Sievering Surgical Clinic

Sieveringer St 9, A-1190 Vienna Tel: 328 8777

Gastroenterology Unit

Bloating

Diagnosis & Treatment

Bloating

Patient information on digestive disorder

AKA: pyrosis, dyspesia, acid indigestion

Definition

One of the most common complaints of patients with indigestion is bloating or gastrointestinal gas indigestion. Gas, bloating and belching often are related to aerophagia, sometimes a habit of anxious individuals, occasionally aggravated by the ingestion of carbonated beverages or by gum chewing.

Complaints of bloating and flatulence are common in patients with the irritable bowel syndrome (IBS), apparently the result of an underlying motility disturbance and food intolerance.

 

Definition

The terms dyspepsia and indigestion are often used interchangeably with bloating, though a dyspepsia is defined as a combination of epigastric pain and bloating caused by inhibited gastric motility. Bloating, a substernal burning pain is commonly used interchangeably with gastroesophageal reflux disease rather than just to describe a symptom of burning in one's chest.


Causes of bloating

Bloating, the most frequent symptom of duodenogastral reflux, is experienced variably in response to gastritis caused by the reflux of irritant biliary, alkaline gastric or gastroduodenal content. Presumably such reflux is most often the consequence of an incompetent gastric motility. Factors influencing duodenogastric reflux and its effects are not fully elucidaded but include the volume of gastric content, the quantity and corrosiveness of the refluxed material, the clearance of this material by the stomach, and local gastric tissue resistance.

Delayed gastric emptying also may contribute to symptoms of gastroesophageal reflux in some patients. Patients may experience increased bloating after overeating or after recumbency following meals, after eating spicy foods, fatty foods, or chocolate, after drinking citrus juices, cola drinks, coffee, or alcohol, or after smoking.

Some of the preceding cause a reduction in lower esophageal sphincter pressure, with presumed consequent increased gastroesophageal reflux. Anticholinergic medications may have similar effects. While alkaline reflux esophagitis may be observed in some patients without preceding gastric resectional surgery, such operations as well as gastroenterostomy particularly predispose to this problem.

There are many causes bloating including:

Presentation

  • typicaly bloating starts about 60 minutes following meal or in the morning.

  • A thorough history and examination are essential in establishing the underlying cause and identifying appropriate investigations.

  • Associated symptoms may include:

    • Gastrointestinal symptoms.

    • Lethargy, weakness.

    • Underlying conditions, e.g. chronic gastrointestinal infection, heart.

    • Anorexia nervosa.

 

Differential diagnosis

Severe generalised muscle wasting is also seen as part of a number of degenerative neurological and muscle diseases and in cardiac failure.

Investigations

  • A thorough check-up isimperative.

Investigations will depend on the context of the weight loss and should endoscopy and autoimmune disease screen.

 

| 25.01.2011 | Read more | Print |

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