Meteorism
| Classification according to ICD-10 | |
|---|---|
| R14 | Flatulence and related conditions meteorism |
| ICD-10 online (WHO version 2019) | |
As flatulence , bloating or flatulence is an excessive accumulation of air or gas in the digestive tract, usually the large intestine ( meteorism intestinalis ) or stomach , rare in the free abdominal cavity ( flatulence peritoneal ), referred, which is associated with pain. There is no significant loss of intestinal gases. However, since these gas accumulations predominantly occur in (functional) disorders in the colon area, the medical literature often speaks of flatulence or gas as a disruptive gas formation in the gastrointestinal area. Often there are also acoustic signals in the stomach itself such as gurgling, bubbling and rumbling.
A bloated stomach can have 5 causes (which begin with the letter "f" in English): "flatus" ( wind ), "fluid" ( ascites ), "fat" ( fatty tissue ), "faeces" ( feces ), "fetus" " ( Fetus , pregnancy ).
Symptoms
- spherical, distended belly
- Flatulence
- Stomach cramps
causes
The cause is often slack abdominal muscles , which lead to a rapid increase in abdominal circumference when gas accumulates. Furthermore, increased gas production in the large intestine can occur with a diet rich in fiber and therefore also rich in cellulose . While ruminants can utilize this cellulose, it is partially broken down in the human intestine by the intestinal flora there , which can lead to the formation of up to 11 liters of hydrogen per day. This gas is processed by other bacteria ( methane producers ) into up to 2 to 4 liters of methane per day. The resulting gas mixture can either be absorbed into the blood through the intestinal wall and finally exhaled, escape as a "wind" ( flatus ) or lead to an increased accumulation of gas with distension of the abdomen and elevated diaphragm . When percussion (tapping) the abdominal wall, this leads to a characteristic sound similar to the beating of a drum.
Meteorism in connection with aerophagy (air swallowing) occurs less frequently . Meteorism can occur as a symptom of typhoid , an intestinal obstruction , dyspepsia , exocrine pancreatic insufficiency and the resulting maldigestion , peritonitis , heart failure or cirrhosis of the liver with portal hypertension , whereby the following applies to the latter: "First the wind, then the rain." the meteorism with flatulence is followed by ascites (the accumulation of fluid in the abdomen).
Adult patients often believe that their symptoms can be traced back to constipation and develop a laxative abuse (laxative abuse). It is not possible for children to make this connection. On the other hand, they may have learned a form of bowel evacuation in which they initially suppress the urge to defecate and also take too little time to defecate. This poor stool hygiene can lead to unexplained abdominal pain , the cause of which only becomes clear in the hospital.
Meteorism in infants can be a symptom of three-month colic .
The bloated stomach can also indicate a food intolerance.
therapy
Treatment depends on the underlying condition. The symptomatic therapy of a meteorism without further symptoms is often unsatisfactory.
The following medicinal measures can be considered:
- Antispasmodics for suspected increased tone of the smooth muscles in the intestinal tract
- Prokinetics
- Carminatives
- Defoamer; see Simeticon
- Enzyme replacement with pancreatin in pancreatic insufficiency
Individual evidence
- ↑ James CE Underwood: General and Systematic Pathology, International Edition E-Book. Elsevier Health Sciences, 2009, ISBN 978-1-437-72874-3 , p. 133 ( limited preview in Google book search).
