What is it?

Abdominal bloating, tympanites, or flatulence is a pathological condition associated with the presence of an excessive amount of gas in the gastrointestinal tract. Normally, the human intestines should contain approximately 200 ml of gas, but in the case of flatulence, their volume increases, resulting in abdominal distension. The pathology can be caused by problems with gas elimination or increased gas formation intensity. Accumulation occurs in the stomach and in the bends of the colon.

About the condition

During food processing inside the stomach and intestines, gases accumulate. Typically, they are a byproduct of microbial activity or result from the interaction of gastric acid with bicarbonate. Air can also be swallowed during eating or talking.
In healthy individuals, gas formation is usually not a problem. Excess gas is expelled through belching, absorbed through the intestinal walls into the blood, or exhaled. Normal gas elimination may be hindered by the accumulation of a large amount of high-density fecal matter in the intestine.

Types of flatulence

Depending on the cause of gas accumulation in the gastrointestinal tract and abdominal bloating, the following types of flatulence can be distinguished:

  • Mechanical: develops due to obstruction of intestinal content and gases due to adhesions, tumors, or stenosis.
  • Circulatory: arises from diseases that disrupt blood circulation in the GI tract (ischemic colitis, portal hypertension, etc.).
  • Psychogenic: manifests during severe stress or mental disorders, during which intestinal smooth muscle spasms may occur.
  • Altitude: occurs during ascent, when atmospheric pressure drops, increasing the volume of gas inside the body and pressing on the walls of internal organs.
  • Dysbiotic: results from disturbances in normal gut flora; in this case, there is increased growth of opportunistic bacteria.
  • Digestive: is a symptom of pathologies associated with digestive process disruption due to enzymatic insufficiency, such as gastritis or pancreatitis.
  • Alimentary: this type of flatulence is caused by consuming foods high in gas or gas-producing potential; among them are carbonated drinks, legumes, milk, cabbage, and others.
  • Dynamic: arises from disruptions in intestinal motility, where gas movement through the GI tract slows down; it can be a result of acute infectious diseases, intoxications, or occur in postoperative intestinal paresis.

Symptoms of flatulence

In the presence of abdominal distension caused by a pathological process, the expelled gas usually has an unpleasant odor. The main symptoms of flatulence are:

  • Heartburn
  • Frequent belching
  • Rapid satiety
  • Increased abdominal volume
  • Uncontrolled gas release
  • Severe discomfort in the abdomen
  • Painful sensations and a feeling of bloating
  • Rumbling or sensation of movement in the abdominal area
  • Feeling of strong pressure in the epigastric region
  • Spasmodic pains in the intestines due to internal stretching by gases.
    Flatulence is a condition in which the stomach or intestines accumulate such an amount of gas that it causes rumbling and severe belching. At the first signs of abdominal distension, sometimes mood deterioration and insomnia are observed. This combination of symptoms significantly disrupts the quality of life of individuals suffering from abdominal bloating.

Causes of flatulence

In addition to non-pathological causes such as stressful situations or consumption of food that causes increased gas production, flatulence can be caused by gastrointestinal diseases.
With small intestinal bacterial overgrowth syndrome, some bacteria from the large intestine enter the small intestine with a sterile environment. This leads to fermentation and putrefaction processes in the GI tract, accompanied by abundant gas release.
Abdominal bloating may result from imbalances in the gut microbiota. Due to the disruption of bacterial composition, the body may be unable to fully digest incoming food, causing it to decompose directly in the intestines and release a lot of gas. This can happen due to prolonged antibiotic use or dysbiosis.
With congenital or acquired deficiency of digestive enzymes, gastrointestinal tract malfunctions occur, and food is not fully digested.
In summary, almost any pathological disruption in the functioning of the digestive system can cause flatulence.

Abdominal distension can be a symptom of the following diseases:

  • Colitis
  • Gastritis
  • Duodenitis
  • Pancreatitis
  • Cholecystitis
  • Parasitic infections
  • Gastric ulcer disease
  • Intestinal obstruction
  • Acute intestinal infections.
    In addition to diseases, abdominal distension can also be caused by physiological conditions of the individual. For example, due to age-related changes in the body at the age of 50-60, there is atrophy of the intestinal wall muscles, and it lengthens. In addition, digestive function deteriorates with age, contributing to increased gas formation.

Diagnosis of Flatulence

When symptoms of flatulence appear, it is necessary to consult a therapist. Subsequently, if abdominal bloating is caused by a gastrointestinal disease, a gastroenterologist will be involved in the diagnosis. To obtain information about the extent of gastrointestinal tract (GIT) damage and the localization of the pathological process, a comprehensive examination of the digestive system is conducted, which includes both laboratory and instrumental diagnostic methods.

Laboratory methods include:

  • Biochemical blood analysis;
  • Analysis of blood for pepsinogen content;
  • Culture for pathogenic microflora and dysbiosis;
  • Determination of the level of pancreatic enzymes in blood and urine;
  • Examination of feces to determine the level of biochemical indicators (metabolites of volatile fatty acids, propionic, acetic, and butyric acids), which contribute to the vital activity of microorganisms in the GIT.
    Instrumental methods include:
    • Abdominal X-ray to confirm or exclude internal organ damage;
    • Ultrasound (US) for rapid and accurate determination of the condition of the GIT organs, detection of tumors, cysts, and other formations;
    • Colonoscopy, endoscopic examination to visualize the inner lining of the digestive organs for inflammations, tumors, and other defects.

Treatment of Flatulence

If improper nutrition is the cause of abdominal bloating, it is necessary to adjust the diet, limiting the consumption of foods that cause increased gas production. Meals should be consumed in a calm environment and without haste.
If flatulence is a consequence of gastrointestinal organ diseases, treatment should aim to eliminate these pathologies or induce remission. If necessary, treatment is conducted to restore the microflora, eliminate enzymatic insufficiency, and normalize intestinal motility. To reduce gas volumes in the GIT, prescribed by a doctor, carminative agents, adsorbents, and enzymes are used.

Prevention of Flatulence

Prevention of flatulence primarily involves proper nutrition. It is necessary to eat regularly and control portion size. The diet should be designed so that individuals receive an adequate amount of macro- and micronutrients, vitamins, and minerals. Fried, fatty foods, smoked meats, and canned foods should be limited. Alcohol, fast food, sweet carbonated drinks are better to be completely excluded.
It is also necessary to timely diagnose and treat gastrointestinal tract pathologies, which can become the cause of flatulence development. Regular visits to a gastroenterologist will help identify them at an early stage of development and eliminate them before the appearance of pronounced symptoms.