INTRODUCTION
The digestive tract normally contains gas (air), which is eliminated from the body through the mouth or through the anus:
- Belching is the term used to indicate the escape of air from the stomach through the mouth (popularly through a belch );
- Flatulence, on the other hand, is the term that indicates the expulsion of gas through the anus (popularly by means of a fart ).
Some conditions can cause the formation of more gas or make its presence more symptomatic (through a particularly swollen belly), even if the air is present in normal quantities, for example in subjects inclined to swallow a lot of air (suffering from aerophagia) or those who eat some specific foods defined at risk, not being used to them.
Generalizing it is, therefore, possible to count among the most common causes of swelling
- Accumulated gas, due to the impossibility of expelling it,
- Constipation,
- Aerophagia,
- Pathological conditions (such as celiac disease, food intolerances, irritable bowel syndrome, …).
However, an occasional presence of excess gas should not be a cause for concern, while if the symptom is present in a more or less systematic way (and perhaps accompanied by other disorders) it is advisable to consult a doctor.
CAUSES
It is normal for gas
- Enter the digestive tract by swallowing air,
- It is formed when the bacterial flora of the large intestine breaks down some undigested foods.
The gas can therefore increase if you swallow more air or if you consume certain foods and so the belly can appear swollen and sometimes painful.
Air swallowed
Everyone swallows small amounts of air when eating and drinking, but the magnitude can increase under some specific conditions:
- Chewing gum,
- Drinking carbonated or fizzy drinks,
- Eating or drinking too fast,
- Smoking,
- Sucking hard candy,
- Using suboptimal dentures.
The swallowed air that does not erupt enters the intestine and will later be expelled from the anus.
Intestinal bacteria
The stomach and small intestine do not fully digest some components of carbohydrates, especially some sugars, starches, and fibers. The undigested carbohydrates then enter the large intestine, where there are bacteria capable of carrying out some chemical fermentation transformations and thus generating a physiological quantity of gas which must then be disposed of.
Food and drinks cause bloating
There are several foods and drinks that can induce excessive gas production and consequent stomach and abdominal bloating:
Vegetables
- Asparagus
- Artichokes
- Beans and legumes in general
- Vegetables belonging to the brassicaceae, such as
- Cabbages
- Cauliflower
- Broccoli
- Brussels sprouts
- Mushrooms
- Onions.
Fruits
- Apples
- Peaches
- Pears
Cereals
Almost all cereals are consumed in the whole form, due to the fiber present.
Dairy products
- Cheese
- Ice-cream
- Yogurt
Drinks
- Apple juice
- Pear juice
- Carbonated drinks
- Drinks with high corn syrup content (rich in fructose)
- Fruit drinks (such as fruit punch)
- Milk
Conditions conducive to excess gas or symptoms
Some conditions can lead to greater production of gas, or to a greater symptomatology in their presence (for example swelling in the belly and/or abdominal pain ).
Among the situations most commonly linked to these disorders we remember:
Overgrowth of bacteria in the small intestine
This expression indicates both an abundance of bacteria and a variation in the type of bacteria present in the small intestine. These bacteria can produce excessive amounts of gas, as well as diarrhea and weight loss. Overgrowth of small intestine bacterial flora ( SIBO ) is almost always a complication of other conditions.
Irritable colon
Irritable bowel syndrome includes a group of symptoms, including abdominal pain or discomfort and changes in bowel function, which appear together. It can alter the movement of air along the digestive tract. A bloated sensation can also be caused by an increased sensitivity to normal amounts of gas.
Gastroesophageal reflux
Gastroesophageal reflux disease (GERD) is a chronic condition in which stomach contents flow back into the esophagus. A person with GERD may frequently resort to belching to relieve discomfort.
Intolerances and problems in the digestion of carbohydrates
Food intolerance can lead to bloating when:
- The intestines do not empty properly,
- The food present traps the gas,
- An excessive amount of gas is created.
The most common carbohydrate digestion problems that can induce excessive gas and bloat are:
- Lactose intolerance is a condition in which the person has digestive symptoms, such as bloating, diarrhea, and bloating, after eating or drinking dairy products.
- Fructose intolerance, a condition in which the person has digestive symptoms, such as bloating, diarrhea, and bloating, after eating fructose-containing foods.
- Celiac disease , an immune disorder that arises from intolerance to gluten, a protein found in wheat, rye, barley and some products such as lip balms and cosmetics. In people with celiac disease, gluten causes damage to the lining of the small intestine.
- Sensitivity to non-celiac gluten , a condition with numerous aspects still to be clarified and which nevertheless seems to be able to originate from a reaction (not immune, unlike celiac disease) developed towards gluten.
Gastroenteritis
Some stomach-intestinal tract infections, sometimes as trivial as typical winter intestinal flu can also cause swelling and pain, as can more serious conditions such as giardia infections.
Conditions that alter the movement of air along the digestive tract
Conditions that alter the movement of air along the digestive tract can cause problems with bloating and bloating. These conditions include voiding syndrome (also known as dumping syndrome), abdominal adhesions, abdominal hernias, and situations that cause intestinal obstructions, such as colon or ovarian cancer.
SYMPTOMS
A swollen belly is often associated with:
- Burps,
- Flatulence,
- Abdominal bloating,
- Abdominal pain, cramps or discomfort.
More specifically, the symptoms vary from person to person, also as regards the extent to which they occur, but it should be noted that:
Burping from time to time, especially during and after meals, is normal. In the case of very frequent episodes, it is possible that too much air is swallowed and re-emitted before it enters the stomach.
Flatulence: According to authoritative sources ( MSD manual ) the anal emission of air from 13 to 21 times a day is often completely normal, however it should be noted that the expelled gas may contain small quantities of sulfur, but tends to be higher the concentration and more the smell will be unpleasant.
In the event of problems, however, the following may arise:
- Swelling. Abdominal bloating is a feeling of fullness or expansion in the abdomen. It occurs most often during or after meals.
- Abdominal pain or discomfort. These symptoms can be felt when air does not move normally along the intestine.
When to contact your doctor
There are no guidelines that define the frequency or normal volume of flatulence, as well as the extent to define swelling as pathological; it is advisable to consult your doctor if:
- The symptoms are a source of annoyance,
- The emission of gas is constantly associated with a particularly unpleasant odor,
- Symptoms change suddenly,
- There are other associated symptoms, such as
- Constipation ,
- Diarrhea (or alteration between these first two symptoms),
- Persistent abdominal pain,
- Bowel incontinence ,
- Blood in the stool ,
- Unexplained weight loss.
DIAGNOSIS
Doctors can identify the causes of a swollen belly with a history and physical examination.
It can also resort to instrumental tests in case of suspected associated conditions.
Anamnesis
For the medical history, the doctor will want to know:
- Symptoms
- Eating habits,
- Drugs (prescribed or self-medicated),
- Current and past medical conditions.
The doctor may possibly have a diary compiled in which the subject must note the composition of the meals and the possible onset of symptoms. The diary could highlight the foods that cause the gas. Checking the diary can also be used to find out if the subject has a greater production or rather a greater sensitivity to normal quantities of gas.
Physical examination
- During the physical examination, doctors typically:
- Check for swelling or distension of the abdomen,
- Listen to abdominal sounds with a stethoscope,
- Palpate the abdomen to check for pain or tenderness.