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Air in the stomach - causes, symptoms and therapy
contents
- definition
- Flatulent foods as the main cause
- Special case: food intolerances
- Delayed gastrointestinal passage
- Disturbed activity of intestinal bacteria
- Causes of air in the abdominal cavity
- Other causes of air in the stomach
- Associated symptoms
- diagnosis
- therapy
- nutritional intervention
- Home remedies and naturopathic therapy
- Medical therapy
- Operative therapy
definition
The fact that air accumulates in the stomach from time to time is unpleasant, but completely normal. In the course of the digestive process, between two and four liters of methane are naturally produced daily in the intestine, namely as degradation products of intestinal bacteria, which are involved in the decomposition of food. A certain proportion of this methane gas is released from the body via the bloodstream into the lungs and later exhaled as carbon dioxide. However, it may well happen that in the intestine too much intestinal wind (flatus) arises at once, which then leads to bloating (Flatulenzen), which are no longer discharged through the bloodstream, but the much faster "disposal path" of the rectum.
The amount of actual intestinal gas is essentially determined by two essential factors:
- Activity status of intestinal bacteria: Our intestinal mucosa is colonized by a variety of bacterial cultures, which we urgently need for digestive processes. On the way through the intestines they decompose the porridge, producing their own digestive gases. The amount of accumulating digestive gases is particularly dependent on the composition of the food.
- Gastrointestinal Passage: Also the way of the food supply through the gastrointestinal tract, the so-called gastrointestinal passage, is significantly involved in the formation of flatulence. Because of various causes, it can namely come to a reduced peristalsis of the intestine and thus to a jam of the food pulp. As a result, the intestinal bacteria more time for their digestive processes and therefore also accumulate more digestive gases.
A pinching waistband, a distended abdominal wall, feeling of fullness and general malaise - it is always unpleasant, if too much air has accumulated in the stomach. Often this is harmless and normal, but may also indicate a long-term occurrence on a health problem. (Image: ALDECAstudio / fotolia.com) Flatulence is therefore the result of certain dietary habits. Especially after eating flatulent foods such as beans or cabbage you can almost put the clock after that, it comes a little later to more or less severe flatulence. It can also be annoying accompanying symptoms such as abdominal pain, even if diet-based Flatulenzen in general are not considered dangerous.
The situation is different when air in the abdomen is caused by an underlying disease. Here, first of all, a distinction must be made between two different forms of air accumulation. When it comes to air retention in the abdominal area, usually the so-called flatulence (meteorism) is responsible for the complaints.
Meteorism is a chronic form of normal flatulence, primarily due to weakened abdominal muscles. Here, the daily accumulating amounts of methane gas due to a chronically reduced intestinal peristalsis are transferred only insufficiently from the intestine into the bloodstream, which in the long term in addition to air in the intestine can cause a permanently bloated abdomen and persistent intestinal spasms.
But it is also possible that air does not accumulate directly in the intestine. There is talk of air accumulation in the abdominal cavity (pneumoperitoneum). This hardly happens with a healthy body. And most diseases can not cause pneumoperitoneum. Much more often, this special form of air in the abdominal cavity is the result of a surgical intervention, in which it comes to increased passage of methane gas or air from the intestine into the abdominal cavity. And also traumas in the area of the abdominal cavity are able to provide in this way for air in the abdomen.
It can be seen that one has to differentiate between the three forms of air accumulation in view of the causes of air in the abdomen. Although bloating and acute phases of a swollen abdomen can often be caused by the same factors of influence, the causal mechanism as well as the health risk of both variants of air in the intestine are very different. There are also certain similarities between meteorism and pneumoperitoneum, whereby air in the abdominal cavity is usually even more dangerous than chronic flatulence. The reason for this is the fact that air in the abdominal cavity is a permanent intestinal injury, which causes the passage of air into the free abdominal cavity.
Flatulent foods as the main cause
A certain amount of air or gases is as mentioned always in our gastrointestinal tract. However, this is not only due to the pathogenesis of intestinal gases in the context of bacterial decomposition processes. Just because we eat a lot of air with food and drink, a certain amount of fresh air in the digestive tract rumbles in addition to methane. Hectic food, exciting conversations during the meal or very carbonated drinks add to this natural air content in addition.
With the food and drink also always some air is swallowed, therefore cavorting in addition to methane and a certain amount of fresh air in the digestive tract. Frantic food, exciting conversations during the meal or very fizzy drinks additionally promote this. (Image: estradaanton / fotolia.com) Nevertheless, the main cause of flatulence, however, is to be found in the diet. For example, there are foods such as beans or cabbage, which lead due to their fiber richness to relatively high emissions of digestive gas from the gut bacteria. So, if you eat a lot of fiber-rich foods, your digestive gases will start to increase because their decomposition process takes a long time because of the high fiber content.
On the other hand, there are also sulfurous foods like the onion. This contains on the one hand known larger amounts of sulfur compounds, which in the digestive tract increased - and sometimes also very bad smelling - cause gas formation within the food pulp itself. On the other hand, onions are not only rich in sulfur, but are also classified as fructan-containing foods.
Fructans are larger molecular compounds of the fructose fructose, which can be decomposed by the human digestive tract only in the colon. For this reason, onions pass through the stomach and small intestine mostly undigested, until finally the decomposition of the food takes place in the large intestine. A circumstance that, in the case of onion digestion, naturally promotes particularly intensive decomposition processes of the colon bacteria and with this process also an increased emission of bacterial methane precipitations.
Another group of foods that cause bloating relatively often is raw food. The intestinal bacteria often have to work twice as hard here to dissolve the nutrients from the raw food, which is especially true for relatively hard vegetables such as carrots. As a result, of course, the methane output of digestive bacteria also increases, causing bloating as a result. In addition to raw vegetables, especially raw, unripe fruit varieties are to be mentioned here as particularly flatulent.
So there are very different reasons why certain food components bring an increased flatulence risk. Roughly, the whole of flatulent foods can be restricted to the following products:
- Onions and onion vegetables (for example garlic, leek or leek),
- Cabbage (e.g., kohlrabi, Brussels sprouts, red cabbage or cabbage),
- Legumes (such as beans, peas or lentils),
- raw vegetables (such as carrots, peppers or lettuce)
- and unripe fruit (such as apricots, cherries or plums).
One group of foods that often causes bloating is raw food. The intestinal bacteria often have to work twice as hard to dissolve the nutrients, which is especially true for relatively hard vegetables such as carrots. (Image: Rebel / fotolia.com) It should be mentioned that because of increased gas formation in the intestine, eating a fiber-rich diet or eating flatulent foods alone does not have to worry about it right away. Because the foods shown are basically very healthy. Dietary fiber, for example, prevents constipation and provides a long-lasting satiety effect.
In addition, a high-fiber diet lowers the risk of colorectal cancer and cardiovascular disease. If you increase the fiber content in the diet also gradually, the vegetables steam before consumption and softens legumes before further processing a night in water, the bloating effect is usually short-lived. With one exception.
Special case: food intolerances
If one observes that relatively soon after the consumption of certain foods flatulence in combination with convulsive abdominal pain and / or diarrhea occur, one should be alert and let the matter clarify if necessary medical attention. For here it is in all likelihood not ordinary accumulations of air in the stomach, but the accompanying symptoms of food intolerance.
It is often the food intolerance that the suspect foods in small quantities (initially) are still tolerated. Only in the later course or with a concrete excess of food allergens then sets in an incompatibility reaction. This is usually based on the fact that corresponding food ingredients can not be digested by the body.
However, the problem is not the intestinal bacteria, but missing enzymes, as is the case for lactose intolerance (lactose intolerance), for example. Here, the enzyme lactase necessary for the breakdown of lactose, which is formed in the mucous cells of the small intestine, is missing.
If the enzyme lactase is missing, the milk sugar can not be broken down and reaches undigested into the large intestine, where it is finally utilized by the intestinal bacteria. The result is again an unintentional increase in methane emissions by the bacteria. At the same time, acids are also formed by the lactose intolerance, which, in addition to bloating, can provoke painful irritation of the intestinal walls in the case of lactose intolerance.
Incidentally, lactose intolerance is actually completely natural for adults, as originally the production focus of the body for lactase was in infancy, where the enzyme is necessary for the cleavage of lactose from breast milk. In the western world, however, due to the traditional dairy industry and the associated increased consumption of animal milk and dairy products, a gene mutation has developed over the centuries that maintains the body's lactase production well beyond adolescence.
All persons without this lactase mutation therefore have to deal with indigestion whenever they consume dairy products. And even in many people with mutation, the enzyme production in later adulthood nevertheless occurs.
Lactose intolerance is actually quite natural for adults, as the body originally focused on lactose production in infancy, where the enzyme is needed to break down lactose from breast milk. (Image: absolutimages / fotolia.com) Similar to lactose intolerance, flatulence also occurs in other food intolerances. As good as any food with appropriate predisposition can lead to an intolerance. However, the following variants are particularly common:
- Intolerance to fructose (fructose intolerance),
- Intolerance to glutamates (gatamate intolerance),
- Intolerance to table sugar (sucrose intolerance),
- Incompatibility with histamine (histamine intolerance / histaminosis),
- Intolerance to gluten protein / gluten intolerance (celiac disease),
- Intolerance to lactose (lactose intolerance)
- and intolerance to mucosal sugar (galactose intolerance).
Important: In addition to dairy products, the foods that are especially frequently used include whole grains, soy products, finished products, baked goods, sweets and some fruits and vegetables. It is not possible to differentiate between healthy and unhealthy foods, even if food intolerances are generally associated with unhealthy food products.
Delayed gastrointestinal passage
Food often plays a role in the development of chronic flatulence. In many cases, a permanent diet is in such cases
- too greasy food,
- strong protein diet,
- White flour products,
- Fast food and finished products
responsible. In addition, the habit of consuming very large amounts of meal provokes long-term bloating due to a delayed gastrointestinal passage. The cause is almost always a reduced intestinal peristalsis, so a disturbed functionality of the intestinal muscles. This is usually responsible for the contraction pulses that pass the food pulp through the digestive tract.
Fast food and finished products often play a role in the development of chronic flatulence. In addition, the habit of consuming very large amounts of meal provokes long-term bloating due to a delayed gastrointestinal passage. (Image: Studio Romantic / fotolia.com) In the field of drugs just have preparations such as muscle relaxants or analgesics a similar effect. They can temporarily paralyze the intestinal musculature and thus promote flatulence through a reduced intestinal peristalsis. This can be observed, for example, with opioid-containing analgesics such as morphine or oxycodone as well as with the muscle-relaxing drugs diazepam and baclofen.
However, there are many other reasons for slow muscle activity in the intestine or a delayed gastrointestinal passage of the food pulp. For example, bottlenecks in the intestine can be considered as a result of benign or malignant tissue growths such as
- diverticulum,
- ulceration,
- scar tissue
- or tumors.
An intestinal obstruction (Illeus) or congenital anatomical anomalies, such as a large bowel, can not be ruled out as the cause of chronic flatulence.
Another very common condition that accompanies bloating, abdominal pain, diarrhea or constipation is irritable bowel syndrome. Due to various, medically not completely clarified causes, this symptom complex leads to a disturbance of intestinal peristalsis with bloating and intestinal cramps as leading symptoms. Likewise, hormones affect the activity of the intestinal muscles. The phenomenon of hormone-induced flatulence can be observed in this regard, especially in women again and again.
So the circulating hormone progesterone, which is released in the second half of the cycle after ovulation, for example, relaxing on the peristalsis. Shortly before the onset of menstruation, symptoms such as flatulence and constipation often develop. The symptoms are medically even counted among premenstrual syndrome (PMS) in these circumstances.
Especially during the second half of the cycle these symptoms are intensified by a certain nutritional behavior (a lot of sweets and carbohydrates), which is just too common not only during menstruation but also during pregnancy. And yes, even pregnant women suffer due to their altered progesterone levels again and again chronic flatulence. In addition to hormonal factors, of course, the size of the child as a space-demanding obstacle to an undisturbed gastrointestinal passage is also an unfavorable factor.
Pregnant women repeatedly suffer from chronic flatulence due to their altered progesterone levels. The size of the child as a space-demanding obstacle is - in addition to hormonal influences - an unfavorable factor for an undisturbed gastrointestinal passage dar. (Image: Drobot Dean / fotolia.com) Disturbed activity of intestinal bacteria
Regarding chronic flatulence, the causes are not quite as harmless. Although dietary factors also play a role here, serious underlying diseases of the gastrointestinal tract come into question here as well. First and foremost, here is a sustained disturbed bacterial balance in the intestinal flora (dysbiosis) to call. It occurs especially in chronic gastrointestinal diseases, but may also arise as a result of drug therapy or by improper eating habits.
In the field of drugs, for example, antibiotics are known to bring the intestinal flora decidedly out of balance. Because the main characteristic of antibiotic agents is known to kill bacteria, the drugs unfortunately do not distinguish between harmful infectious bacteria and intestinal bacteria. If the active ingredients strongly attack a naturally occurring bacterial colonization in the intestine, other, sometimes actually dangerous bacterial strains have the opportunity to multiply in the intestine and thus significantly damage the digestive system.
Air in the intestine due to increased bloating is still the most harmless consequence, because what suffers mainly from the harmful bacterial proliferation are intestinal mucosa and intestinal walls. In the worst case, a so-called antibiotic-induced colitis threatens here. This is a chronic intestinal inflammation caused by antibiotics.
Incidentally, some other gastrointestinal diseases, which are also associated with bloating due to disturbed intestinal flora, are Crohn's disease and ulcerative colitis. The extreme dysbiosis, as well as the disease-related inflammatory processes in the gastrointestinal tract, trigger in these diseases even the slightest external stimuli (such as food) severe abdominal cramps and indigestion such as bloating or diarrhea.
Causes of air in the abdominal cavity
Accumulation of air in the abdominal cavity is rare. But if that is so, the causes are usually not to be joked. Especially due to injury-induced triggers, such as a perforation of the stomach or intestinal walls, indicates in air pockets in the abdominal cavity usually on an advanced ulcer or tumor disease. In trauma medicine, pneumoperitoneum is also known as a consequence of severe trauma to the digestive tract after trauma (e.g., physical altercation). By contrast, air discharge into the abdominal cavity is rather intentional in some surgical procedures, such as laparoscopy.
Other causes of air in the stomach
Stress can be found again and again as a cause of indigestion with or without bloating. The same applies to liver and biliary disorders, which often lead to impaired production of bile. This is in addition to enzymes, a harmonious intestinal flora and a well-functioning intestinal muscles also essential for the digestive processes. For this reason, diseases of the liver or bile are often associated with flatulence as a concomitant symptom.
Stress can be found again and again as a cause of indigestion with or without bloating. The same applies to liver and biliary disorders, which often lead to impaired production of bile. (Image: Adiano / fotolia.com) The same thing happens in diseases of the pancreas. If this function is limited by inflammation, for example, it can no longer deliver the digestive enzymes it produces to the small intestine in the required amount. This primarily results in stool movements with undigested food residues. But flatulence or constipation are not uncommon in pancreatic diseases.
Associated symptoms
If it is a case of bloating, which is clearly due to the consumption of bloating food or recurring cycle complaints, a visit to the doctor with air in the stomach is not really necessary. If the accumulation of air on the other hand repeatedly occur in connection with the consumption of certain foods or join even more accompanying symptoms such as
- stomach pain,
- Blood admixtures during bowel movements,
- Diarrhea, constipation or stool changes in consistency and color,
- Stress symptoms (e.g., high blood pressure, fatigue, or irritability),
- Nausea and vomiting
In addition, a doctor's visit is urgently advised. Above all, blood in the stool is always a symptom that requires a special observation, because behind it can hide serious diseases. If fresh blood is added during or after bowel movements, a doctor should always be consulted.
diagnosis
First, air in the abdomen is diagnosed by questioning the patient. In most cases, this can provide detailed information about exactly when the complaint arose, how severe it is, and whether there are concomitant or pre-existing conditions that could explain the accumulation of air. Dietary habits should also be addressed during the patient discussion.
Following the interview with the patient, a physical examination is usually carried out. Touch tests play a major role to determine how much the abdomen is bloated. For the final determination of causes then also imaging techniques such as ultrasound, gastric or colonoscopy are used. Allergy tests to determine food intolerance are suspected.
Following the patient survey, a physical examination is usually performed. Touch tests play a major role to determine how much the abdomen is bloated. (Image: pressmaster / fotolia.com) therapy
Persistent flatulence is not an isolated disease but is the result of a previous stimulus or a persistent health complaint. Before applying any treatment measures, it should therefore be clarified beyond doubt, which cause is based on the accumulation of air. Of course, there are also but also simple home remedies and tricks for the resolution of one-off flatulence, such as in the wake of nutritional peculiarities. Below is a brief overview:
nutritional intervention
If it should turn out in the course of medical examinations that a food intolerance is responsible for the accumulation of air in the abdomen, it is obvious to avoid appropriate food. But even for people without intolerances, there are some recommendations regarding the daily diet:
- Take enough time to eat food and drinks.
- Hasty slings should be avoided.
- Carbonated drinks should be reduced in case of recurrent flatulence.
- Legumes should swell in water for a few hours before consumption.
- In case of flatulence caused by raw food, vegetables should be briefly simmered before consumption.
- The fiber content in the diet is only gradually increased if necessary.
- The consumption of very sugary foods should be reduced.
- Oily and very rich meals should also be avoided.
- To strengthen the intestinal flora from time to time probiotics (such as probiotic yoghurts) eat.
- In case of doubt, observe eating behavior and digestive problems for a while.
A few more words about the absence of flatulence: The intestinal winds that accumulate during digestion are absorbed only to a small extent via the intestinal mucous membrane into the blood. The much larger proportion is derived by the departure of flatulence to the outside. Suppressing the flatulence is therefore counterproductive and could eventually even lead to pain and reflex bowel cramps. In a relaxed and undisturbed atmosphere, the flatulence urge should therefore be indulged, even if it may be unpleasant or embarrassing for many.
Home remedies and naturopathic therapy
If flatulence occurs despite nutritional measures, a short, vigorous walk or external heat treatment of the abdominal wall can often be relieved with a heat pad or hot water bottle.
Targeted stress reduction in everyday life has a similarly positive effect on the normalization of digestive processes. And also naturopathy can offer some treatment strategies here. For example, the consumption of chamomile or fennel tea has a relaxing and deflating effect. Simply prepare two or three cups after the meal and drink them swallowed.
Naturopathy also offers some treatment strategies to combat flatulence. For example, the consumption of chamomile or fennel tea has a relaxing and deflating effect. (Image: Gehkah / fotolia.com) Also helpful is a massage of the abdominal wall with caraway oil. Distribute this circularly from bottom right to bottom left over the abdomen, being careful not to press too hard on the abdomen when massaging, but to act with gentle and gentle movements.
Another naturopathic tip is the chewing of coriander, curcuma or caraway seeds after eating. The three plants are considered digestive and are not without reason part of many digestive schnapps and bitters. However, especially the plant seeds are said to work particularly well against accumulation of air in the abdomen.
Medical therapy
The medicinal therapy of accumulations of air in the abdomen attacks in different places. For example, there are medicines that lower the surface tension of the digestive gases, making them more common for passage through the gut or absorption into the bloodstream. These medications are often over-the-counter and can be used in accordance with the dosing instructions for babies. These include, for example, drugs with the active ingredients Dimeticon and Simeticon.
Observing a temporal relationship between the consumption of dairy products and the occurrence of flatulence, the observation could be based on a lactose intolerance. It sometimes helps to introduce the milk-lactose enzyme lactase from the outside. Since lactose intolerance is now a very common diagnosis, this enzyme is available for free sale in pharmacies, drug stores or even supermarkets. Nevertheless, the intake should be discussed in advance with the family doctor.
For any other underlying diseases that may be the cause of flatulence, there are also appropriate medications in most cases. Which, however, is the right one, must be discussed individually and under consultation with the attending physician.
Operative therapy
Intraperitoneal injuries leading to pneumoperitoneum logically require surgical management of the wound. Whether sewn, stapled or another surgical procedure is used here, doctors decide on a case-by-case basis. If a disease-related perforation of the organs to blame for the passage of air into the abdominal cavity, so next to the wound closure as a last resort sometimes even only a partial resection of the damaged organ sections into consideration. However, this is a relatively rare exception. (Ma)