Flatulence

Intestinal wind Medical: flatulence English: flatulenceBlowing, also called flatulence, is an excessive accumulation of air or gases in the digestive tract. Harmless and easy to treat, flatulence is a condition caused by flatulent foods or a hasty meal. One speaks of meteorism when the abdomen is distended and bulging (“flatulent abdomen”).

In flatulence, the actual flatulence, an excessive amount of intestinal gases is released through the anus. However, sometimes flatulence can also be a symptom of a serious illness, in which case the doctor must be consulted. In principle, it is quite normal for small amounts of gases to form in the intestine.

They are formed when stomach acid is neutralised and by the activity of useful bacteria in the large intestine and escape naturally without causing discomfort. About 40 percent of Germans suffer from these and other gastrointestinal problems at times. Flatulence is caused, among other things, by the consumption of flatulent foods (e.g. cabbage, beans), unhealthy eating habits and intolerances (e.g. lactose intolerance, gluten intolerance) as well as stress and hectic pace. Flatulence can also occur as a side effect of various drugs or as a concomitant of various diseases.

Causes

The possible causes of flatulence are manifold. Usually they have harmless causes. Flatulence is an excess of gas that is formed in the intestines and eventually goes away in the form of flatulence.

A frequent cause of this is nutrition. Some foods cause flatulence, such as legumes and cabbage. Whole grain products also promote the formation of intestinal gases.

In addition, the bacterial flora of the intestine is significantly involved in the formation of the gases. These gases are produced in the metabolic process of the bacteria and then become noticeable by flatulence. If sweets are eaten frequently, flatulence can occur more often, as bacteria prefer to metabolize sugary foods and thus produce more gases.

The intestinal flora is in a sensitive equilibrium, which can get out of balance. A frequent cause of this is antibiotic therapy. This can cause the intestines to be overgrown with fungi or certain species of bacteria.

The imbalance of the intestinal flora can then manifest itself as flatulence. (However, part of the intestinal wind is also caused by swallowed air, which enters the gastrointestinal tract when speaking, eating and drinking and then travels through it. A lot of air is often swallowed, especially during hectic eating.

Finally, flatulence can also be caused by various food intolerances. The flatulence is then usually very pronounced and occurs in direct connection with food intake. If the triggering food is left out, the flatulence also decreases rapidly.

Lactose intolerance – milk protein intolerance – is particularly common among food intolerances. Intolerance to gluten and fructose can also occur. Psychological factors also play a role in digestion.

Therefore, psychological stress, worries and strain factors can also manifest themselves in the form of flatulence. Many women also complain of flatulence at times during pregnancy. Less frequent causes of flatulence are, for example, irritable bowel syndrome, liver or pancreas diseases, chronic inflammatory bowel disease or intestinal cancer.

These diseases, however, usually have other symptoms that are more important than the flatulence itself. The primary way in which the air leaves the body is by exhalation. The gases enter the bloodstream through the intestinal wall and finally reach the lungs, where they leave the body again with the air we breathe.

If the quantity of gases in the intestine becomes too large, larger gas bubbles form which can no longer be breathed out. Foaming occurs. There are two ways for the gas bubbles thus accumulated in the abdomen to escape from the body: “upwards” by burping (“belching”) or “downwards” by flatulence (medically: flatulence).

The excessive air in the abdomen can cause further discomfort. These include a feeling of fullness and pressure pain (flatulence) in the stomach and intestines, bloated abdomen, nausea and intestinal noises. Basically, patients feel the need to deflate the air in order to reduce the corresponding excess pressure in the intestine.

The degree of suffering from flatulence can vary. It is particularly pronounced when the flatulence is accompanied by severe pain. For those affected who are in the public eye because of their profession or who regularly attend meetings in their daily work or maintain frequent customer contact, flatulence can also cause a strong feeling of shame.

But flatulence can also be a distressing problem in the private sphere. Sometimes flatulence requires treatment. Flatulence sometimes has a bad to stinking smell.

This is normal, as the intestinal gases are conducted through an intestinal area that is interspersed with bacteria. However, if the intestinal gases are excruciatingly strong, it must also be examined whether the cause of the flatulence could be a fungal infection. With flatulence, there is too much air in the gastrointestinal tract, which expands the digestive tract unnaturally and thus causes discomfort.

Since the intestine is supplied with nerves, excessive stretching of the intestinal wall triggers a moderate to severe abdominal pain in the case of flatulence, which lasts until the air has dissipated or escapes. The pain usually has a pulling, tearing character. If the air cannot escape, cramp-like pain in the area of the intestine can also occur.

The pain caused by flatulence can also be transmitted to the upper abdomen (upper abdominal pain and flatulence) and can be so strong that the patient’s general condition deteriorates. If, in addition to the flatulence, diarrhoea also occurs, two diseases are shortlisted as causes. The first is lactose intolerance or gluten intolerance, the second is an infectious disease, such as so-called gastroenteritis.

Some chronic inflammatory diseases, such as ulcerative colitis or Crohn’s disease, can also be the cause of bloating symptoms with diarrhoea. Here, too, an exact diagnosis should be made as soon as possible if the symptoms do not disappear within 14 days. In order to diagnose flatulence (flatulence), the doctor will first inform himself about possible medications taken, previous illnesses and accompanying symptoms, as well as diet and lifestyle.

This is followed by a thorough physical examination, during which the doctor palpates the abdomen, taps it and listens to it with a stethoscope. Under certain circumstances the doctor palpates the rectum with his finger (so-called rectal examination). Depending on the results of the previous examinations and the presumed cause, further examinations are part of the diagnosis in the case of flatulence.

These include an ultrasound (sonography) of the abdomen, X-rays, blood tests, urine and stool tests and tests for food intolerances (e.g. lactose tolerance test, see lactose intolerance). It may be necessary to perform a gastroscopy and/or a colonoscopy with removal of small amounts of tissue (biopsy). Imaging procedures such as computer tomography or magnetic resonance imaging or ERCP (imaging of the bile and pancreatic ducts) can also be helpful in the search for the causes.

As a rule, such a complex diagnosis is not necessary in the case of flatulence. In many cases, a test for food intolerance already provides sufficient information on the cause of the symptoms and the doctor can dispense with further examinations. Indications of serious gastrointestinal diseases are frequent vomiting, vomiting of blood, blood in the stool, unintentional weight loss, fever and foul-smelling, voluminous stools.