ABDOMINAL BLOATING & BELCHING

Intestinal gas is a topic that people often find difficult to discuss, but we all have gas in our intestinal tract. Gas can contribute to a sense of bloating (fullness), belching, abdominal cramps, and flatulence (gas). These symptoms are usually brief and resolve once gas is released by belching or flatulence. Some people can be more sensitive to even normal amounts of gas and develop the above symptoms.

Symptoms

Belching is a normal process and results from swallowed air accumulating in the stomach. The air can either be belched back or can be passed out of the stomach into the small intestine and be subsequently passed as rectal gas (flatus).

Bloating refers to a sense of fullness in the upper abdomen. This can be influenced by gas and/or food accumulation in the stomach. Some patients experience the symptom with normal amounts of gastric gas.

Flatulence refers to the passage of rectal gas. The gas is generally a combination of swallowed air and gas produced by the action of colon bacteria on undigested carbohydrates.

Gas which accumulates in the right upper portion of the colon can lead to pain which could seem like gallbladder pain. Gas which accumulates in the left upper portion of the colon can radiate up to the chest and seem like cardiac pain.

Risk Factors

Excessive air swallowing, and certain foods and carbonated beverages are significant contributors to belching and flatulence. Some patients with Irritable Bowel Syndrome (IBS) appear to be uniquely sensitive to normal or only slightly increased volumes of intestinal gas and may develop abdominal cramps as a result.

Diagnosis

The diagnosis of esophageal reflux or gastric inflammation should be excluded by endoscopy (examining the esophagus and stomach with a flexible tube while the patient is sedated).

If lactose intolerance is suspected, milk can be withdrawn from the diet and symptoms observed. However, lactose can be administered orally and the hydrogen gas which is generated in susceptible people can be measured in the breath.

If bacterial overgrowth is suspected, your physician may administer a hydrogen breath test. Blood tests are not usually helpful for gaseous problems but testing for celiac disease may prove useful since failure to absorb wheat, barley, and rye can lead to excess flatulence.

Patients complaining of excessive gas passages may benefit from keeping a “flatus” diary for three days.

Treatment

Dietary

  • Eliminate carbonated Beverages (Soda & Beer)
  • Milk & Dairy Product
  • Chewing Gum
  • Artificial Sweeteners

If symptoms fail to respond to the dietary strategies noted above, medical help should be sought to be confident that no other underlying abnormalities are present.

If symptoms fail to respond to the dietary strategies noted above, medical help should be sought.

IMPORTANT POINTS

  • Belching and flatulence are normal body processes.
  • Swallowed air is “gas” in the body and contributes significantly to symptoms.
  • Unabsorbed dietary carbohydrates can cause gas production by colon bacteria.
  • Carbonated beverages, sucking on hard candy, and chewing gum should be avoided.
  • Abdominal distension when erect but not recumbent may be due to weak abdominal muscles.
  • Increasing frequency or severity of symptoms should prompt medical attention.