Content

Introduction

The term meteorism it is used to indicate the excessive presence of gas in the gastrointestinal tract. It manifests itself with abdominal swelling, a widespread disorder in the population of all ages. It is an annoying sensation of fullness and tension, extended to the whole abdomen or limited to part of it, sometimes associated with a visible increase in abdominal circumference.

The swelling may be accompanied by abdominal pain and cramps, in mild or severe form, belching and flatulence.

The production of gas in the gastrointestinal tract is the natural result of the digestion process. It is, therefore, a completely normal phenomenon. The gas derives mainly from the "ingestion of air, during the swallowing of food and drinks, and from the fermentation of some foods by the" good bacteria "(intestinal bacterial flora) present in the intestine.

Under normal conditions, most of the gas is absorbed by the intestinal walls and circulated in the blood, only to be eliminated by breathing. Any excess gas is expelled from the mouth, with belching, or through the anus.

The problems of meteorism and abdominal bloating arise when, for various reasons, the gas becomes trapped or does not move properly along the gastrointestinal tract, exceeding the normal quantities or those tolerated by each.

Generally, the overproduction of gas depends on the type of food consumed or wrong eating habits.Simple changes in the diet and the adoption of a correct lifestyle, normally allow to keep the disorders under control. Sometimes, however, meteorism indicates the presence of a health problem, even a serious one, on which it is necessary to investigate and intervene with proper care.

Symptoms

Bloating occurs with abdominal bloating, sometimes accompanied by one or more of the following disorders (symptoms):

  • abdominal pain, cramps or spasms
  • excessive emission of gas from the mouth (belching) or from the anus (flatulence)
  • visible increase in the circumference of the abdomen (abdominal distension)

The ways in which the disorders manifest themselves are extremely varied. They can occur alone or in association with each other, with a frequency and intensity related to the characteristics of the individual and their sensitivity to gas.

Several studies show that even normal amounts of gas can cause abdominal discomfort and discomfort in people with above average sensitivity to pain and bowel movements. This is the case, for example, of those suffering from anxiety or irritable bowel syndrome.

When to see your doctor

In general good health, abdominal bloating and other gas-related ailments, while annoying and embarrassing, need not cause concern. Their presence is a sign of normal intestinal activity and does not require a medical evaluation.

If the disturbances become persistent or intolerable, interfering with the quality of daily life, the family doctor can suggest the necessary measures to reduce their occurrence, or, if appropriate, refer to a gastroenterologist specialist.

Normally, correcting your eating habits and lifestyle is enough to get good results.

Consultation with the doctor is of fundamental importance in the event that the disorders were to be accompanied by:

  • presence of blood in the stool
  • change in stool consistency
  • fecal incontinence
  • unintentional weight loss
  • severe constipation or persistent diarrhea
  • repeated episodes of nausea and vomiting

These disorders (symptoms) may indicate the presence of a health problem, which requires further investigation.

Instead, it is essential to go to the nearest emergency room in case of prolonged chest pain or abdominal pain, as immediate medical intervention may be necessary.

Causes

Meteorism can have multiple causes. In most cases it originates from factors related to nutrition, but, if associated with other signs and disorders (symptoms), it can be the alarm signal of some gastrointestinal diseases or other diseases of varying severity.

The accumulation of gas in the upper part of the abdomen can depend on an excessive ingestion of air (sometimes caused by particular emotional states), from overeating, from smoking or from the habit of chewing gum. The overproduction of gas in the lower abdomen may be due to the "intake of foods that contain gas or promote its formation, the inability to completely digest some foods or an altered balance of bacteria that are normally present in the intestinal tract. called "colon".

Foods that produce gas

Foods that induce the formation of gas in one person do not necessarily cause the same effect in another. However, some foods produce gas, in all indiscriminately, due to their same composition.These are foods containing certain classes of carbohydrates, such as insoluble fibers or certain types of sugars (oligosaccharides, disaccharides, monosaccharides and fermentable polyols), which are not easily absorbed in the "small intestine and pass almost intact (undigested) in the" large intestine ( colon). Once they enter the colon they are subject to fermentation by the intestinal bacterial flora, which decomposes them producing gas.

The foods that, in some cases, are the main ones responsible for the production of gas are:

  • beans and legumes in general
  • fruit
  • vegetables
  • Whole grains
  • sweets and foods rich in simple sugars

Other factors related to nutrition

The accumulation of gas can also depend on:

  • carbonated drinks, for example, beer can increase the volume of stomach gas because it is made effervescent with the addition of carbon dioxide
  • some eating habitseating hastily meals, drinking through a straw, chewing gum, sucking on candy, and talking while eating, increase the amount of air ingested
  • fiber supplements, some supplements based on psyllium and whole bran, used to combat constipation, can contribute to the production of intestinal gas
  • artificial sweeteners, sorbitol, mannitol and xylitol (fermentable polyols), contained in dietary foods and drinks, can cause the formation of excess gas in the colon

Medical conditions

The problems of abdominal bloating and meteorism can depend on numerous medical conditions, of varying severity, including:

  • chronic inflammatory bowel diseases, excess gas may be present in chronic inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease
  • irritable bowel syndrome, changes in intestinal mobility and excessive sensitivity (hypersensitivity) of the intestine, typical of this medical condition, can cause cramps and abdominal swelling even with the passage of minimal amounts of gas
  • excessive growth of intestinal bacteria or alterations in the balance between the different types (intestinal dysbiosis), the alteration of the intestinal flora, in terms of the number or type of bacteria that normally colonize the intestine, can cause the overproduction of gas, diarrhea and weight loss. The main causes of intestinal flora imbalance are: frequent or excessive use of antibiotics, intestinal infections and prolonged stress
  • food intolerance, the excessive production of gas may depend on the inability to digest and absorb some foods, such as the sugar contained in milk and dairy products (lactose) or proteins such as gluten, present in wheat, barley and rye
  • constipation (constipation, constipation), the difficulty in evacuating the intestine can prevent the "elimination of gas from the anus. Furthermore, by increasing the stagnation time of the stool inside the intestine, the bacterial fermentation of food residues increases with consequent overproduction of gas.
  • intestinal obstruction, abdominal swelling comes on abruptly and is associated with disorders (symptoms) such as inability to pass air and / or stool, nausea and vomiting. In the presence of these disorders, it is necessary to contact the treating doctor immediately and, if not available, to the emergency room
  • ileus, the swelling is secondary to a reduced propulsive activity of the intestine which may depend on various causes such as:
    • changes in blood electrolytes (decrease in potassium concentration, increase in blood calcium concentration)
    • abdominal surgery
    • diabetes
    • impaired functioning of the thyroid gland (hypothyroidism)
    • use of drugs (opiates)
    • diseases already ascertained (diagnosed) and for which you are under medical supervision

Diagnosis

To ascertain (diagnose) the causes of abdominal swelling, the family doctor usually inquires about the person's health over time (medical history) by asking questions about:

  • eating habits
  • any medications taken
  • present and past illnesses
  • type of disorders (symptoms) present

The compilation of a food diary, in which to write every day the composition of meals and the possible appearance of disorders (symptoms), could help the doctor to understand if the swelling depends on the "intake of certain foods or on a greater sensitivity of the" bowel to gas.

After having collected the information on the state of health and eating habits, the doctor usually performs the examination (physical examination), palpates the abdomen with his hands and listens to the movements of the intestine with a stethoscope. The physical examination allows the doctor to check for pain, tenderness and tension and to check the functioning of the gastrointestinal tract.

If the doctor suspects the presence of a disease associated with meteorism, he will prescribe further tests and possibly a gastroenterological visit. If not, it provides advice on eating choices and habits that will help improve the ailments (symptoms).

Therapy

If bloating is caused by another health problem, the disease causing it must be treated. In the absence of associated diseases, meteorism is combated by correcting dietary habits and lifestyle and / or with natural or pharmacological remedies.

There is no one-size-fits-all solution. Much depends on the response of each to the changes introduced in the diet and the remedies used but, with the appropriate adjustments, it is possible to identify the most suitable strategy to eliminate the disorders or, at least, contain them.

Food advice

Dietary changes can help reduce the amount of gas produced or eliminate excess gas by facilitating its passage into the gastrointestinal tract.

The compilation of a daily diary in which to note the foods and drinks consumed and any disorders (symptoms) associated with their intake, will help to understand which changes to make to the diet, which foods to eliminate and which to consume in small quantities:

  • reducing the amount or frequency of consumption of foods higher in insoluble fiber, such as:
    • beans and legumes in general
    • onions
    • broccoli
    • Brussels sprouts
    • cabbages
    • cauliflower
    • artichokes
    • asparagus
    • pears
    • apples
    • peaches
    • plums
    • wholemeal flour
    • rye
  • reduction in the consumption of some foods containing some sugars (oligosaccharides, disaccharides, monosaccharides and fermentable polyols such as:
    • milk and dairy products, reducing the consumption of milk and its derivatives with a higher lactose content, such as fresh cheese and ice cream, can help relieve disorders (symptoms) especially in subjects with lactose intolerance (sugar contained in milk). In these cases, you can eat lactose-free products (delactosed) or products with a particular enzyme, lactase, which facilitates digestion.
    • artificial sweeteners, Eliminate or cut down on artificial sweeteners and products that contain them, such as chewing gum and sugar-free diet drinks or foods
  • reducing the consumption of foods or beverages that can slow down the digestive process such as:
    • fried or high-fat foods, the fat present in food slows down digestion and increases fermentation. Eliminating fried foods, or foods containing large amounts of fat, can reduce ailments
    • foods rich in air, we must reduce the consumption of foods and drinks that incorporate air, such as highly leavened foods, whipped cream, milkshakes and fruit smoothies
    • carbonated drinks, we must avoid or, at least, limit the consumption of carbonated drinks, as they release carbon dioxide
    • fiber supplements, some fiber supplements can make ailments worse. Before taking them, therefore, it is advisable to consult your doctor
  • increased consumption of:
    • water, it is It is important to maintain good hydration as fluids facilitate intestinal transit and prevent constipation (constipation).
    • herbal teas based on fennel and anise, the use, at the end of a meal, of herbal teas and decoctions based on carminative plants, such as fennel and anise, which limit intestinal fermentation and promote the expulsion of gas, can contribute to the improvement of ailments.

Exclusion diet

The elimination of entire food groups can deprive the body of the nutrients necessary for its healthy functioning and, on the other hand, fibers are necessary to ensure correct intestinal transit and regulate the levels of sugar and cholesterol in the blood.

To identify the foods towards which a greater individual sensitivity is manifested, on the advice of the gastroenterologist doctor and with the supervision of the nutritionist, an exclusion diet can be used.

The diet provides for the elimination of one food at a time for a period of at least two weeks, sufficient to determine the improvement of the disorders (symptoms). After the foreseen time has elapsed, the excluded food can be gradually reintroduced and it will be possible to move on to elimination. of another food.

The doctor can, therefore, develop a food plan aimed at controlling disorders (symptoms) that ensures, at the same time, the right amount of fiber.

Hygienic-food advice

  • reduce portions, many foods that increase gas production contain the nutrients required by a healthy and balanced diet. Instead of eliminating them altogether, it is advisable to consume them in moderate quantities to see if the body is able to tolerate them. It is therefore recommended to consume small frequent meals rather than a few large meals, which, moreover, slow down digestion
  • eat meals without rushing, to promote digestive processes: it is important to chew long and slowly, avoiding swallowing bites without chewing
  • avoid chewing gum, candies and the use of straws to drink, all these activities facilitate the ingestion of air
  • concheck the state of the dental prostheses, slow or inadequate prostheses can cause "increased salivation and, therefore, the ingestion of air bubbles contained in the saliva
  • not smoking, when you inhale smoke you also inhale air
  • physical activity, practicing regular physical activity, even moderate but constant, such as a short walk after meals, promotes intestinal transit, reducing the risk of constipation (constipation) which hinders the release of gas from the anus

In case of flatulence with an unpleasant smell, just limit foods with a high sulfur content, such as:

  • broccoli
  • Brussels sprouts
  • cabbages
  • cauliflower
  • beer
  • high protein foods

Natural or pharmacological remedies

In some cases the disturbances (symptoms) caused by meteorism can be reduced by taking, with the prior consent of the doctor, the following remedies:

  • Supplements based on digestive enzymes
    • alpha-galactosidase it is an enzyme absent in our body which is essential for digesting complex carbohydrates, contained in legumes, cereals, fruit and vegetables. Its intake before meals favors the digestion of foods containing carbohydrates, otherwise subject to bacterial fermentation.The use of this enzyme is not recommended in children under 12 years of age
    • beta galactosidase (or lactase), is an enzyme which, taken before meals, allows people intolerant to it to digest lactose, the sugar present in milk and its derivatives. During pregnancy and breastfeeding, lactase should only be used after consulting a doctor
  • simethicone, antifoam drug that can be purchased without a prescription, capable of breaking gas bubbles and making them easily eliminated. It can also be administered in infancy, however there is no scientific evidence of its effectiveness in reducing disorders
  • charcoal (or activated carbon), a natural remedy used before and after meals for its ability to trap gas. However, there is no scientific evidence that can confirm its beneficial effects. In addition, charcoal can limit the absorption of drugs and nutrients, as well as stain the inside of the mouth and clothes

If meteorism is associated with an imbalance of the bacterial flora, the doctor could prescribe a specific antibiotic therapy based on antibiotics, such as rifaximin, which are non-absorbable and, therefore, with reduced side effects, able to rebalance the intestinal flora.

Bibliography

Mayo Clinic. Gas and gas pains (English)

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