Persistent flatulence may be gas or illness;  See tips

Persistent flatulence may be gas or illness; See tips

In my gastroenterology clinic, every week I see patients who complain that their clothes are too tight, and their stomach feels tight.

“It feels like I am 30 weeks pregnant,” which is something patients ranging from 65-year-old men to 20-year-old women often tell me.

So it’s no surprise that all of these patients experience bloating – an unpleasant feeling of pressure in the stomach estimated to affect 1 in 5 adults. (A distinct but related phenomenon called bloating describes the visible increase in abdominal circumference that often accompanies the problem.)

But understanding why the swelling occurs and treating it can be a challenge for both patients and doctors. “People think, ‘Oh, it’s just bloating,’ and the problem is often underestimated or considered unimportant,” said Kimberly Harrer, M.D., a gastroenterologist, an expert in gut motility at the University of Michigan Health in the US.

For most people, swelling and puffiness go away after a short period of time. But some people are more likely than others to develop a tumor.

People with certain medical conditions — such as lactose intolerance, celiac disease, or disorders that affect the way the intestines transport contents throughout the body (such as gastroparesis) — often experience bloating from excess gas.

If you don’t have these conditions but the swelling has persisted for several months, you likely have something called functional swelling. Conditions such as irritable bowel syndrome and chronic idiopathic constipation fall into this category. In these cases, medical examinations usually give normal results, but swelling is an important and frequent symptom that hinders daily life.

These bloating conditions often occur not because of too much gas production, but because of the way the abdomen reacts to it. “When bloating occurs, a lot of the problem is with body mechanics,” said Linda Nguyen, M.D., gastroenterologist, clinical professor of medicine at Stanford Medicine (USA).

Abnormal muscle movements — and the associated swelling — can occur when the nerves in the intestine and abdominal wall overreact with normal levels of pressure coming from inside the intestine. It is called visceral hypersensitivity.

Thus, even small amounts of gas produced by normal digestion can cause discomfort and bloating.

Experts often recommend that patients first seek to identify and then eliminate anything from their diet or lifestyle that may be causing the swelling. Some foods are traditional bloating triggers, especially foods rich in insoluble fiber such as cruciferous vegetables, lentils, and beans.

Other common triggers include fermented drinks such as beer and kombucha, artificial sweeteners sucralose, onions, and fruit. Sometimes, behaviors such as drinking soda, chewing gum, or smoking can increase the risk of bloating by increasing the amount of air you swallow.

With so many potential triggers, it can be difficult or even harmful to try eliminating problem foods on your own. Therefore, Harrier said, the recommendation is to seek guidance from a dietitian.

In some cases, treating the underlying cause of the swelling may require more than just adjusting your eating and lifestyle habits. Patients with gastroparesis or severe constipation may benefit from a medication called prucalopride, which helps empty the stomach and expel waste. (Experts do not recommend home interventions to empty the colon, such as colonic irrigation, due to the risk of causing trauma or injury to the gastrointestinal tract.)

Some causes of bloating are not directly related to the intestines. According to Harir, some patients who snore or use CPAP (continuous positive airway pressure) devices to combat sleep apnea, for example, may experience additional swelling upon waking in the morning.

Patients with liver disease may experience flatulence. Menstruation and some types of contraceptives can increase bloating.

Harrer emphasized that no one should feel embarrassed or embarrassed about changes in the abdominal area. “Patients should feel free to discuss the swelling with their doctors and get the help they need.”

Translated by Clara Allen

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