| ID | 26 |
|---|---|
| Name | GASTROINTESTINAL GAS |
| Cause | Gas in stomach is primarily caused by swallowing air when you eat or drink. Most stomach gas is released when burp. Gas forms in your large intestine (colon) when bacteria ferment carbohydrates — fiber, some starches and some sugars — that aren't digested inpatients small intestine. |
| Signs Symptoms | Belching, bloating and distention, and passing gas. |
| Diagnosis | On medical history A review of dietary habits A physical exam |
| Investigations | On medical history A review of dietary habits A physical exam |
| Management | If have gas pains are caused by another health problem, treating the underlying condition may offer relief. Otherwise, bothersome gas is generally treated with dietary measures, lifestyle modifications or over-the-counter medications. Diet Dietary changes may help reduce the amount of gas in the body produces or help gas move more quickly throughthe system. Reducing or eliminating the following dietary factors may improve gas symptoms: High-fiber foods. High-fiber foods that can cause gas include beans, onions, broccoli, Brussels sprouts, cabbage, cauliflower, artichokes, asparagus, pears, apples, peaches, prunes, whole wheat and bran. Avoid high-fiber foods for a couple of weeks and gradually add them back. Dairy. Reducing dairy products from your diet can lessen symptoms. Advise also may try dairy products that are lactose-free or take milk products supplemented with lactase to help with digestion. Sugar substitutes. Eliminate or reduce sugar substitutes, or try a different substitute. Fried or fatty foods. Dietary fat delays the clearance of gas from the intestines. Cutting back on fried or fatty foods may reduce symptoms. Carbonated beverages. Avoid or reduce your intake of carbonated beverages. Fiber supplements. Water. To help prevent constipation, Advise drink water with meals, throughout the day and with fiber supplements. Alpha-galactosidase (Beano, BeanAssist, others) helps break down carbohydrates in beans and other vegetables. Lactase supplements (Lactaid, Digest Dairy Plus, others) help digest the sugar in dairy products (lactose). These reduce gas symptoms if you're lactose intolerant. Simethicone helps break up the bubbles in gas and may help gas pass through your digestive tract. T Activated charcoal advise taken before and after a meal may reduce symptoms, |
| Introduction | Gastrointestinal gas may be due to swallowed air e.g nitrogen and oxygen and that produced in the gut- carbondioxide, hydrogen, methane. There is two consequences of excessive gastrointestinal gas: i. Belching- involuntary or voluntary release of gas from the stomach or oesophagus (eructation); ii. Flatus- passage of intestinal gas through rectum. Excessive passage of flatus is due largely to gases formed by bacterial fermentation of carbohydrates in the intestine such as H2, CO2 & CH4. Many problems of abdominal bloating or distension with pain appears to be caused by disordered bowel motility rather than excessive gas. |
| History | |
| Etiology | refer under cause |
| Clinical Features | |
| Preventions | Identify and limit or avoid gas-inducing foods such as beans, lentils, broccoli, cabbage, onions, and carbonated drinks |
| Treatment | Treatment: 1. Specific treatment if any cause. 2. Correction of aerophagia- anxiety states are often associated with deep breathing and sighing and consequent swallowing of considerable quantities of air. So, underlying anxiety states should be treated. 3. Instruct the patient to avoid dietary, indiscretions, such as eating too rapidly, drinking large quantities of iquids with meals, taking laxatives, chewing gums, eating too much while under emotional stress. 4. Nutritious and well tolerated diet; avoid diet that lead to excessive flatulence. 5. Drugs: i. Carminative mixtures are used to expel gas from stomach and intestine (by inducing relaxation of the cardio-oesophageal sphincter); ii. Charcoal (ultracarbon) and simethicone are only of placebo value, iii. Anticholinergics- sedative durgs serve to diminish the flow of saliva, thereby reducing aerophagia and bowel motility. iv. Rifaximin (a nonabsorbable oral antibiotic) 400mg twice daily may reduce abdominal bloating and flatulence in approximately 40% of the patients. The improvement of the condition is due to antibiotic suppression of gas producing colonic bacteria, but, there may be relapse of the same within days after stopping the drug |
| Complications | Chest pain that might mistake for a heart attack |
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