Flatulence

Introduction Gastrointestinal bloating is caused by a variety of reasons, the gastrointestinal tract is not smooth or obstructed, the gas of the gastrointestinal tract can not be excreted with the gastrointestinal motility, accumulated in the gastrointestinal tract called abdominal bloating. Gastrointestinal bloating can be functional or organic. Such as intestinal irritable syndrome, stomach caused by mild phlegm, bloating of the gastrointestinal tract, for functional bloating. Most of the pyloric obstruction and intestinal obstruction are organic bloating. Gastrointestinal bloating often coincides with constipation. Generally speaking, abdominal distension has abdominal bulging.

Cause

Classification of causes of flatulence:

First, the gastrointestinal tract is not smooth

(1) Upper gastrointestinal disorders

1, acute gastric dilatation

2, slow gastric emptying or stomach cramps

3, pyloric obstruction caused by various reasons

(1) Peptic ulcers: such as duodenal ulcer, gastric antrum and pyloric canal ulcer.

(2) benign and malignant tumors of the gastric antrum or duodenum.

(3) Inflammatory diseases.

(4) Congenital diseases: such as adult hypertrophic pyloric stenosis. Pyloric septum, duodenal septum, etc.

4. Anastomotic stenosis after gastrectomy

5, duodenal stasis

(2) Lower digestive tract diseases

1, intestinal obstruction

(1) Mechanical intestinal obstruction: such as intestinal adhesion, intussusception, inflammatory bowel disease, intestinal tuberculosis, intestinal tumor, intestinal mites, fecal stone or foreign body congenital intestinal atresia.

(2) Dynamic intestinal obstruction: such as paralytic ileus, spastic intestinal obstruction.

(3) vascular intestinal obstruction.

2, digestive tract malabsorption syndrome

3, intestinal irritable syndrome

Second, liver, gallbladder, pancreatic diseases

1. Liver such as hepatitis and liver tumors.

2, gallbladder disease cholelithiasis, gallbladder tumors and so on.

3. Pancreatic disorders, acute pancreatitis, chronic pancreatitis, pancreatic cysts, pancreatic tumors, annular pancreas, etc.

Third, systemic diseases

1. Toxic intestinal paralysis caused by acute infection

2, electrolyte imbalance

IV. Gastrointestinal bloating caused by other causes

1, eating too fast

2, rickets

3, endoscopic examination of excessive gas injection

4, taking too much gas or drugs

mechanism

First, the composition and source of gas in the gastrointestinal tract

(1) The source of gas in the gastrointestinal tract

1. The gas under swallowing accounts for 60%-70%.

2, the gas produced in the gastrointestinal tract accounts for 30% to 40%, and the food is fermented by the bacteria in the intestine to produce gas.

(B) the composition of the gas in the gastrointestinal tract

Gastric components in the gastrointestinal tract vary widely, depending on the amount of gas, the composition of the food, and the type of bacteria. The main gases are:

1. Oxygen enters the stomach and intestines by swallowing action. Eating a liquid diet is more powerful than eating solid foods. Since oxygen can be quickly absorbed by the gastrointestinal membrane, the oxygen content of the gastro-intestinal gas is less than that in the air. Oxygen content.

2. Nitrogen In theory, nitrogen can diffuse human intestinal lumen from blood, and bacterial fermentation can also be produced, but the nitrogen in the gastrointestinal tract is mainly derived from the air of the pharynx.

3. There are three sources of carbon dioxide in the intestinal tract of carbon dioxide: 1 When the partial pressure of carbon dioxide in the blood is larger than that in the intestinal lumen, the carbon dioxide in the blood is dispersed into the intestinal lumen; 2 when the bicarbonate secreted by the upper digestive tract is mixed with gastric acid; Bacterial glycolysis.

4. When hydrogen is normal, hydrogen is only produced in the colon, and non-absorbed carbohydrates and unabsorbed proteins are produced by bacterial glycolysis. When there is poor digestion and absorption, a large amount of hydrogen can be produced in the small intestine.

5. Methane is produced by special anaerobic bacteria in the colon. The gas in the intestines is methane-like, and there are about seven methane in the intestines. The gas in the intestines is present in the intestines a few weeks after birth, and reaches the human level at 8-9 years old.

Second, the direction of gas in the gastrointestinal tract

Gas in the gastrointestinal tract is mainly excreted from the stomach through the mouth, or descending through the anus. Part of the intestinal wall diffuses human blood and is exhaled through the lungs. When the source of the gastrointestinal gas is greater than the outward direction, the gas accumulates in the gastrointestinal tract, causing bloating. For example, when the electrolyte is disordered, the muscle tension of the stomach wall is weakened, and the gas discharge in the gastrointestinal tract is unfavorable. Diabetes involving the gastrointestinal nerve causes the "gastric phlegm" to cause bloating.

an examination

Related inspection

Determination of carcinoembryonic antigen (CEA) by gastric tract cholangiography

Diagnosis of flatulence:

First, medical history

Pay attention to whether the patient has a history of ulcers and whether there has been a history of abdominal surgery in the past. Pay attention to the onset of illness, the speed of progress, the location where bloating begins to appear, whether there is nausea, vomiting, diarrhea, constipation and other medical history. Diabetes in the medical history pays attention to stomach phlegm, fever, night sweats, cough, abdominal distension should pay attention to intestinal tuberculosis. Second, physical examination

Generally speaking, abdominal distension has abdominal bulging. The bulging limited to the upper abdomen is mostly caused by gas accumulation in the stomach or transverse colon. Intestinal bloating in the small intestine can be limited to the mid-abdomen, or it can be a full abdominal bulging. Colonic bloating can be limited to the lower abdomen or the lower left abdomen. When the pyloric obstruction occurs, the upper abdomen may have a stomach type and a peristaltic wave, and the intestinal type and intestinal peristaltic wave may be seen when the intestinal obstruction occurs, and the bowel sounds are hyperthyroidized or weakened. Patients with peritonitis may have tenderness and muscle tension.

Third, laboratory inspection

1. Fecal examination: routine examination has diagnostic significance for intestinal inflammation and intestinal parasitic diseases. Sustained occult blood is often positive for gastrointestinal tumors.

2, liver function test: Diagnostic value for acute and chronic hepatitis.

3, duodenal drainage: collection of bile for routine examination and culture, the diagnosis of biliary infection has diagnostic value.

4, pancreatic function test: pancreatic exocrine function test, blood, urine amylase determination, lipase determination, increased values often reflect pancreatic inflammation.

5, small intestine absorption function test: can check the fat content of feces D-xylose absorption and excretion test, vitamin B12 absorption test.

Fourth, equipment inspection

(1) X-ray examination

1, abdominal plain film: pyloric obstruction, acute gastric dilatation of the abdominal plain film can show a huge stomach and liquid level. The intestinal level can be seen in the liquid level, the upper end of the obstruction is dilated, and the small intestine obstruction can be seen in the plane of the ladder. The megacolon intestinal tube significantly broadens the gas accumulation.

2, barium meal angiography: pylorus and intestinal obstruction is completely banned, incomplete obstruction can be used cautiously in the case of gastrointestinal decompression. Used to understand the location of obstruction.

3, barium enema: mainly used for the examination of colonic lesions.

(two) laparoscopy

Gastrointestinal bloating should be classified as a contraindication.

(3) B-mode ultrasound and CT examination

Mainly used to understand the morphological changes of the liver, gallbladder, pancreas.

Differential diagnosis

Differential diagnosis of bloating:

Intestinal flatulence is very common in the clinic, often manifested as hernia, abdominal distension, abdominal pain and loss of gas (fart). Abdominal percussion has a buzzing sound, generally can be exhausted, defecation, only when there is an intestinal obstruction caused by abdominal distension, will stop the exhaust, defecation.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.