Abdominal air is normal, but can be unpleasant and highly embarrassing sometimes.
Flatulence: a taboo subject
You just don’t talk about some things, such as flatulence. Even at the doctor, it is better to avoid it – understandable, but of course wrong. If you are constantly plagued by a bloated belly, feeling of fullness and rumbling in the intestine, or if you have the impression that something is wrong with your stomach, a visit to your health care provider should definitely be your best option.
There is mostly nothing to worry about bloating. Often it is just a nutritional problem that can be managed with a few adjustments (see chapter “Self-help, therapy ” in this article).
Sometimes there is a Food Intolerance
Sometimes, there can also be real food intolerance behind a bloated belly: intolerance to fructose or intestinal fructose malabsorption, milk sugar (lactose intolerance), or gluten (celiac disease, see below). It is common to feel bloated when you have other complaints such as abdominal pain and irregular bowel movements, especially diarrhea.
One of the most common pathological causes of bloating is irritable bowel syndrome. You can find more information about this below.
Inflation or More?
If the intestine cramps, it can “pinch” the air at its curvatures on the right and left of the abdomen. The consequences include hyperinflation, clothing becomes tight, stomach ache, and violent rumbling.
The trapping of air can have many reasons. But it is often due to the gas being retained and severe constipation. In rare occasions, it happens during the narrowing of the intestine due to scars, inflammation, or a tumor behind it. It can also be caused by the irritable bowel already mentioned above.
Alternatively, if the pain is more to the right in the upper abdomen, under the diaphragm, you will suspect biliary colic. Cramp-like pain on the left side can also suggest a heart attack. The impression of a heart attack sometimes underlines other complaints such as shortness of breath, tightness of the heart, stumbling in the heart, and chest pain, which are by no means rare in the case of hyperinflation. Even sweating and dizziness are possible. The dysfunction even has a name: Roemheld Syndrome. Let your doctor rule out that there isn’t another disease.
In an extreme case, acute hyperinflation can indicate an intestinal obstruction or an intestinal paralysis. Air is increasingly present here, but like most of the parts, it is blocked. Both can be accompanied by severe abdominal pain for various reasons. These are emergencies, but they occur much less frequently than other symptoms like severe constipation. Although it can resemble a paralysis of the intestine, the doctor will usually not consider this a really serious emergency.
Where Does the Air in the Stomach Come From?
It is quite natural that more air is produced in the intestine after eating bloating food. Often, however, the digestive problems are also a bit of a matter of the head. When time is short, stress and nervousness or out of habit, some people eat too hastily and swallow a lot of air (aerophagy). This can then be felt as a feeling of fullness in the stomach or leaves it by belching. With this, only a small part reaches the lower levels of the digestive tract.
The majority of the intestinal gases arise during digestion itself, such as carbon dioxide (CO 2) from the neutralization of stomach acid and fatty acids in the intestine. Fatty acids come from food fats. They also occur together with CO 2 when sugar compounds (carbohydrates) enter the large intestine undigested and are fermented by bacteria. This happens in the case of the intolerance to milk sugar, but it can also be related to a high-fiber diet, which is why it is important to increase fiber slowly.
Part of the resulting CO 2, which is odorless, reaches the lungs via the blood and is exhaled. The rest of the intestinal air – a mix of CO 2, hydrogen, nitrogen, methane, plus ammonia, sulfur, and other fermentation products (odor components!) – moves through even the narrowest spaces in the intestine. The gases pass through it in about half an hour. For comparison: solid food needs a day.
Last but not least, certain dishes are often to blame for a feeling of fullness after eating, pinching in the stomach or flatulence. Some of them are unhealthy sweet and fat and those in the “Diet”, “Light” or “Ready & Fast” categories. This means ready-made foods that contain flavor carriers such as milk sugar, sorbitol as a sugar substitute, or fructose (fructose) as a sweetener.
The ingredients cause stomach problems for many people. The simple sugar fructose occurs naturally in many fruits. However, experts warn of an oversupply due to its increasing presence in food. There is evidence that fructose has an adverse effect on metabolism. Nevertheless, you shouldn’t do without fruit in healthy quantities!
Bloated Stomach: When to See a Doctor?
Flatulence is mostly harmless and depends on the diet. If no explanation can be found, the bloating is unusually strong and uncomfortable, it is important to research the cause. Even more so if there are other complaints, such as abdominal pain, repeated or persistent chest pain, irregular stools, blood on the stool.
The first step is to talk to a practitioner. It is about personal living habits, as far as they concern health and current complaints. All cards must be on the table, even if it is sometimes embarrassing. Then there is a physical exam. More on this in the chapters ” Diagnosis ” and “Causes”.
What You can Do about Flatulence?
Flatulence is undoubtedly annoying but therapy is usually not necessary. First countermeasure: check your lifestyle. A few changes can work wonders, such as not eating foods that are very fat or intolerable. Instead of fewer, perhaps too rich meals, we recommend several small, easily digestible servings a day. This as well as regular outdoor exercise noticeably relieves the strain on the intestine. More tips in the chapter “Self-help, therapy”.
Various medicinal plants, such as fennel tea, peppermint, anise, and caraway, can help the intestine (carminative effect) and have an antispasmodic effect.
If severe stress has hit the stomach or intestines, one starting point is to question the personal situation, to set other priorities, and to temporarily put aside less important things. Psychological therapy may have a stabilizing effect in the short term or a relaxation procedure like meditation.
If flatulence is based on a certain disease, your doctor will initiate appropriate therapy.
Flatulence, The Feeling of Fullness: Causes at a Glance
Pregnancy, early baby
- Pregnancy: Under the influence of the changing hormones in pregnancy, many women are plagued by constipation and gas. Because the increased progesterone levels relax organs like the intestine, it becomes sluggish. Food can be used even better this way, but at the same time gas formation in the intestine increases. Later it gets tight in the stomach, which usually exacerbates the problems.
- Infancy: Infants are more likely to experience hyperinflation in the first few months of life. The air in the stomach may also play a role in the three-month colic. This usually results in crying attacks that are extremely stressful for both the baby and the parents. After weeks of adjustment, the difficulties are over. Often it is because the intestines are still getting used to the work and don’t have the right bacteria established yet.
- Medications: For the side effect of flatulence, active ingredients such as acarbose or miglitol to lower elevated blood sugar in type 2 diabetes, some penicillin-containing antibiotics, anti-inflammatory drugs such as the drug diclofenac, then lactulose and other laxatives are known.
- Psychological factors: Anxiety and stress can trigger various gastrointestinal complaints. Affected people sometimes eat too quickly and swallow too much air (aerophagy). Of course, this can also happen out of habit. Relaxation therapy or nutritional advice may help.
Too much gas in the gut
- Diet rich in fiber with a high proportion of soluble fiber, which is mainly found in fruits, various vegetables, and carbonated drinks
- Intolerance to fruit sugar ( fructose intolerance or intestinal fructose malabsorption) or milk sugar (lactose intolerance)
- Celiac disease (gluten-sensitive enteropathy): intolerance to gliadin, a component of the gluten protein in most cereals. There are also diseases similar to celiac disease, such as allergies or hypersensitivity to wheat.
- Sugar substitutes such as sorbitol: Sorbitol is found in many diet and light products
- Chronic pancreatitis: If the pancreas is damaged, it does not produce enough digestive enzymes, among other things. There are pronounced digestion problems (maldigestion). Sometimes this is also the result of cystic fibrosis; it can affect the digestive function of the pancreas at an early stage.
- Bacterial colonization in the intestine (SIBO): Bacteria from the large intestine colonize the small intestine, where they really don’t belong. There they interfere with fat digestion, among other things. The consequences: fat stools, bloating, abdominal pain.
- Short bowel syndrome: complex indigestion after removal of a section of the small intestine. Among other things, intestinal gases are increasing.
- Giardiasis: The small intestine parasite Giardia lamblia is native to the tropics and subtropics. Among other things, the infection can lead to bowel problems with abdominal pain, diarrhea, and flatulence.
- Treatment with antibiotics: Antibiotics can impair the natural intestinal flora. If certain bacteria gain the upper hand, this can increase the exposure to intestinal gases and lead to bloating and diarrhea.
- Supplements sometimes cause flatulence depending on the composition and performance of the digestion.
Too little gas leaves the intestine through the blood (impaired gas absorption)
- Portal hypertension (portal hypertension): The portal vein transports the nutrient-rich blood to the liver. Blood builds up if there is high pressure in this area. There are various, mostly serious reasons for this and it also affects digestion. There is a feeling of fullness, bloating, and loss of appetite. One of the causes is liver disease.
- Heart failure: If the right ventricle is weakened (right heart failure) or the heart as a whole (heart failure), venous blood, which is supposed to flow to the heart, can sometimes build up back into the liver. It then hardens and portal hypertension can occur (see the previous section).
Stomach or bowel movements are disturbed (chronic or acute motility disorder)
- Irritable bowel syndrome: Irritable bowel syndrome is one of the most common causes of bloating symptoms. The movement pattern of the intestine is chronically disturbed here, and it reacts more and more painfully to normal air content. Irritable bowel movements often result in irregular bowel movements – diarrhea, constipation, or both.
- Gastric paralysis (gastroparesis, gastric atony): Muscle activity in the stomach wall can be weakened or paralyzed due to various causes. Acute paralysis of the stomach can occur, as a result of severe blood sugar derailment in diabetes mellitus with diabetic coma or a high risk of coma (emergency!). Chronic gastric emptying disorders, which can include diabetic nerve damage or the autonomic diabetic neuropathy type, cause constant bloating, pressure and pain in the upper abdomen, nausea, vomiting with the result of malnutrition and weight loss problems.
Autonomic diabetic neuropathy can also affect the esophagus or the intestine; In the case of the intestine, diarrhea and constipation are alternating shortly after eating, possibly also bloating. Overall, autonomic diabetic neuropathy is rare in the gastrointestinal tract.
- Intestinal paralysis: the intestinal activity has stopped, the abdomen is bloated. Sometimes an intestinal obstruction precedes. However, the paralysis can also be a reaction to another acute event, such as surgery, renal colic, acute pancreatitis, or poor circulation in the intestine. The symptoms include severe bloating, but typically without stool and winds, depending on the cause, nausea, more or less violent vomiting (possibly “in a gush”), and severe abdominal pain (emergency!).
- Doctors will differentiate the clinical picture from the rare so-called intestinal pseudo-obstruction, a special transport disorder, especially of the small intestine. Here, too, acute treatment is required in the clinic, but no emergency surgery! In the event of suspected acute gastric or intestinal paralysis, consult a doctor immediately or call emergency.
- Colon cancer: Another possible cause of increasing digestive problems and bloating is colon cancer (colon cancer, rectal cancer). Symptoms are usually absent at first. In the further course, various digestive problems, including flatulence, and possibly blockage of the intestine can occur. It is all the more important to use free early detection measures.