flatulence

from Wikipedia, the free encyclopedia

Flatulence is the medical term used for the normal accumulation of gas in the intestine , which arises as a result of the digestive processes in the digestive tract of higher multicellular animals, including humans , and inflates the hollow organ intestine. The discharge of the flatulence (s) through the anus is known as flatus (from Latin flatus , wind, flatulence ), wind or intestinal wind . The German terms Leibwind and Blähwind are considered out of date .

A swelling of the intestinal lumen and thus the abdominal cavity due to an excessive accumulation of gas without waste is called meteorism . If the intestinal gases are stuck (flatus incarceratus) , painful abdominal cramps ( wind colic ) can occur.

Flatulence refers to the increased rectal escape of intestinal gases, often caused by increased development of gases in the digestive tract (e.g. methane , carbon dioxide , hydrogen , hydrogen sulfide and other fermentation or digestion gases ) as a result of malassimilation (problems with absorbing nutrients in the digestive system), bacterial overgrowth from the Food or other parts of the intestine or, less often, by swallowing air while eating, drinking or slurping hastily . In the opinion of doctors, 24 gas leaks in 24 hours are considered normal, only excessive gas leaks would be called flatulence.

Classification according to ICD-10
R14 Flatulence and Allied Conditions
ICD-10 online (WHO version 2019)
Sound sample Flatus

The entire symptom picture (meteorism with flatulence) is colloquially summarized as flatulence . Colloquially, different folk onomatopoeic names are used for the intestinal winds , depending on the region . B. Furz or Pups, in Bavaria also Schoaß, Austria also Schas (also written Schaas ), Pimpf, Pumpf or Pfurz, which are sometimes perceived as vulgar .

The escape of gases from the stomach through the esophagus is called burping , belching, or ructus .

causes

The normal digestive process of humans, which can take up to 42 hours, produces intestinal gases. Most of it diffuses into the bloodstream and is exhaled through the lungs. Intestinal winds are then an excess of gas of around 0.5 to 1.5 liters per day that does not leave the body in this way. Causes of excess gas can be the composition or amount of food or food components; Likewise, digestive disorders (e.g. exocrine pancreatic insufficiency , in which individual nutrients are poorly, delayed or not at all absorbed by the intestinal wall and then ferment in the intestine with gas formation ).

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 ).

Food ingredients that can lead to flatulence
Food
ingredient		 Frequency
( epidemiology )
in the population		 Symptoms /
clinical picture
Lactose about 15% a) Lactose intolerance
Fructose
(fruit sugar)		 about 10% b) Intestinal fructose intolerance
histamine about 1% Histamine intolerance
gluten about 0.2%
(details there )		 Celiac disease
Chitin
a high proportion of water-soluble fiber .
Legumes c)
Inulin (contained in Jerusalem artichoke , yacon )
Sugar substitutes sorbitol , xylitol and mannitol with individual intolerance
Pentosans ; contained in legumes and rye (bread)
a) Lactose intolerance (intolerance to milk sugar ). In German-speaking Europe, around 15% of the adult population are lactose intolerant. Lactose intolerance is more common in Africans and Asians than in Europeans. In the case of lactose intolerance , the milk sugar contained in milk and milk products is not absorbed in the small intestine , but begins to ferment there and in the large intestine . However, a number of other symptoms can also occur (see there ).
b)Intestinal fructose intolerance: Scientific studies in various countries show that around a third of people poorly absorb fructose through the small intestine ( fructose malabsorption ). Of a third of people, around a third have symptoms due to the malabsorbed fructose, for example flatulence (because the fructose then ferments in the small intestine and large intestine), diarrhea , nausea and abdominal pain , as a result also irritable stomach or irritable bowel .
c)The consumption of legumes can cause a significant increase in gas production, as they contain the sugar molecules rhamnose , raffinose and stachyose , which cannot be used in the small intestine and are only broken down in the large intestine by the bacteria of the intestinal flora . These types of sugar are relatively readily soluble in water; their content in the said foods can therefore be reduced by soaking them and throwing away the soaking water. Rhamnose and stachyose are also found in higher concentrations in the foods onions , celery , cabbage , crispbread , chicken eggs , sauerkraut and watermelons .

Other causes of intestinal gases:

  • carbonated beverages (most of the CO 2 in them leaves the body through belching )
  • Air in food (porous baked goods, foams, whipped creams and whipped cream)
  • Neutralization of gastric and fatty acids with the bicarbonate of the digestive glands
  • Diffusion from venous blood
  • Gas-producing and gas-consuming bacteria: hydrogen-producing bacteria in the colon and sulfate-reducing bacteria
  • Swallowed air. Air swallowing is a common process that occurs while speaking and eating, especially when eating large portions quickly. Air swallowed in this way can be expelled through burps and hiccups , or it can lead to gas.
  • Aerophagia (excessive swallowing of air).
  • Consumption of raw cereal porridge, fresh yeast pastries or dried fruit .
  • When the food is chewed, it is mixed with saliva . The saliva amylase (ptyalin) contained in the saliva is used to break down the starch contained in food . Insufficient salivation - common when drinking quickly - can therefore lead to inadequate breakdown of these substances when consuming starchy drinks (for example, cereal milk , rice milk , soy milk , almond milk , smoothies , naturally cloudy, unfiltered fruit juices , vegetable juices ). This then causes fermentation of the starch in the gastrointestinal tract and the resulting (together with an excess of fructose ) symptoms such as gas and flatulence. For some cures , spoonfuls of fruit and vegetable juices are recommended to make them easier to salivate.
  • Creatine when used as a dietary supplement in sports
  • At the beginning of a pregnancy, an increased level of the hormone progesterone has a calming effect on the muscles of the internal organs and thus also on the peristalsis of the intestine. The intestinal contents stay longer in the intestine and there is therefore increased flatulence.
  • Irritable bowel syndrome
  • Exocrine pancreatic insufficiency

Physiological processes

The components of the downdraft are nitrogen (from swallowed air), hydrogen (as a breakdown product of carbohydrates , see also hydrogen breath test ), methane, carbon dioxide and sulfur compounds .

Orders of magnitude of the gases in the gastrointestinal tract
origin Art Amount per day
Swallowed air mainly N 2 and O 2 2 liters
CO 2 released in the stomach by gastric and organic acids in food CO 2 15-30 liters
bacterial degradation of food CO 2   H 2 H 2 S CH 4 15 liters
Diffusion of blood gases into the intestinal cavity N 2   O 2   CO 2 15 liters
all in all about 50 liters
Diffusion of intestinal gases into the blood about 50 liters
Anal gas discharge about 2 liters

(For comparison: a domestic cattle emits around 200–400 grams of methane (or 160 liters) per day, a sheep 25 g.)

The majority of intestinal gases are produced during digestion by bacteria such as Escherichia coli , Bacteroides vulgatus or Methanobrevibacter smithii . These are the producers of hydrogen, methane and sulfur compounds, which are the reason for the easy inflammability of the flatus.

Carbon dioxide is produced, for example, during various types of fermentation or when food containing carbonate reacts with hydrochloric acid in the stomach or the gas from food containing carbonate is released by the stronger acid

The substances indole and skatole as well as hydrogen sulfide used to be responsible for the smell . Gas chromatographic investigations in 1984 showed, however, that sulfur compounds such as methanethiol , hydrogen sulfide and dimethyl sulfide are primarily the odor-forming components.

The noises that are often made when the gases escape are caused by the vibration of the anal opening . The sound varies depending on the tension in the sphincter , the speed at which the gas is expelled, and the volume of the amount of gas expelled.

Intestinal gases inevitably contain moisture and this contains the microorganisms residing in the intestine. This can by germs to urethritis come from intestinal bacteria (UTI) due.

Diffusion into the blood and exhalation

Most of the intestinal gases diffuse into the bloodstream and are exhaled through the lungs. Little is known about the toxicity of intestinal gases diffused into the blood; even the weak narcotic effect of methane is controversial.

Although hydrogen sulfide can influence cell processes at the cellular level, hydrogen sulfide diffusing into the blood would be toxic. It forms sulfides with metal atoms, thus destroying the hemoglobin and reducing the number of erythrocytes . Exhaling therefore seems unlikely.

According to a study from 2009, halitosis (bad breath) and foetor ex ore (bad breath) come from the oral cavity in 90% of cases and another 5–8% from the ENT area, gastrointestinal diseases are less than 0.1% the cause.

Analytics

The reliable qualitative and quantitative determination of the individual components of the intestinal gases can be done by coupling gas chromatography with mass spectrometry . The constituents so identified were mainly hydrogen sulfide , methanethiol and dimethyl sulfide .

Unwanted departure

The inability to hold back one's winds at will is one of the symptoms of fecal incontinence ("incontinence for flatus").

The unwanted loss of stool in flatulence (in medicine as a symptom of rectal cancer ) is referred to as a so-called false friend or colloquially as Schurz , Austrian materialschas or Schas mit Quastl .

This can occur especially in the early stages of diarrhea , when one is not yet aware of the problem.

treatment

There are various home remedies for uncomfortable flatulence :

  • Avoiding foods that are considered to promote gas
  • In the event of intolerance to certain foods: Avoid these foods - for example, dairy products in the case of lactose intolerance or red wine or cheese in the case of histamine intolerance
  • Enzyme replacement therapy ( pancreatin , fungal enzymes ) for underlying exocrine pancreatic insufficiency
  • Yielding of tenesmus (instead of the bowel movement to restrain; to see constipation ) with "two, possibly three bowel portions" to longer stay of the feces in the colon to reduce and largely eliminate the colon. In other words, bowel movements before going to a sauna , an event or before going to bed.
  • The abdominal massage , in which the stomach is gently massaged in a clockwise direction, can help with both small children and adults . In the process, any stuck gas bubbles that can be painful will loosen.
  • A rolling cure in which the patient alternates between lying on one side and the other so that the gases rise or are displaced by other intestinal contents following gravity (purely mechanical) and can then be excreted more easily.
  • Local heat, for example by placing a hot water bottle
  • Use of so-called carminatives such as caraway . Their active ingredients are essential oils , which release the cramps in the intestines and make it easier for intestinal gases to escape. However, these remedies do not prevent flatulence, but only ensure a more inconspicuous discharge of intestinal gases. However, essential oils are only suitable to a limited extent for small children. Many essential oils can promote allergies.

There are also antiflatulent drugs; Examples are simethicone and polydimethylsiloxane (PDMS), both of which have a defoaming effect, and activated carbon , which binds the gases over their large surface area. Infants in particular swallow a lot of air when sucking, which then forms voluminous stable foam in the digestive system. Defoaming agents cause these foams to dissolve into larger gas bubbles that find their way through the intestine more easily and quickly. A German observational study was able to show that a plant combination with myrrh (plus chamomile and coffee charcoal ) is effective and tolerable for intestinal diseases with chronic and acute diarrhea. The herbal combination of three is also particularly effective in alleviating the symptoms of flatulence in irritable bowel patients.

An anal pessary is an intestinal tube inserted into the anus and placed there , which enables the intestinal gases to escape continuously without making any noise and thus prevents a bloated stomach and associated abdominal pain. The special shape of the tube (similar to an anal plug ) prevents it from disappearing as an anal foreign body in the rectum when worn every day . In the case of flatulence, infants use the aviator's grip and gentle abdominal massages, as well as "flatulence catheters" or "baby intestinal tubes" . See also intestinal tube application .

reception

Trivia

Some people have the ability to modulate the pitch of the downdrafts by specifically tightening the intestinal sphincter. The best known of these art farters , who used to appear at fairs and fairgrounds, was the French Joseph Pujol , who also appeared in the Paris Moulin Rouge in the 1890s under the stage name Le Pétomane (from French le pet 'the fart' ) . Pujol is said to have had the ability to suck in air through the anus and to produce odor-free noises and tones. His repertoire included the imitation of thunderstorms, from cannon strikes to the intonation of melodies. Such performances have also become known in recent times. As part of the Luna Luna amusement park created by André Heller in 1987 , several art farters appeared. With a similar number, the Briton Paul Oldfield (* 1966) , who appeared under the stage name Mr. Methane , traveled from 1991 to television shows around the world.

The medical-scientific study "Flatulence on airplanes: just let it go" deals with the effects of flatulence during air travel, under the aspects "negative pressure in the airplane", "effect of suppressing intestinal winds on health" and "possibilities for odor reduction in airplanes". "

Intestinal gases in animals

According to estimates by the FAO , 18% of anthropogenic greenhouse gas emissions , 65% of nitrous oxide emissions, 37% of methane emissions and 9% of carbon dioxide emissions are caused by intestinal gases (flati or burps) of ruminants in animal production . Today 1.5 billion cattle are grazing around the world. If the climate and temperatures warm up, plants would be less nutrient-rich, which means that more methane would form in animal stomachs. In the course of rising temperatures and growing animal populations worldwide, methane emissions from livestock could rise to over 70 percent higher levels by 2050 than at present.

Ruminants burp large amounts of the gases formed in the digestive tract (because of the different structure, see rumen ). If a ball of plants or a foreign body in the esophagus blocks the belching, life-threatening inflation ( rumen symptom ) can develop, which can be "vented" by a veterinarian with a rumen sting with a trocar (see also colic (horse disease) , stomach tympany or intestinal tympany at Guinea pig relatives and drum addiction in rabbits ).

See also

Web links

Commons : Flatulence  - collection of images, videos, and audio files
Wiktionary: flatulence  - explanations of meanings, word origins, synonyms, translations

literature

  • Giulia Enders , Jill Enders (illustrations): Gut with charm. All about an underrated organ . Ullstein, Berlin 2014, ISBN 978-3-550-08041-8 .
  • Tomi Ungerer (Illustrator): The fart . Ed .: Alfred Limbach, Robert Putz (=  Heyne Books / 01 . No. 6163 ). 14th edition. Heyne, Munich 1995, ISBN 3-453-01678-5 (first edition: 1980).
  • Mary Roach : Gulp. On a journey of discovery through our digestive tract . DVA, Munich 2014, ISBN 978-3-421-04640-6 (Original title: Gulp . Translated by Katrin Behringer).
  • Barbara C. Bowen: The 'Honorable Art of Farting' in Continental Renaissance Literature. In: Jeff Persels, Russell Ganim (Eds.): Fecal Matters in Early Modern Literature and Art. Studies in Scatology. Studies in European Cultural Transition, Volume 21. Ashgate, pp. 1–13.
  • Keith Thomas: The Fart in 17th Century England. Social embarrassment and body control? In: Historische Anthropologie 20 (2012), issue 2, pp. 200–224.

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