Flatulence
The content of the article:
- Causes of flatulence
- Types of flatulence
- Signs
- Features of flatulence in newborns
- Diagnosis of flatulence
-
Treatment of flatulence
Medication for flatulence: Penzital
- Prevention of flatulence
Flatulence (from the Greek μετεωρισμός - lifting up) is a symptom that accompanies a number of pathological conditions and diseases, and also occurs in somatically healthy patients, consisting in an excessive accumulation of gases in the intestinal lumen.
Gases are normally contained in the human gastrointestinal tract in the form of small bubbles mixed with gastric and intestinal contents. Normally, from 1 to 2.5 liters of gases are released in 5–20 episodes during the day through the oral or anal opening, as well as through the lungs, where gases are delivered through the circulatory system.
Flatulence is an excess of gas in the intestinal lumen
The gas composition of the internal environment of the intestinal tube is very diverse: the main ones in terms of volume are carbon dioxide, nitrogen and hydrogen, the presence of oxygen, hydrogen sulfide, ammonia, etc. is also noted. According to various sources, from 20 to 70% of the total volume of gas is swallowed during digestion, some diffuses from the bloodstream, part is formed as a result of the enzymatic activity of microorganisms in the intestinal lumen. Carbon dioxide is actively synthesized in the stomach cavity during the reaction of neutralization of hydrochloric acid of gastric juice or fatty acids from food with bicarbonates.
It is generally accepted that the amount of gases, which is a product of the activity of its own microflora, in the stomach and small intestine does not exceed 20%, while in the large intestine gases are of endogenous origin in almost 75-100% of the total volume.
Flatulence is a common problem in all age groups, from newborn babies to elderly patients.
Causes of flatulence
The causes of flatulence can be different and vary depending on the age of the patients, the presence of concomitant diseases, the existing pathologies of the gastrointestinal tract, the individual characteristics of the body, as well as nutrition.
Flatulence in children is usually triggered by the following causative factors:
- malformations of the oral cavity [cleft lip, cleft palate (the so-called cleft palate), fistulous passages between the esophagus and trachea];
- improper attachment of the baby to the breast, when the sealing of the mouth is not ensured or the wrong feeding technique from the bottle (air in the tip of the nipple, swallowing air at the end of feeding);
- diseases of the ENT organs, in which nasal breathing is disturbed;
- improper eating behavior (anxiety of the baby, talking during feeding);
- inaccuracies in the mother's diet during breastfeeding (foods that increase gas formation);
- lactase deficiency (a condition in which the child's body is unable to assimilate milk sugar due to a lack of a utilizing enzyme);
- functional and anatomical immaturity of the digestive tract;
- swallowing air (aerophagia) when crying.
Hurry eating contributes to flatulence.
Flatulence in adult patients is more common in the following cases:
- hasty meal;
- talking, smoking while eating;
- missing part of the teeth or incorrectly manufactured dentures;
- eating a large number of foods, the digestion of which is accompanied by active gas formation (legumes, foods containing coarse fiber, carbonated drinks, fermentation products, etc.);
- enzyme deficiency;
- violation of the circulation of bile acids;
- maldigestion, malabsorption (failure of cavity and parietal digestion);
- dysbiosis;
- violation of the processes of moving the food mass through the intestines, the development of fermentation, putrefaction (adhesions, volumetric neoplasms);
- postoperative intestinal paresis;
- intoxication syndrome;
- electrolyte disturbances;
- endocrine diseases;
- taking certain pharmaceuticals (prednisolone, lactulose, high-dose iron-containing drugs);
- peritonitis;
- anomalies in the structure and location of the large intestine;
- irritable bowel syndrome;
- situations of acute or chronic persistent stress;
- disorders of local microcirculation with concomitant gastrointestinal diseases;
- age-related changes in the blood supply to organs and tissues;
- neurological and mental diseases, accompanied by a disorder of the local innervation of the gastrointestinal tract;
- functional states (premenstrual syndrome in women);
- bacterial overgrowth syndrome; and etc.
Types of flatulence
In accordance with the development mechanism, the following types of flatulence are distinguished:
- alimentary (food), arising from the use of products that cause excessive gas formation;
- digestive (digestive), which develops as a result of disruption of the processes of digestion and evacuation of food;
- dysbiotic, the main development mechanism in this case is a violation of the balance of microflora, the predominance of gas-forming microorganisms;
- mechanical, when the accumulation of gases is due to the direct difficulty of their evacuation;
- dynamic (psychogenic or functional) due to changes in peristalsis;
- dyscirculatory, caused by local circulatory disorders;
- high-altitude (due to changes in atmospheric pressure when climbing to altitude).
Signs
Symptoms of flatulence can be divided into 3 main groups:
- pain in the abdomen;
- dyspeptic disorders;
- excessive discharge of gases, or flatulence.
Painful sensations with flatulence to one degree or another disturb almost all patients. The pain can be intense cutting, cramping in nature and stop after the discharge of gas or be mild, more like a state of indistinct discomfort.
The intensity of pain in flatulence directly depends on the amount of gas in the intestine, but is also largely determined by individual visceral sensitivity.
Pain sensations with flatulence are of a cutting, cramping character
Dyspeptic symptoms of flatulence are presented quite widely:
- bloating (patients complain of a feeling of fullness, tightness of clothing, an increase in abdominal circumference), decreasing or stopping after passing gas, defecation or taking special drugs;
- excessive belching (more often with air, less often with rotten, sour). In a healthy person, belching is normal and is one of the main mechanisms for preventing the penetration of gases swallowed during eating, during conversation, etc., into the lower parts of the digestive tract;
- instability of the stool, alternation of constipation and diarrhea;
- rumbling in the stomach;
- nausea, hiccups, in infants - regurgitation.
Flatulence is a sudden "explosive" release of gas through the anus. Patients characterize this condition as an intolerable, difficult to control feeling of fullness in the lower abdomen and rectum, resolved by the discharge of a large amount of gas. When trying to suppress flatulence, patients note the occurrence of pain in the umbilical region or in the lower abdomen, increased bloating.
Features of flatulence in newborns
It is believed that flatulence in children during the first months of life is the main cause of restless behavior, crying and refusal to eat (according to some reports, in 70% of cases). This condition in newborns has a physiological rationale:
- at the time of birth, enzyme systems function to provide lactotrophic nutrition, are inferior in relation to other products, and therefore digestion reacts sharply to errors in the mother's diet;
- the muscular layer of the digestive tube is insufficiently expressed, which explains the imperfection of peristalsis;
- the fundus and cardiac section of the stomach are much worse developed than the pyloric section;
- functional dysbiosis;
- low acidity of gastric juice;
- varying degrees of maturity of the large intestine;
- high permeability of the intestinal epithelium; etc.
Flatulence in children during the first months of life is the main cause of crying and anxiety.
The presence of flatulence in an infant is usually indicated by the following signs:
- episodes of anxiety, unreasonable or arising after eating, stopping spontaneously, taking antifoam, after contact of the abdomen with a heat source (for example, a warm diaper);
- periods of anxiety occur systematically, often at the same time or at regular intervals after feeding;
- when crying, the child pulls the legs to the stomach;
- the abdomen is swollen, hard to the touch;
- there is no lag in physical development, weight gain occurs according to age.
Diagnosis of flatulence
Since flatulence is not a symptom characteristic of any particular disease, but can occur against the background of many pathological and functional conditions, the main method of diagnosis is the collection of anamnestic data.
Instrumental research methods are usually aimed at excluding gross pathology, life-threatening diseases:
- X-ray examination of the intestine with a contrast agent;
- Ultrasound of the abdominal organs;
- jejunoscopy with biopsy and morphological examination of biopsy;
- colonoscopy and sigmoidoscopy;
- a trial elimination diet for flatulence with the elimination of FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) products from the diet, which contain a significant amount of fermentable fructooligosaccharides and alcohols (legumes, crucifers, milk, apples, plums, grapes, products from yeast dough, etc.), as a rule, leads to the elimination or a significant decrease in the intensity of painful manifestations, which is a diagnostic criterion.
Treatment of flatulence
Treatment of flatulence is carried out in a comprehensive manner and includes both drug therapy and lifestyle modification measures:
- a diet moderate in foods that increase gas formation, avoiding foods containing excessive amounts of monounsaturated and essential fats;
- adsorbents;
- defoamers;
- enzyme preparations;
- normalization of the microbial composition of the gastrointestinal tract (pro- and prebiotics);
- prokinetics;
- local antispasmodics.
In many cases, eliminating gas-producing foods from the diet helps to cope with flatulence.
Treatment of flatulence in children from birth in most cases is carried out with the help of simethicone-based defoamers, since these drugs are intact in relation to the intestinal wall, act exclusively at the site of application and do not have systemic effects.
Medication for flatulence: Penzital
One of the drugs that can be part of the treatment of various conditions that cause flatulence is Penzital. It is a medicinal product containing pancreatic enzymes, which helps to improve digestive processes and normalize the state of the gastrointestinal tract. Amylase, lipase, trypsin and other enzymes in pancreatin (the active ingredient of Penzital) help break down fats, proteins and complex carbohydrates, due to which the drug is able to compensate for gross nutritional errors. The heaviness in the stomach and flatulence resulting from the use of spicy, fatty, exotic foods, as well as overeating, are eliminated after taking it.
Unlike other drugs with a similar effect, Penzital does not contain bile components, therefore it does not increase the secretion of the pancreas and can be used for diseases of the biliary tract and liver.
Trypsin blocks the excessive secretion of the pancreas, thereby helping to reduce the pain of pancreatitis.
Indications for use: flatulence, dyspepsia, diarrhea of non-infectious etiology, pancreatitis, cystic fibrosis. Penzital is prescribed:
- with deterioration in chewing function in the elderly;
- with functional disorders of the digestive tract caused by inactivity, including prolonged immobilization;
- with impaired assimilation of food due to the postponed resection of the stomach and small intestine;
- in preparation for a diagnostic examination of the abdominal organs (ultrasound, radiography).
The form of release of Penzital - tablets for oral administration, protected from gastric juice by a film membrane (enzymes are activated in the alkaline environment of the small intestine), in packs of 20 and 80 tablets. Take during or immediately after a meal with a little liquid. The recommended dose is 1-2 tablets with each meal (3 times a day). The maximum therapeutic activity of the drug occurs 30–45 minutes after administration.
Prevention of flatulence
In order to prevent flatulence, the following measures are recommended:
- refusal to eat while lying down, during a conversation, hastily (in situations where the risk of aerophagia increases);
- an increase in the volume of fluid consumed up to 2-2.5 liters per day (non-carbonated drinks);
- dosed physical activity, strengthening the abdominal muscles;
- small meals;
- refusal to wear tight belts, corsets that increase intra-abdominal pressure.
Prevention of flatulence in newborn babies in most cases consists in the implementation of the correct feeding technique for the child (nipples by age, preventing the baby from swallowing air from the nipple nose, correct attachment to the breast), the mother's compliance with dietary recommendations when breastfeeding.
YouTube video related to the article:
Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
