies, Milk, and Wheat(bread/rice etc.) cause you to bloat? BRUH what can I eat at all? Someone help please

Fiona Ma: well, it all makes sense now. Had mainly brokkoli and cauliflower in a creamy sauce amongst other things for dinner. fml

Angela Alexis: I ate burgers with coffee early morning. Now is evening. I just slept and after waking up. I am already bloated. I don't understand yyyy.

Joseph Hunt: Beans, Onions, cauliflower, spouts and broccoli. But make sure to get your five a day of vegetables. Aren't most of those vegetables, and healthy ones?

Rayees Mathroof: Wtf I spend soo much for my bloated abb and many doctors no one gave me a best solution... finally I’m in starvation mode... 😕

jogender jakhar: I’m taking the fish oil pills from last two days and now I’m facing the gastric problem in my abdominal what should i do to get cure or fixed it??

tara ss: I am asthmatic and even when i do not have a habit of overeating i still feel uncomfortable and start having trouble breathing after i eat. I also take all food groups. Idk what it is.