Flatulence

　　How is gas distension caused? Briefly described as follows:

　　One, Gastrointestinal tract obstruction

　　1, Upper gastrointestinal diseases.

　　(1) Acute gastric dilatation.

　　(2) Delayed gastric emptying or gastric paresis.

　　(3) Pyloric obstruction caused by various reasons.

　　A, Peptic ulcers: such as duodenal ulcers, antral and pyloric ulcer.

　　B, Benign or malignant tumors in the antrum or duodenum.

　　C, Inflammatory diseases.

　　D, Congenital diseases: such as adult hypertrophic pyloric stenosis. Pyloric septum, duodenal septum, etc.

　　(4) Anastomotic stenosis after gastric resection.

　　(5) Duodenal stasis.

　　2, Lower gastrointestinal diseases.

　　(1) Intestinal obstruction.

　　A, Mechanical intestinal obstruction: such as intestinal adhesions, intussusception, inflammatory bowel disease, intestinal tuberculosis, intestinal tumors, intestinal ascaris masses, fecal stones or foreign bodies, congenital intestinal atresia, etc.

　　B, Dynamic intestinal obstruction: such as paralytic intestinal obstruction, spastic intestinal obstruction.

　　C, Vascular intestinal obstruction.

　　(2) Malabsorption syndrome of the digestive tract.

　　(3) Irritable bowel syndrome.

　　Two, Liver, gallbladder, and pancreatic diseases

　　1, Liver diseases such as hepatitis and liver tumors.

　　2, Gallbladder diseases: cholelithiasis, gallbladder tumors, etc.

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

　　Three, Systemic diseases

　　1, Toxic ileus caused by acute infection.

　　2, Disordered electrolytes.

　　Four, Gastrointestinal gas distension caused by other reasons

　　1, Eating too fast.

　　2, Contagious belching.

　　3, Endoscopic examination with excessive inflation.

　　4, Consumption of foods or drugs that produce excessive gas.

　　What diseases can gas distension cause? Briefly described as follows:

　　1, Influence on respiration

　　Gas distension can cause abdominal distension, elevate the diaphragm, reduce the size of the chest cavity, and limit the respiratory function of the lungs, which may cause dyspnea.

　　2, Influence on blood circulation

　　Abdominal distension can raise the diaphragm, compress the chest cavity, and affect the contraction and relaxation function of the heart. Intestinal distension increases the intraluminal pressure, affecting the blood circulation of the intestinal wall. An increase in intraperitoneal pressure hinders the return of the inferior vena cava, due to a decrease in the amount of blood returning to the heart, affecting cardiac ejection.

　　3, Water and electrolyte

　　Severe abdominal distension, retention of intestinal contents, compression of the intestinal wall, which not only affects the absorption of intestinal contents, but also causes the plasma of the intestinal wall to渗入肠腔, leading to a loss of balance in water and electrolytes.

　　4. Absorption of toxins

　　The retained food residue in the intestinal lumen ferments and decomposes under the action of bacteria, produces toxins and gas, is absorbed by the body, and aggravates the condition.

　　Patients with abdominal distension should pay attention to whether there is a history of ulcer, previous abdominal surgery. Pay attention to the onset, the speed of progression, the location where abdominal distension first appears, and whether there is a history of nausea, vomiting, diarrhea, constipation, etc. Patients with diabetes in the medical history should pay attention to gastroparesis, and patients with fever, night sweats, cough, and abdominal distension should pay attention to intestinal tuberculosis.

　　Abdominal distension can also be caused by Qi deficiency, Qi heat, and Qi cold. Treatment should be with Qi-regulating and promoting agents, such as costus root, areca nut, tangerine peel, citrus reticulata, tangerine peel, and magnolia bark. Avoid eating gas-producing foods such as legumes and tubers. Distribute the three meals of the day reasonably, eat evenly between hunger and satiety, generally eat to 80% of fullness, do not overeat, to adapt to the digestive capacity of the gastrointestinal tract. Eating too much can easily lead to indigestion and bloating. Excessive consumption of soy products, potatoes, melons, etc., can easily produce gas and cause bloating, and attention should be paid to avoid them. Yogurt, especially yogurt containing bifidobacteria, can increase beneficial bacteria in the intestines, inhibit the proliferation and growth of putrefactive bacteria in the intestines, and is beneficial for maintaining the normal balance of bacteria in the intestines. Therefore, drinking yogurt appropriately is conducive to the recovery of normal intestinal function and is beneficial for eliminating gastrointestinal bloating.

　　What examinations should be done for abdominal distension? Briefly described as follows:

　　1. Physical examination

　　Generally speaking, abdominal distension is associated with abdominal bulging. Bulging localized to the upper abdomen is often seen due to gastric or transverse colon gas accumulation. Abdominal distension due to small intestinal gas can be localized to the middle abdomen or generalized. Abdominal distension due to colonic gas can be localized to the lower abdomen or lower left abdomen. In cases of pyloric obstruction, there may be a gastric shape and peristaltic waves in the upper abdomen; in cases of intestinal obstruction, intestinal shape and peristaltic waves can be seen, with increased or decreased bowel sounds; patients with peritonitis may have tenderness and muscle tension.

　　2. Laboratory examination

　　10. 1. Fecal examination: Routine fecal examination has diagnostic significance for intestinal inflammation and intestinal parasitic diseases. Persistent positive occult blood in feces often suggests gastrointestinal tumors.

　　9. Liver function test: Has diagnostic value for acute and chronic hepatitis.

　　8. Duodenal drainage: Collect bile for routine examination and culture, which has diagnostic value for biliary tract infection.

　　7. Pancreatic function test: The exocrine function test of the pancreas, blood and urine amylase determination, lipase determination; an increase in measured values often reflects pancreatic inflammation.

　　6. Small intestinal absorption function test: Can check the fat content of feces, D-mannose absorption and excretion test, vitamin B12 absorption test, etc.

　　3. Instrumental examination

　　1. X-ray examination

　　(1) Abdominal flat film: In cases of pyloric obstruction or acute gastric dilatation, abdominal flat film can show a large gastric bubble and liquid level. In intestinal obstruction, a liquid level can be seen, with the upper end of the intestinal tract dilated; in small intestinal obstruction, a ladder-like liquid level can be seen. The colon in megacolon is significantly widened and gas-filled.

　　(2) Barium meal: Contraindicated in complete obstruction of the pylorus and intestines; incomplete obstruction can be cautiously used under the condition of gastrointestinal decompression to understand the location of the obstruction.

　　(3) Barium enema: Mainly used for the examination of colonic lesions.

　　2. Laparoscopic examination

　　Gastrointestinal bloating should be listed as a contraindication.

　　3. B-ultrasound, CT examination

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

　　Bloating patients should avoid eating gas-producing foods such as beans and tubers. Chew food slowly and do not eat too much at one time. Avoid drinking carbonated drinks, chewing gum, and try not to drink drinks with a straw, as these will increase the intake of gas inadvertently. Distribute meals reasonably, keep hunger and satiety balanced, generally eat to 80% of fullness, do not overeat, to adapt to the digestive capacity of the gastrointestinal tract, eating too much is easy to cause indigestion and bloating. Eating too much of soy products, potatoes, melons, beans, etc. is easy to produce gas and bloating, and attention should be paid to avoid them. It is advisable to eat yogurt, especially yogurt containing bifidobacteria, which can increase the beneficial bacteria in the intestines.

　　The treatment methods of bloating are briefly described as follows:

　　1. Laxative. If constipation, you can squeeze the medication such as glycerin suppository into the rectum, which can expel feces and gas, reduce the pressure in the colon. If defecation is not successful, you can insert a rectal tube into the anus to reach the sigmoid colon, so that the gas in the intestines can be excreted outside the body.

　　2. Gastrointestinal decompression. Insert a gastric tube through the nasal cavity or mouth into the gastrointestinal tract, and then connect a suction device on the outside of the tube to extract the gas and liquid in the gastrointestinal tract, reduce the pressure on the gastrointestinal tract, allow the gastrointestinal muscles to rest, and wait for recovery.

　　3. If the above two methods do not work and there is no evidence of intestinal obstruction, you can choose drugs such as neostigmine or phentolamine. Neostigmine can inhibit cholinesterase, enhance peristalsis of the intestinal tract, promote排气, the dosage is 0.045-0.06 mg/kg body weight, subcutaneous injection; phen tolamine can increase lung ventilation, excite the smooth muscle of the intestinal tract, promote peristalsis of the intestinal tract, relieve bloating, the dosage is 0.2-0.5 mg/kg body weight, subcutaneous injection.

　　4. Fast, intravenous infusion, correct electrolyte imbalance. If bloating is caused by low blood potassium concentration, potassium chloride can be infused intravenously.

　　5. After the bloating disappears, you can take multi-enzyme tablets and probiotic preparations.

　　6. Avoid eating gas-producing foods such as beans and tubers.