Bloating: Causes, Symptoms and Treatment

Bloating, or flatulence, is a fairly common problem in the population.

The accumulation of gases leads not only to an increase in the size of the abdomen, but can also be accompanied by pain, rumbling, and gas emission. All this leads to discomfort and reduces the quality of human life.
Despite the fact that flatulence in the intestines is the norm, flatulence can be either a symptom of a disease or a consequence of poor nutrition.

Air enters the intestines when food is swallowed. Also, gases are formed during the digestion of food eaten and the neutralization of bile acids and pancreatic juice. In addition, gas enters the intestines from the bloodstream.

Gas mainly accumulates in the area of ​​the bends of the transverse colon, as well as in the stomach.

How much gas will be formed during digestion depends on the intestinal microflora, nutrition, age, lifestyle, the presence or absence of diseases of the gastrointestinal tract.

Causes

Why does flatulence occur? Bloating can be associated with both dietary habits and diseases of the gastrointestinal tract.

So, the reasons for increased gas production, not associated with the pathology of the organs of the gastrointestinal tract, are as follows:

• the use of products that increase gas production. These include potatoes, legumes, cabbage, soda, and rye bread. Flatulence is also caused by the use of apples, raisins, cherries, grapes;
• incompatibility of products. For example, some fruits need to be eaten 2 hours after a meal or an hour before a meal;
• aerophagia - swallowing air while eating. More air enters the stomach when food is eaten quickly. Therefore, you need to eat in a calm atmosphere, without rushing;
• lactose intolerance - some people are deficient in an enzyme that breaks down dairy products. Therefore, after eating milk and dairy products, there is increased gas formation and bloating;
• pregnancy - an increase in gas formation occurs in the later stages. This is due to the pressure of the enlarged uterus on the intestines, which reduces its motor activity, the movement of the food bolus slows down.

Flatulence can be one of the symptoms of the disease.

Pancreatitis

Pancreatitis is an inflammatory process in the pancreas. It is characterized by heaviness in the epigastrium, bloating, nausea, vomiting, pain after eating.

Soreness can "give" to the lower back. In addition, pancreatitis is characterized by light, "fat" feces, which are poorly flushed from the toilet.

The cause of inflammation of the pancreas is alcohol abuse, smoking, chronic renal failure, long-term medication, heredity, tumor, cysts.

Due to a malfunction, the pancreas does not produce enough enzymes to break down food. This leads to a delay in digestion, its disturbance and increased gas production.

Hepatitis and cirrhosis of the liver

Hepatitis is an inflammatory process in the liver, the final outcome of which is cirrhosis.

With hepatitis, patients complain of flatulence due to a decrease in bile secretion, which disrupts the digestion of food. There is also discomfort in the right hypochondrium, yellowing of the skin, weakness, fatigue, itching.

With cirrhosis, the listed symptoms are accompanied by an increase in the anterior abdominal wall and the appearance of veins on the skin of the abdomen.

Dysbacteriosis

This condition is characterized by a decrease in the number of beneficial bacteria and an increase in the number of disease-causing microbes in the intestines. Such changes lead to disruption of normal digestion and the occurrence of flatulence.

Intestinal obstruction

Obstruction in the intestinal area can lead to tumors, polyps, adhesions, gallstones, foreign bodies. Also, obstruction can be not only mechanical, but also dynamic (functional).

The latter occurs as a result of inflammatory processes in the abdominal cavity (peritonitis, ulcerative colitis, etc.).

Also, intestinal obstruction occurs in chronic renal failure (last stage), diabetes mellitus, insufficient potassium in the blood, impaired calcium and magnesium metabolism.

With intestinal obstruction, the patient complains of cramping abdominal pain, swelling, absence of gas and feces, nausea and vomiting.

Characterized by thirst, decreased dynamic activity, dry skin, increased heart rate, decreased blood pressure.

Cholecystitis

The disease is characterized by heaviness in the abdomen and its swelling, pain in the epigastrium (in the navel and 2-3 cm above it), right hypochondrium, under the right shoulder blade.

Later, nausea, vomiting join, the body temperature rises, the pulse becomes frequent.

The cause of cholecystitis is obesity, dramatic weight loss, type 2 diabetes mellitus, female sex, taking oral contraceptives, starvation, pregnancy, age over 40.

Irritable bowel syndrome

Irritable bowel syndrome is a disorder of bowel function that is accompanied by recurrences of abdominal pain that occurs at least 1 time per week.

In this case, the pain syndrome is associated either with defecation, or with an altered frequency or shape of stool. Such signs should bother the patient for the last three months and at least six months.

One of the signs of irritable bowel syndrome is flatulence. Patients note that bloating appears after eating, increases during the day. At the same time, in the morning hours, such symptoms are not observed.

Also, patients with irritable bowel syndrome complain of abdominal pain. The pain syndrome can be aching, burning, dull.

Sometimes the patient describes the pain as dagger, twisting, constant. The abdominal discomfort is worse after eating.

The pain goes away after having a bowel movement, taking drugs that reduce the spasm (antispasmodics), or passing gas. Women find that the soreness in the abdomen gets worse during menstruation.

Another complaint of patients with irritable bowel syndrome is stool disorder. Often disturbed by diarrhea or constipation, sometimes they alternate.

Diarrhea occurs in the morning after the first meal. Stool frequency is 2 to 4 times, sometimes more, in a short period of time.

Irritable bowel syndrome causes - stress, anxiety and depressive disorders, impaired intestinal motility, dysbiosis, malnutrition, heredity.

Ulcerative colitis and Crohn's disease

Ulcerative colitis is a chronic pathology characterized by an inflammatory process in the mucous membrane of the large intestine.

Patients with ulcerative colitis complain of blood in the stool, diarrhea (up to 15-20 times a day), including at night, false urge to defecate.

Constipation, bloating, soreness in the left abdomen, and weight loss are also characteristic.

The causes of ulcerative colitis are not fully understood. Perhaps infection, heredity, stress, and the use of non-steroidal anti-inflammatory drugs play a role in the onset of the disease.

Crohn's disease is a chronic pathology characterized by inflammation of all tissues of the gastrointestinal tract, from the oral cavity to the anal canal.

Patients complain of diarrhea for more than 6 weeks, while there is no blood in the stool. Also, patients are worried about soreness in the abdomen, fever, nausea, vomiting, impaired gas and feces, and bloating.

The causes of Crohn's disease are heredity, impaired immunity, dysbiosis.

Intestinal infection

Salmonella infection or helminthiasis can lead to bloating.

With salmonellosis, the patient complains of diarrhea, soreness and heaviness in the epigastrium, nausea, vomiting, and bloating.

The diarrhea is very thin and lasts about 4 days. Symptoms occur 2 hours after eating contaminated meat, eggs, or dairy products.

With helminthiasis, the temperature rises, pain appears in the muscles and joints, swelling and rashes on the skin. Characterized by swollen lymph nodes, liver and spleen, abdominal pain and bloating, diarrhea, or constipation.

Neuropsychiatric disorders

Stress, hysteria, neurosis can lead to bloating. These conditions contribute to the excitement of the nervous system and spasm of the intestinal muscles, which disrupts peristalsis and digestive processes.

Which doctor to contact

If bloating occurs, you should consult a therapist or gastroenterologist. The doctor will prescribe the necessary examination and treatment. You may need the help of an infectious disease specialist, oncologist or psychiatrist.

Survey

What examinations do you need to undergo to identify the cause of flatulence? Laboratory and instrumental methods will help to diagnose.

Laboratory methods:

• coprogram - allows you to detect undigested food debris, helminths, bile pigments in the feces;
• feces for carbohydrates - the study is necessary to diagnose diseases of the pancreas and inflammatory bowel pathologies;
• feces for pancreatic elastase-1. This test also helps diagnose diseases of the pancreas, as it produces this enzyme;
• fecal lipidogram - allows you to determine the violation of the splitting and absorption of fats, to diagnose tumors, enteritis and diseases of the pancreas;
• a general blood test - a low level of hemoglobin and red blood cells may indicate bleeding, helminthiasis. An increase in the level of leukocytes and ESR indicates inflammation;
• biochemical blood test - an increase in the level of ALT, AST, bilirubin, alkaline phosphatase indicates hepatitis, an increase in amylase - about pancreatitis, an increase in C-reactive protein - about an inflammatory process.

Instrumental research methods:

• sigmoidoscopy and colonoscopy - these studies are necessary to assess the condition of the intestinal mucosa, taking biopsies from suspicious areas. With sigmoidoscopy, the rectum and sigmoid colon are examined, and with colonoscopy, the entire large intestine. Before conducting these studies, the patient needs to prepare. Preparation takes 1 to 3 days, during which you should adhere to a liquid-based diet, drink a laxative the night before the study. The examination is carried out under anesthesia;
• irrigoscopy - X-ray examination of the large intestine with a contrast agent;
• Ultrasound of the abdominal organs - allows you to assess the condition of the abdominal organs, identify a tumor or inflammation;
• bowel ultrasonography - an ultrasound examination of the bowel. Allows you to identify neoplasms and free fluid during inflammation;
• barium x-ray ­– helps to identify a possible tumor that blocks the intestinal lumen, diverticulum, ulcer, obstruction.

Treatment

Before starting treatment, it is necessary to establish the cause that causes flatulence. Rare abdominal distension, without identified pathologies, does not require any treatment.

In all other cases, dietary adherence and drug therapy will be required.

Diet

First of all, you must follow the diet. Food should be taken in a calm environment at the same time.

There is no need to rush, because eating food quickly leads to swallowing large amounts of air, which contributes to flatulence.

To reduce fermentation processes in the intestine, the following foods must be excluded from the diet:

• potato;
• grape;
• kvass;
• fatty and fried foods
• milk;
• beans;
• Salo;
• peas;
• bakery products;
• black bread;
• coffee;
• smoked meats;
• chocolate;
• spices.

Keeping a food diary is recommended. In it you need to write down the foods that you have consumed and the body's reaction to them. Subsequently, you can remove from the diet that food that caused gas and bloating.

Drug treatment

Flatulence requires a complex effect. To combat increased gas production, the following drugs are suitable:

• enterosorbents. Activated carbon (1 tablet three times a day), Enterosgel, Polyphepan, Laktofiltrum, Polysorb. However, it must be remembered that these drugs absorb not only compounds unnecessary for the body, but also remove useful substances;
• defoamers - this group includes Espumisan. It speeds up the elimination of gas from the intestines. The drug can even be given to children;
• probiotics are bacteria that can be found in foods, medicines, and supplements. Probiotics have a positive effect on the intestinal microflora. To maintain the effect of taking probiotics, you need to take drugs produced in the country of their consumption. Otherwise, the result may be absent, since the conditions of transportation of the probiotic could be violated. The drugs in this group include Lactobacterin, Bifidumbacterin, Linex, Hilak Forte;
• enzymes - necessary for diseases of the pancreas. Enzyme preparations improve digestion. This group includes Mezim, Pancreatin, Creon;
• prokinetics - drugs that normalize the motor activity of the organs of the gastrointestinal tract. The drugs in this group include Domperidone, Motilium, Itoprid Hydrochloride (Trimedat);
• herbal ingredients – dill water and dill fruits.

Folk remedies

You can get rid of bloating with the help of folk recipes. However, alternative treatment can only be used in conjunction with drug therapy, after finding out the cause of flatulence.

You should consult your doctor before using the recipes below.

Recipes:

• Pour 15 g of chamomile with 200 ml of boiling water and leave for half an hour. Then strain and take half a cup in the morning and evening. This infusion reduces flatulence, abdominal pain and intestinal spasm;
• squeeze juice from potatoes and drink on an empty stomach in the morning. Repeat the procedure for 10 days. Then take a break, after which the course should be repeated;
• pour boiling water over a tablespoon of ginger, leave for half an hour. Take on an empty stomach in the morning. Mint and cinnamon can be added to ginger. You can also eat ginger raw. This product speeds up digestion and improves blood circulation;
• Pour 30 g of mint with a glass of boiling water and leave for 20 minutes. Strain the infusion and take it throughout the day;
• Pour 2 teaspoons of dill seeds with water and place on fire. Boil for 15 minutes, then leave for half an hour, then strain. Take half a glass twice a day before meals;
• chop carrot seeds and eat a teaspoon three times a day with warm water;
• flaxseed oil, take 10 ml on an empty stomach in the morning;
• eat fennel in any amount or add to salads.

Prophylaxis

How to avoid excessive gassing? You should avoid eating foods that increase the likelihood of flatulence: potatoes, legumes, cabbage, soda, rye bread.

Flatulence is also caused by the use of apples, raisins, cherries, grapes. You also need to eat in a relaxed atmosphere, take your time.

People with lactose intolerance need to avoid excessive consumption of dairy products. An important point of prevention is the diagnosis and treatment of the causes of bloating.

Conclusion

Flatulence is bloating that occurs when gas builds up in the intestines. Bloating can be caused by both physiological and pathological causes.

Physiological reasons include eating potatoes, legumes, cabbage, rye bread, soda, apples, grapes, cherries, and raisins.

Also, increased gas production can be caused by pregnancy, lactose intolerance and fast food intake.

Pathological causes of flatulence include pancreatitis, hepatitis, cirrhosis of the liver, dysbiosis, intestinal obstruction, cholecystitis, irritable bowel syndrome, ulcerative colitis and Crohn's disease, neuropsychic disorders.

The study of feces for carbohydrates, pancreatic elastase-1, lipidogram, coprogram, general and biochemical blood test help to diagnose the cause of bloating.

From instrumental methods, sigmoidoscopy, colonoscopy, irrigoscopy, ultrasound and X-ray of the abdominal organs are used.

Treatment of flatulence is based on diet and intake of enterosorbents, defoamers, prokinetics, probiotics, enzyme preparations.

Prevention is reduced to eating in a relaxed atmosphere, excluding foods that increase gas production and diagnosing and treating the causes of flatulence.