Where do gases come from?
The main sources of gases are swallowed air and fermentation of undigested carbohydrates in the colon. More gas is formed when a lot of poorly absorbed carbohydrates enter the intestine: from legumes, cabbage, onions, apples, sweeteners. Slow movement of contents during constipation increases fermentation. In irritable bowel syndrome, normal amounts of gas are felt as severe bloating due to increased sensitivity.
- Swallowing air - fast food, chewing gum, talking while eating, soda
- Foods rich in fermentable carbohydrates (FODMAPs)
- Lactase deficiency and fructose intolerance
- Constipation and immobility
- Irritable bowel syndrome and SIBO
Diseases that cause flatulence
Bloating can accompany diseases in which the digestion or absorption of food is impaired, as well as conditions with slow intestinal motility. In such cases, there are usually other symptoms - changes in stool, pain, weight loss.
- Celiac disease
- Chronic pancreatitis with enzyme deficiency
- Inflammatory bowel diseases
- Gastroparesis, including diabetes mellitus
- Hypothyroidism
- Tumors of the intestines and ovaries
Symptoms
Typically, bloating increases in the evening and after eating, and decreases in the morning. If the abdomen constantly increases and does not decrease even after an overnight rest, it is necessary to exclude the accumulation of fluid in the abdominal cavity and space-occupying formations.
- Feeling of fullness and heaviness in the abdomen
- Visible abdominal enlargement
- Rumbling, frequent passing of gas
- Belching
- Cramping pain that goes away after passing gas
Diagnostics
The doctor clarifies whether the complaints are related to certain foods, how the stool has changed, and whether there are any warning signs. It is useful to keep a food diary for 1-2 weeks. The minimum examination includes blood and stool tests and an abdominal ultrasound. Depending on the results, a hydrogen breath test, tests for celiac disease, gastroscopy or colonoscopy are prescribed.
- Complete blood count, biochemistry, TSH
- Coprogram, calprotectin, stool test for parasites
- Ultrasound of the abdominal cavity and pelvis
- Hydrogen breath tests with lactose, fructose, lactulose
- Gastroscopy and colonoscopy according to indications
Treatment and prevention
Treatment is aimed at the cause: for lactase deficiency, lactose is limited, for SIBO, a course of antibiotics is prescribed, and for constipation, stools are normalized. For functional bloating, a diet restricting fermentable carbohydrates (low-FODMAP) is effective, which is best done under the supervision of a doctor or nutritionist. Drugs based on simethicone and antispasmodics alleviate the symptoms, but do not eliminate the cause. Regular physical activity improves the movement of gases through the intestines.
- Eat slowly and chew food thoroughly
- Limit carbonated drinks, chewing gum and sweeteners
- Introduce legumes and cabbage gradually, in small quantities
- Move more, especially after eating
- Do not go to bed immediately after eating a large meal
