Patients often complain of belching air after eating or throughout the day. The reasons for this condition are many and varied. Below are the main ones and methods for eliminating the unpleasant syndrome.
The presence of frequent belching can be reduced by analyzing its causes.
- 1 Description
- 2 Reasons
- 2.1 Physiological
- 2.2 Pathological
- 3 Symptoms
- 4 After eating
- 5 Regular belching
- 6 Pain with belching
- 7 Healthy burping
- 8 For digestive dysfunction
- 8.1 Esophagitis
- 8.2 Lump in throat with belching due to reflux
- 8.3 Neurosis
- 9 Stomach diseases
- 9.1 Gastritis
- 9.2 Ulcers
- 9.3 Changes in the gastric evacuation section
- 9.4 Cancer
- 10 Pathologies of the esophagus
- 10.1 Achalasia cardia
- 10.2 Zenker's diverticulum
- 10.3 Scleroderma
- 10.4 Pathologies of the diaphragm
- 11 Other pathologies
- 11.1 Duodenogastric reflux
- 11.2 Bauhinian valve insufficiency
- 11.3 Dysbacteriosis
- 11.4 Chronic pancreatitis
- 12 Pathologies of the biliary tract
- 13 Causes of wheezing on an empty stomach
- 14 Diagnostics
- 15 Treatment
- 15.1 Drug therapy
- 15.2 Surgical therapy
- 16 Folk remedies
- 17 Diet
- 18 Forecast
- 19 Prevention
Description
Belching is the return of the contents of the esophagus into the mouth. This action is preceded by a feeling of fullness and heaviness due to excess pressure inside the stomach. To alleviate the condition, the body itself provokes the release of gases back into the esophagus with belching.
The appearance of rare odorless and tasteless belching is considered normal from a medical point of view. This happens when you involuntarily swallow air, which accumulates in a volume of 2 ml. To normalize the pressure in the gastrointestinal tract, the air itself comes out in small portions in the form of an imperceptible belch. If an involuntary release of air occurs outside of eating or drinking, while emitting a pungent odor, bad taste, that is, the risk of developing functional disorder stomach (pneumatosis), accompanied by airbrushing, nervous belching. Consultation required.
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Causes
- physiological, when belching air appears after a meal;
- pathological when the belching contains gases formed in the gastrointestinal tract.
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Physiological
The air itself comes out in small quantities without strong smell. This phenomenon does not cause discomfort. Provoking factors:
1. eating in a hurry, as a result, air is swallowed and accumulates in the gastrointestinal tract, which then comes out;
2. conversations while eating;
3. overeating, due to which the stomach cannot cope with the volume of incoming food, it stagnates, ferments with the release of gases.
4. excessive consumption of soda;
5. physical activity after a meal, due to which food is not properly digested and poorly absorbed, stagnation and excessive gas formation appear;
6. frequent chewing of gum;
7. pregnancy in the 2nd trimester. At this stage, the uterus enlarges and begins to compress the diaphragm;
8. the first two months of a baby’s life, when air accumulates during sucking.
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Pathological
During the process, a person experiences a sharp taste and smell. At the same time, the patient experiences other specific symptoms of gastrointestinal pathologies. In this case, the belching is permanent. Occurs against the background of the following conditions:
- destruction of the gastrointestinal tract, such as stenosis of the esophagus, narrowing of the stomach, kinks, tumors growing into the lumen of organs;
- gastrointestinal dysfunction caused by gastritis, ulcers, inflammation of various etiologies;
- pathologies of the liver and gall bladder;
- gastroesophageal reflux, accompanied by the release of food from the stomach into the digestive tract;
- cancerous tumors in the gastrointestinal tract;
- nerve dysfunction;
- problems with the heart and vascular system.
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Symptoms
- sour belching with flatulence against the background of high acidity with gastritis, mucosal ulcers;
- rotten belching due to rotting processes, stagnation of products in the stomach with pyloric stenosis, cancer, gastritis;
- belching large volumes of air due to high gas formation in the gastrointestinal tract. Occurs after eating certain foods dry, having conversations, due to nasal congestion;
- bitter belching due to the backflow of bile into the contents of the stomach with cholecystitis, cholelithiasis.
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After meal
At normal operation In the gastrointestinal tract, air belching after a meal appears rarely and infrequently. Causal factors associated with swallowing excess air:
- at wrong mode nutrition;
- during times of stress;
- with a passion for sodas.
Excess air presses on the walls of the stomach, causing bloating. Pressure balancing is carried out by releasing gases through the opened cardia between the stomach and esophagus. Light belching occurs.
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Regular belching
The causes are identified during an examination aimed at identifying hidden pathologies of the gastrointestinal tract. For this purpose, a patient’s medical history is compiled, laboratory and instrumental studies body.
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Belching pain
The causative factor lies in the development of the disease, causing disruption digestion. Discomfort is felt due to improper nutrition and the presence bad habits. Provoking factors:
- Smoking after the meal.
- Improper consumption of fruits. They should be eaten before or 1.5 hours after a meal. Otherwise, the organic matter in the fruit begins to interact with consumed but still undigested food, forming gases.
- Tea after the meal. The leaves of the drink contain enzymes. They make the process of protein digestion more difficult, which interferes with normal digestion.
- Bath procedures. Warm water increases blood flow in the extremities, but reduces it in the stomach. Therefore, food is not completely digested, stagnation and fermentation occur. These processes cause belching with abdominal pain.
- Loose elastic band or belt. This action after eating greatly relaxes abdominal muscles, the stomach begins to work worse, belching occurs with pain.
- Addiction to cold drinks. Drinking after a meal is undesirable due to the risk of disrupting normal fermentation and absorption of lipids.
- Sleep after a meal. With general relaxation of the body, digestion is disrupted, which provokes not only discomfort, but also the development of gastroenterocolitis.
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Healthy burping
Air venting is rare. There is no smell or taste after it. A gas bubble forms in the stomach due to swallowing air during a snack. Regurgitation will occur due to excessive activity after the meal. Healthy belching often worries:
- obese people;
- those who abuse coffee, strong tea, garlic, onions, and fatty foods;
- people using inhalers;
- pregnant women.
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For digestive dysfunction
Diseases of the digestive system often cause air belching.
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Esophagitis
The pathology is characterized by inflammation of the walls and mucosa in the esophagus. Accompanied by:
- sensation of a lump, scratching in the throat;
- heartburn;
- aching, paroxysmal pain behind the sternum, in the jaw and shoulder, between the shoulder blades.
Simultaneously with inflammation, the functioning of the esophageal muscles is disrupted and peristalsis is reduced, which is often accompanied by regurgitation - the reflux of the contents of the digestive tract into the mouth.
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Lump in throat with belching due to reflux
Gastroesophageal reflux is accompanied by esophagitis and weakening of the sphincter muscle. Due to inflammation of the stomach walls, digestive secretion increases. These phenomena cause heartburn, lump sensation and belching. At the same time, the patient experiences:
- pain behind the sternum, radiating to the left;
- nausea with occasional vomiting;
- mild cough;
- lack of air at night and in the morning;
- weakness;
- nervous disorders;
- sleep disturbance;
- sour taste in the mouth.
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Neurosis
The body reacts sharply to stressful situations, such as a change in familiar surroundings, loss loved one, dismissal from work. Nervous stress affects the digestive system. Due to constant worries and nervous breakdowns a person cannot eat properly and swallows air. As a result, belching appears, and due to muscle spasm, a feeling of a lump appears.
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Stomach diseases
The cause of constant air ulceration is dysfunction of the cardia and other pathologies.
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Gastritis
In acute and chronic course accompanied by belching dull ache, heaviness, distension, vomiting. With the onset of tissue atrophy, the belching becomes rotten, and the patient loses appetite. Vitamin B12 and iron deficiency develops. Pallor, weakness, and brittle nails and hair appear. If gastritis is caused by Helicobacter, belching comes with heartburn and morning hunger pains.
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Ulcers
Accompanied by sour belching due to destruction of the mucous membrane, as well as:
- sharp or dull pain after meals, at night, in the morning;
- decreased appetite;
- constipation;
- nausea with relieving vomiting, while the vomit contains residues of food and bile.
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Changes in the evacuation section of the stomach
Spasm of the teres muscle and luminal stenosis occurs. Excessive pressure is created inside the organ and stagnation of the contents. The result is air with a rancid odor and sour taste. The causes of the disease are varied:
- burns;
- scarring of ulcers;
- tumors.
Without treatment, the pathology quickly progresses, and belching comes out with vomiting.
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Cancer
Young malignant tumors cause belching, which is similar to the phenomenon of gastritis. Signs:
- lack of appetite;
- satiety in small portions;
- refusal of meat;
- anemia;
- feeling of heaviness.
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Pathologies of the esophagus
This group of pathologies is also often accompanied by belching.
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Achalasia cardia
The lower esophageal sphincter spasms, creating zones of narrowing under the sphincter and expansion above the orbicularis muscle. Belching appears due to dysfunction of esophageal peristalsis and impaired swallowing function. Additionally, there is a feeling of a lump in the throat. Reflux disease develops with the backflow of food from the stomach into the esophagus. The burp contains food and the air that comes out is rotten. Heartburn appears.
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Zenker's diverticulum
The pathology is characterized by the presence of a sac-like protrusion at the junction of the pharynx and the esophagus. As it develops, it appears:
- soreness and scratching of the throat;
- discomfort when swallowing;
- air burp with sour smell and food;
- occasional vomiting.
Neglected forms are fraught aspiration pneumonia and mediastenitis.
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Scleroderma
The pathology is accompanied by intensive proliferation of inert tissues with damage to arterioles. Dysfunction of swallowing, belching with heartburn appear along with disturbances in blood flow in the periphery, pain in the joints, and swelling of the extremities.
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Pathologies of the diaphragm
Constant and frequent belching of air characterizes a hernia of the diaphragm. Hernias grow in different parts of the stomach, which increases blood pressure. arise chest pain with recoil between the shoulder blades. Food is thrown into the esophagus and bitter belching appears with food residues. There is heartburn. Vomiting occurs without nausea when eating in a hurry or changing body position.
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Other pathologies
Belching can be caused by other gastrointestinal disorders.
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Duodenogastric reflux
The pathology is characterized by the reflux of the contents of the duodenum into the stomach. Due to exposure bile acids and pancreatic enzymes, destruction of the gastric mucosa begins. Appears:
- non-localized abdominal pain;
- yellowish coating in the mouth;
- belching;
- heartburn.
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Bauhinium valve insufficiency
Is the result congenital pathology or long-term development of inflammation in the intestines. Accompanied by pain, bloating, rumbling. Belching occurs with bitterness, nausea and heartburn appear.
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Dysbacteriosis
It is characterized by the intensive development of pathogenic microflora in the intestines. Called previously past illness, taking strong antibiotics, dysfunction immune system. When seeding pathogenic microorganisms Enteritis develops, accompanied by frequent diarrhea, nausea, heaviness, diffuse pain, belching, flatulence, and heartburn.
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Chronic pancreatitis
With pathology, digestion is disrupted due to a lack of pancreatic enzymes, poorly digested food stagnates, rots, and ferments, which provokes the development of belching with air or food. Pain in the upper abdomen, flatulence, nausea, and occasional vomiting occur. With the simultaneous development of diabetes mellitus against the background of decreased insulin secretion, thirst, itchy skin, and dry mouth appear.
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Biliary tract pathologies
These include:
- dyskinesia;
- chronic cholecystitis;
- sphincter of Oddi dysfunction.
Pathologies are accompanied by bitter belching, nausea with vomiting after physical activity and food.
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Causes of wheezing on an empty stomach
The main reason - neurotic syndromes, which cause cardiospasm in the gastrointestinal tract. Expulsion of air is possible in healthy people without visible disturbances of digestive function. Belching is possible with gastritis, ulcers and other pathologies. The pathology is often accompanied by hunger pain, bloating, nausea and vomiting.
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Diagnostics
- compiling an anamnesis based on the patient’s medical history and complaints;
- laboratory tests: biochemistry, clinical trial blood, stool test occult blood, coprogram;
- instrumental methods (ultrasound, CT, X-ray, endoscopy, etc.) to install more accurate diagnosis if you suspect a disease in the gastrointestinal tract.
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Treatment
Goals - restoration of gastrointestinal functions, cure of existing pathologies or relief of exacerbations chronic forms. It is worth treating only after diagnosing the causative factors.
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Drug therapy
Medications relieve symptoms and prevent their development. They should be taken only as prescribed by a doctor, strictly according to the instructions. After the diagnosis has been established, in order to alleviate the condition and get rid of belching, the following are prescribed:
- antacids that soften mucous membranes;
- prokinetics that improve the functioning of the biliary tract;
- means to reduce the acidity of digestive juice.
Popular medications: “Motilak”, “Omez”, “Raniditin”, “Motonium”, “Rennie”, “Motilium”, “Almagel”, “De-nol”, “Gastal”, “Passazhiks”, “Immodium”, “ Festal." It is also worth drinking: bread soda, magnesia, alkaline mineral water without gas, Maalox.
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Surgical therapy
The method should be used in extreme cases, that is, when tumors, hernias and destructive pathologies of the gastrointestinal tract are detected.
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Folk remedies
- 100 ml of aloe and cranberry juice, 25 g of honey, 250 ml of water. Take 25 g three times a day for a course of 7 days, 2 weeks break, repeat treatment for 6 months.
- A collection of 15 g of yarrow, mint, dill seeds, 30 g of St. John's wort, 2 g of watch. 25 g of the collection is poured into 250 ml of boiling water. Drink 25 g per day.
- Calamus root powder. Take 5 g 15 minutes before meals.
- A decoction of 50 g of elecampane in 1 liter of water. Drink 150 g twice a day before meals for a week.
- Warm goat milk. Drink 250 ml three times a day for up to 3 months.
- Potato and carrot juice in a ratio of 1: 1. Drink 100 ml three times a day.
- After a meal, eat fresh carrots or an apple.
- Drink water before meals. Do not wash down food.
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Diet
- The diet should not contain gas-forming foods: legumes,
cabbage, whole cow's milk, hard cheese, smoked meats, marinades, spicy, fatty; - Soda, alcohol, beer, smoking, and chewing gum are prohibited;
- eat in small portions (250 g) up to 5 times a day.
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Forecast
Physiological, rare belching can be easily corrected by adjusting the diet and regimen. Pathological expression of air depends on the causes of its occurrence. Consequently, the prognosis is determined by the timeliness and quality of treatment of the underlying disease.
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Prevention
- maintaining a proper diet;
- quitting smoking, alcohol;
- timely medical examination;
- treatment of gastrointestinal pathologies;
- weight loss for obesity;
- You can’t sleep, physically work, or go to bed immediately after a meal.
Pancreatic pseudocyst: symptoms and consequences, surgical treatment
A pancreatic pseudocyst is a cystic accumulation of fluid devoid of epithelial lining with high content pancreatic enzymes. This formation is localized in the parenchyma of the organ or in adjacent areas abdominal cavity(in the lesser peritoneal sac).
Causes of pancreatic pseudocysts
There are several significant reasons for the development of the disease. The main ones are:
- Most cases of the disease are associated with alcohol abuse.
- Diseases take second place among the causes biliary tract, complications of which are pseudocysts.
- Complication acute pancreatitis. It leads to the formation of pancreatic pseudocysts in 2-3% of cases.
- A complication of chronic pancreatitis is the cause in 10%. In chronic pancreatitis, pseudocysts manifest as changes in the typical pain pattern.
- In children, the occurrence of the disease is associated with congenital anatomical disorders.
Thus, all factors that lead to the development of pancreatitis, cholecystitis, cholangitis and others are the causes of pancreatic pseudocysts.
Symptoms and complications of pancreatic pseudocysts
In surgical practice for this disease, the clinical picture depends on many factors, such as the duration of the process, the presence of concomitant pathology, the treatment performed, and others.
- Abdominal pain is the most common symptom pancreatic pseudocyst. Occurs with a frequency of 86-90%. The pain is localized in the left hypochondrium and epigastrium, aching and dull in nature, often encircling.
- Nausea, vomiting - occurs in 72% of cases. The appearance of these symptoms is associated with compression of the structures, that is, obstruction of the exit from the stomach and duodenum occurs. When the common bile duct is compressed, another one appears important symptom- jaundice (in 13%).
- Palpable mass - in half of the cases (50%). Upon palpation, a tumor-like mass is determined in the area of the projection of the pancreas.
- In 35% of patients, weight loss is observed.
- Pleural effusion - 15%. The effusion is usually observed in the pleura of the left lung.
- When a pseudocyst ruptures, cardiac and specific symptoms are observed.
- Cardiac: tachycardia, hypotension and shock (depending on fluid loss).
— Specific symptoms rupture of a pseudocyst: when it ruptures into the abdominal cavity, a tense abdomen occurs, strong pain and symptoms of peritonitis. - In case of pseudocyst infection: fever up to 37.9-39.0 degrees, chills and neutrophilic leukocytosis.
- Bleeding from a pseudocyst: hypotension, increasing consolidation in the abdominal cavity. Usually it breaks into the arteries of the spleen or stomach and duodenum.
Diagnosis of pancreatic pseudocyst
Important diagnostic criterion is a correctly collected medical history, the presence of pancreatic diseases in the past (pancreatitis, diabetes, tumors), problems with gallbladder and ducts, alcohol abuse, smoking. In addition, the clinical picture remains important: the appearance of pain, nausea, vomiting and other symptoms.
Lab tests help little in diagnosis and are useful only for preventing the development of complications.
Among laboratory examinations may have meaning:
- Amylase. With pseudocyst normal value up to 50% of the observed.
- Complete clinical (general) blood test (CBC). If leukocytosis is present in the CBC, infection of the cyst cavity should be suspected, and a low hematocrit (decrease in hemoglobin and red blood cells) is associated with bleeding from the pseudocyst.
- Electrolytes, blood urea nitrogen, creatinine, glucose. With a pseudocyst, hypocalcemia, hypokalemia with excessive fluid loss, hypomagnesemia with alcohol abuse and hyperglycemia (sugar levels are significantly increased) are detected.
Special/instrumental examination methods:
- Computed tomography is the most preferred method in diagnosis and is indicated in all cases of suspicion of this disease.
- Ultrasonography. It is important for both primary diagnosis, and for dynamic monitoring of the development of a previously discovered pseudocyst, since it allows you to monitor its size.
- Angiography of pancreatic vessels. Useful in cases of bleeding from a pseudocyst and for differential diagnosis with other diseases (in particular with a ruptured abdominal aortic aneurysm), but is used very rarely due to patient instability.
Treatment of pancreatic pseudocysts
In unstable/severe condition, a triad of resuscitation is performed according to the ABC algorithm with additional oxygen supply, cardiac monitoring and intravenous administration 0.9% saline solution. Transfusion of blood products can be used for hemorrhage (bleeding) from a pseudocyst. For intractable nausea/vomiting, nasogastric suction is indicated, as well as the use of antiemetics - prochlorperazine. With pronounced pain syndrome Meperidine may be used.
Removal of pancreatic pseudocyst: surgical treatment.
Options surgical treatment Pancreatic pseudocysts can be:
- Observation without acute intervention.
- Surgical excision (however possible in few cases).
- In extremely severe conditions or when the cyst wall is immature, external drainage is required - frequency up to 20%.
- For most patients, internal drainage of pancreatic pseudocysts is preferred.
One of the methods still used in some clinics is marsupialization of the pseudocyst.
The essence of this method of cyst removal is that after opening the pseudocyst, its contents are evacuated, and the cut edges of the wound are circularly sutured to the skin and parietal peritoneum. The operation is completed by installing drainage and sterile napkins into the cavity of the pseudocyst. The result of the operation is that the cyst empties outward.
Currently, internal pseudocyst drainage operations are used - that is, the contents of this cavity are drained directly to the organs gastrointestinal tract(stomach, intestines).
Internal drainage options:
- Transventricular cystogastrostomy according to Yurash. It is considered one of the easiest to perform and quite effective operations.
The access for this operation is laparotomy.
Progress of the operation: after entering the abdominal cavity, a 10 cm incision is made in the anterior wall of the stomach. Using hooks, the incision is pulled apart and the posterior wall of the stomach is exposed, which protrudes as a result of pressure from the pseudocyst on it. They puncture the lumen directly through the back wall using a thick needle and suck out the contents. A small incision is then made directly above the puncture site to create common cavity between the stomach and the pseudocyst, which ultimately leads to the emptying of the contents of the cyst into the stomach.
Complete surgical intervention by applying a double-row suture to the anterior wall of the stomach. As for the anterior abdominal wall, it is healing primary intention without installing drainage pipes. - Transduodenal cystoduodenostomy according to Kefschner is similar to cystogastrostomy, but surgical treatment involves the imposition of an anastomosis between the cyst and the duodenum. It is used when it is impossible to perform the Yurash operation, but the effectiveness of such an operation remains at a fairly high level.
- Cystojejunostomy according to Hente is one of the old, but also still used methods of surgical treatment of pancreatic pseudocysts.
The essence of the operation is to create an anastomosis between the jejunum and the cyst, turning off small intestine or without. - Radical treatment: used for small cysts, and the above interventions of internal drainage for large cysts. Small cysts of the body and tail of the pancreas are usually radically excised during resection of the corresponding area. That is, part of the pancreas is removed along with a small cyst. This is done due to the fact that the long-term existence of such cysts leads to chronic pancreatitis and its complications.
Drug treatment of pancreatic pseudocysts (in a hospital setting):
- Potassium chloride (for hypokalemia) - 10 mmol/hour intravenously.
- Calcium gluconate 10% (for hypocalcemia) - 10 ml intravenously (iv) over 15-20 minutes.
- Magnesium sulfate: 16 mmol (2 g) in 50 ml D5W over 20 minutes.
- Meperidine (pain relief): 25-50 mg IV every 3-4 hours.
- Procloperazine (for vomiting): 5-10 mg IV.
Why do women experience bloating and gas?
Discomfort during menstruation
Flatulence in a woman of childbearing age can be considered one of the symptoms of PMS (premenstrual syndrome), because significant physiological changes occur in her body:
1. as during pregnancy, progesterone production increases;
2. as a result of hormonal changes, fluid is poorly excreted;
3. rupture of the follicle in the middle of the cycle (which is the reason why the stomach hurts before menstruation) also leads to inevitable bloating.
Such changes also affect digestion and appetite. An increased feeling of hunger and slow digestion of food provoke excessive accumulation of gases in the stomach and intestines, causing flatulence and increasing a woman’s weight.
Gas formation in the intestines during menopause
During menopause female body also undergoes hormonal fluctuations: sharp rises in estrogen levels contribute to fluid stagnation, and their decrease leads to a reduction in bile production, which causes a deficiency of lubricant in the gastrointestinal cavity and, as a result, constipation and bloating.
Some representatives of the fair sex during menopause, noticing weight gain, pursue the goal of maintaining a slim body and refuse regular meals. This method is wrong: the body is deprived of many nutrients, slow down metabolic processes, and the problem of bloating and flatulence does not remain resolved.
Traditional treatment methods
Based on the cause of flatulence, therapy can vary dramatically. If excessive gas formation is caused by an upset stomach, sorbents are usually used (the classic option is activated carbon). For bloating and pain, antispasmodics are used. Health improvement intestinal microflora and restoration of normal intestinal motility is provided by prokinetics and probiotics, the best of them are Linex, Smecta, Mezim, Espumisan. If found serious pathologies sometimes surgery is required.
To the urgent professional treatment should be resorted to if:
- flatulence and bloating after eating have become chronic;
- prolonged excessive gas formation is complemented by other unpleasant phenomena (pain of any intensity, foul-smelling belching, changes in stool, frequent attacks of nausea and vomiting, constant heartburn, dehydration, general weakness);
- This symptomatology is observed in a child, a woman during pregnancy, an elderly person, including during menopause.
What can and cannot be eaten?
As you know, a common method of combating bloating and flatulence is diet correction. For example, banana and watermelon help prevent this painful condition, and limiting sodium intake helps prevent fluid stagnation.
No diet for flatulence includes processed foods or products containing chemical additives and artificial ingredients. It is also worth giving up foods that cause fermentation processes in the stomach: apples, beans, peas, radishes, prunes, figs, cabbage, soda, kvass. On the contrary, eating vegetables and fruits rich in potassium and fiber is recommended by experts, because these elements relieve the body from dehydration.
It is very important to follow a diet. Ideally, you need to eat at least 4-5 times a day (preferably at the same time), while last appointment food should come in the evening 3 hours before bedtime. Eating at night is strictly contraindicated.
Alternative medicine
Some things can help a woman fight flatulence folk remedies, For example:
1. chamomile infusion (1 tablespoon of the plant’s flowers is poured into 300 g of water, the temperature of which is 80-90°C, and left for 4 hours); You need to drink 30 ml of medicinal liquid before meals;
2. a decoction of parsley root (this ingredient is taken in a 1:5 ratio with water, boiled for 5 minutes and simmered in a water bath for another 15 minutes); The drug should be taken ½ glass no earlier than half an hour before a meal;
3. refined sugar with the addition of ether (you need to add 5-7 drops of anise or dill oil to the sugar); This drug should be taken orally 3-4 times a day.
Self-treatment of flatulence in children and pregnant women unconventional methods, as well as medicines, must necessarily be agreed with a medical specialist.
Treatment of pneumoperitoneum consists of administering gas in
abdominal cavity.
readings
can be used for localization of the process in
lower lobes, as well as with widespread disseminated and
fibrous-cavernous processes to eliminate lymphobronchogen-
no contamination. Although pneumoperitoneum is preferable to
occur with destructive changes localized in the lower lobes
lungs, a positive effect can also be achieved with upper
left location of the process.
In addition, pneumoperitoneum has been successfully used in hemorrhagic
kanye and bleeding, especially in cases where it is not possible to install
source of bleeding or when artificial pneumothorax and me-
Drug treatments were not effective enough.
Pneumoperitoneum increases the frequency of closure of cavities with elastic
stic walls, especially in the middle and lower parts of the lungs;
accelerates the resorption of extensive infiltrative-pneumonic
changes in hematogenously disseminated lesions, aspiration
new pneumonia, fresh lymphobronchogenic inoculations.
body 2-3 weeks of anti-tuberculosis therapy; after childbirth and
abortions on the 5-10th day.
Contraindications
Contraindications to the use of pneumoperitoneum:
pulmonary heart failure;
inflammatory processes in the abdominal cavity, adhesions
in it;
peptic ulcer;
hernia of the white line of the abdomen and inguinal hernias;
amyloidosis of internal organs.
Complications
Among the complications of pneumoperitoneum is observed superficial
subcutaneous and deep emphysema, p at which gas penetrates between
muscles and fascia, peeling them off. In addition, medi-
astinal emphysema, when gas passes through the crura of the diaphragmatic muscle
penetrates the mediastinum. A characteristic symptom is chest pain,
There is cyanosis of the face, swelling in the neck area, upon palpation
a “crunch” is felt in the jugular fossa and on the neck. Sometimes gas penetrates into
the patient's scrotum or may enter the intestinal lumen; in the last
In this case, it is removed naturally.
Serous pneumoperitonitis are rare and occur as
usually asymptomatic. After some break in blowing
pneumoperitonitis resolves and is not further
an obstacle to continuing treatment.
Gas embolism- the most serious complication; the mechanism of its development
the development is the same as for pneumothorax. It occurs more often during
getting the patient up from the couch after insufflation.
90. Pneumoperitoneum Application technique
Gas is administered into the abdominal cavity on an empty stomach.
Needle injection may be pneumothorax -
noah or longer (6-10 cm). Before introducing gas into the abdominal
cavity, the patient is asked to empty the bladder, then
lay on your back; under the lower parts of the chest there are linings -
roll the roller. The skin of the abdomen is treated with iodine or alcohol. P rockol
the abdominal wall is made two transverse fingers below and to the left of the umbilical
ka along the outer edge of the rectus abdominis muscle; the needle is cleaned
drain. Air is introduced into the abdominal cavity through a needle connected to
pneumothorax device.
Unlike pneumothorax, when pneumoperitoneum is applied
the pressure gauge does not fluctuate, and only at the moment of introducing gas into the abdominal
new cavity slight (from +2 to +10) positive
respiratory fluctuations. If there are no fluctuations in the pressure gauge,
Free postures can serve as indicators for the correct position of the needle.
air entrapment in the abdominal cavity, the appearance of tympanitis at the site of
chain dullness. After insufflation is completed, the needle is quickly removed, the skin is moved and lubricated with iodine.
After the gas is administered, the patient experiences pain in the hypochondrium, radiating along the phrenic nerves.
Aerophagia or accumulation of air in the stomach of a child or adult may indicate problems with the digestive system and the development of gastroenterological diseases. If excess air accumulates constantly, you will feel sharp pains, delaying a visit to the doctor is dangerous. If diagnosis and treatment are carried out in a timely manner, the problem can be eliminated and prevented. possible complications.
What are the causes of aerophagia?
When breathing, talking, eating, laughing, yawning, a small amount of air enters the stomach through the mouth. Some of the gases can be released through belching, while the rest is localized in the intestines and comes out through the anus. In a newborn, gases in the stomach are formed due to imperfections in the digestive system. A lot of air irritates the intestinal walls, so the baby often has pain and distension in the abdomen. However, as the baby gets older, it becomes easier, the digestive system improves, and the unpleasant feeling gradually goes away.
Discomfort after eating
Air in the stomach after eating food is not considered a pathology. To remove excess gas, just burp a couple of times, and unpleasant feeling will pass. However, if a lot of gases accumulate, the patient complains of pain in the stomach, and also suffers from nausea, heartburn and a feeling as if he is bursting from the inside; such a symptom is not normal and requires an immediate visit to the doctor.
Diseases
If a lot of air is formed in the intestines and stomach, the person is worried constant belching with an unpleasant odor, this may indicate the development of the following pathologies in the body:
Excessive accumulation of gases in the digestive organ can be a symptom of the development of gastritis. - gastritis;
- stomach ulcer;
- hiatal hernia;
- reflux esophagitis;
- cirrhosis of the liver;
- cholecystitis;
- pancreatitis;
- pyloric stenosis;
- Zenker's diverticulum;
- organ diseases of cardio-vascular system;
- neurological disorders.
How to recognize a pathological disorder?
In gastroenterological diseases, belching is not air the only symptom. The patient complains of accompanying symptoms, among which the most common are:
- increased formation of gases in the rectum;
- hiccups, heartburn;
- pain in the pit of the stomach and in the area of the heart;
- feeling as if there is not enough air;
- abdominal distension;
- loud rumbling and stabbing pain;
- nausea, sometimes accompanied by vomiting;
- bad smell when belching, coating on the tongue.
Diagnostic procedures
Fibrogastroduodenoscopy will help to find out the cause of excessive gas formation in the gastrointestinal tract. Before you begin to treat the problem, it is important to find out what caused the excessive gas formation in the stomach. To do this, it is recommended to visit a gastroenterologist, who will conduct initial examination, will collect important information. To clarify the diagnosis, the patient is given a referral for a number of diagnostic procedures:
- laboratory tests of stool, urine, blood;
- fibrogastroduodenoscopy;
- radiography using a contrast agent;
- coprogram;
- colonoscopy;
- biopsy.
If increased gas formation a newborn suffers, the safest and most informative instrumental method is ultrasonography. It will not harm the baby, but will help to find out the reasons for the development of pathology.
How to get rid of it?
Drugs
Enterol is prescribed for the treatment of gastroenterological diseases. If the air from the stomach does not pass well due to the development of gastroenterological diseases, the following groups of drugs can help combat the problem:
- Antibacterial agents. Prescribed to patients diagnosed with gastritis or stomach ulcers. The following medications will help destroy the Helicobacter pylori bacterium:
- "Enterofuril";
- Pro- and prebiotics. Normalizes digestion and helps remove unpleasant symptoms. Well proven:
- "Bifiform";
- "Acipol";
- "Linex".
- Sorbents. It will be possible to expel toxins and poisonous substances from the body with the help of activated carbon. The following are considered no less effective:
- "Enterosgel";
- "Polysorb".
- Enzymes. They normalize the functioning of the digestive system, thanks to which a person can burp air normally. The drugs also help reduce accompanying symptoms, such as nausea, heartburn, abdominal pain. By effective means this group are:
- "Mezim";
- "Festal";
- "Creon."
Unconventional methods of treatment
Juicing potatoes before eating will prevent excess gas formation. To ease the work of the stomach and prevent excess gas formation, it is recommended to consume daily before each meal. potato juice, which is prepared according to this recipe:
- Peel and wash 1 potato well.
- Grate the tuber, put the pulp in cheesecloth and squeeze out the juice.
- Drink the finished product immediately. Before each use, new juice is prepared.
This useful remedy can normalize digestion and save you from air in the stomach:
- Pour 1 tbsp. l. dried eucalyptus leaves 500 ml boiling water.
- Cover the container with a lid, wrap it up and let the product brew for 30-40 minutes.
- Strain the finished infusion and take a glass 2 times a day.
Another effective and safe recipe using parsley:
- Chop fresh herbs, separate 4 tbsp. l. and pour a liter of boiling water.
- Let the product sit for 3-4 hours.
- Drink 5-6 times during the day.
If aerophagia is not treated in a timely manner, the distended stomach will put pressure on neighboring organs, provoking the development of associated pathologies, such as stretching of the abdominal muscles and the formation of a hiatal hernia.
Pneumoperitoneum (synonymous with aeroperitoneum) is the introduction of gas (oxygen) into the abdominal cavity. The introduction of atmospheric air is undesirable.
WITH therapeutic purpose pneumoperitoneum was used for intestinal tuberculosis and. Currently, pneumoperitoneum is one of the methods of collapse therapy (see) for pulmonary tuberculosis.
Pneumoperitoneum is used for certain diseases of the spleen, liver, diaphragm, cardioesophageal region, internal genital organs in women, with (see).
Position of the patient when applying pneumoperitoneum.
Pneumoperitoneum is applied on an empty stomach after bowel movement. Bladder and cleansing the gastrointestinal tract. A puncture of the abdominal wall is performed with the patient lying on his back with a cushion placed (Fig.). Place of puncture: usually on the left in the lower quadrant of the abdomen along the edge of the rectus muscle. Gas is administered using a device for applying artificial gas. The amount of gas administered depends on the readings and ranges from 300 to 2000 ml. (cm. ).
Complications of pneumoperitoneum: subcutaneous, hemorrhages in the abdominal wall and abdominal cavity, injuries to the intestines, bladder, gas, etc.
Pneumoperitoneum (pneumoperitoneum; from the Greek pneuma - air and peritonaion - peritoneum) is an accumulation of gas in the free abdominal cavity. Pneumoperitoneum occurs when the integrity of the stomach or intestines is violated or due to perforation of an ulcer, as well as with traumatic pneumothorax in case of simultaneous damage to the diaphragm (thoracoabdominal wounds). Clinically, these forms of pneumoperitoneum are recognized by the appearance of a zone of tympanitis in the navel (in a patient lying on his back) and by the disappearance of liver dullness (in a sitting patient).
Pneumoperitoneum is created artificially by injecting oxygen into the peritoneal cavity. Therapeutic pneumoperitoneum is one of the types of collapse therapy (see) for pulmonary tuberculosis.
Diagnostic pneumoperitoneum is used for contrasting the abdominal organs when x-ray examination. Pneumoperitoneum is applied to the patient on an empty stomach with an empty bladder and an enema-cleaned intestine. The patient is placed on his back with a slight turn on his right side; the head end of the table is slightly lowered. On the left, 2-3 cm from the anterior superior iliac spine, along the line connecting it to the navel, 1-2 ml of a 0.5% novocaine solution is injected into the thickness of the skin and at the injection site the abdominal wall is punctured with a thin (up to 1 mm) trocar with side hole at the end. It is necessary to approximately determine the thickness of the abdominal wall and accordingly calculate the depth of the injection to avoid injury to the abdominal organs. After removing the stylet, the trocar tube is slightly advanced in depth. If it goes unhindered, and the syringe inserted into it is warm saline flows in easily and does not flow back out, which means the trocar is in the free abdominal cavity and you can begin insufflating gas. The apparatus for applying artificial pneumothorax (Fig. 1) injects 800-2000 ml of oxygen into an adult, and no more than 500 ml into a child 8-10 years old. At correct technique puncture complications are extremely rare. Injury to the abdominal organs threatens internal bleeding, peritonitis, air embolism. The first sign of damage may be the release of blood or intestinal gases from the trocar.
X-ray picture. Accumulations of gas in the abdominal cavity are easily detected by x-ray examination, since the gas weakly absorbs x-rays. When the patient’s body position changes, the gas moves in the abdominal cavity, always occupying the highest located sections (“at the zenith”). In a vertical position, gas collects mainly under the dome of the diaphragm; in a position on the left side, in the right colonic canal between abdominal wall and liver, etc.
X-ray examination is widely used in the clinic for pneumoperitoneum caused by disruption of the integrity of the hollow organs of the abdominal cavity, and for artificial pneumoperitoneum. In the first case, x-ray detection of pneumoperitoneum serves as evidence of perforation of the wall of a hollow organ. For therapeutic pneumoperitoneum, the radiologist determines the amount and distribution of gas in the abdominal cavity and the position of the diaphragm.
For diagnostic purposes, pneumoperitoneum is used in cases where more than simple methods studies are insufficient to clarify the diagnosis or require clarification morphological features organ damage. Highest value pneumoperitoneum acquired in the recognition of diseases of the diaphragm, chronic lesions of the liver and spleen, tumors of the vault and cardia of the stomach, diseases of the female pelvic organs.
Contraindications: serious condition sick, acute inflammatory lesions abdominal organs, decompensation of the cardiovascular system and kidneys.
X-ray examination of pneumoperitoneum is carried out in different projections and in different positions of the patient’s body (Fig. 2), in order to achieve gas movement in the abdominal cavity and optimal display of the studied organs on the film. Pneumoperitoneum is widely combined with tomography and contrast of the stomach, colon, kidneys, bladder, and uterus.
Rice. 2. Main positions for research in conditions of pneumoperitoneum: 1 - anterior surface of the liver, peritoneum, omentum; 2 - right lobe of the liver; 3 - spleen, descending and sigmoid colon; 4 - liver (especially the left lobe), spleen, stomach, intestines; 5 - liver, spleen, kidneys; 6 - anterior surface of the liver; 7 - diaphragm, liver, spleen, proximal stomach; 8 - diaphragm, proximal stomach, liver; 9 - internal female genital organs.
On radiographs with pneumoperitoneum, all parts of the diaphragm are clearly visible. It is possible to recognize its segmental hypoplasias and hernias and distinguish them from echinococcus or tumors of the liver and spleen. Against the background of gas, all parts of the liver are clearly visible (one can judge their size and plasticity), which makes it possible to identify cirrhosis, cysts or liver tumors (Fig. 3). Splenomegaly and splenic cysts are easily recognized.
Injecting gas into the abdomen while simultaneously inflating the stomach or intestines with gas is a valuable way to detect small tumors digestive tract(see Parietography). In addition, it is possible to determine the transition of a stomach tumor to neighboring organs.
Pneumoperitoneum is of great importance in determining the location, size and surface of the uterus, fallopian tubes and ovaries (gas pelviography). It makes it possible to recognize abnormalities in the development of a woman’s internal genital organs, ovarian cysts, and tuberculosis of the appendages. Some authors use pneumoperitoneum to clarify the diagnosis of cervical cancer (determine its stage) and monitor the effectiveness of radiation therapy.
Rice. 3. Liver diseases: 1 - syphilis (the liver is enlarged, deformed, compacted, fused to the parietal peritoneum); 2 - cirrhosis (the liver is reduced, compacted, its surface is uneven); 3 - echinococcus (in right lobe- partially calcified cyst; the liver in this area is compacted and connected by adhesions to the diaphragm).
In case if in the abdominal cavity air accumulates, which is sometimes observed during perforation of cavitary gas-containing organs, during the development of putrefactive gases under the influence of gas-forming bacteria (pneumoperitoneum), or during artificial injection of gases into X-ray gels according to the Rautenberg method, a loud low-pitched sound is obtained over areas where air has accumulated tones tympanic sound.
If the amount of gas is not great, then it, distributed according to the laws of physics, in the subdiaphragmatic areas, is detected in the zone of tympanic sound above the liver or stomach and spleen, which are pushed down by the accumulated gas. In these cases, the zone of tympanic sound between the pulmonary sound and the dull sound of the liver, resp. spleen, allows one to suspect partial pneumoperitoneum.
On the contrary, when accumulation of large amounts of gases in the abdominal cavity, due to the pushing back of large parenchymal organs(liver, spleen) from the walls of the abdominal cavity, normal areas of dullness of the liver and spleen disappear. However, when making a conclusion based on percussion data about the accumulation of free gas in the peritoneum, one must be careful, since the disappearance of liver dullness, resp. spleen, may depend on other reasons.
Bloated thin and especially the large intestines during flatulence, pressing on the lower surface of the liver, as indicated in the lecture on tapping the liver, cause a rotation of the liver about the transverse axis and cause less adherence of its upper surface to the chest (retroversio hepatis), i.e., the marginal position of the liver and reduction in the diameter of absolute liver dullness.
In the case when flatulence very large, as, for example, with peritonitis, the band of contact of the liver with the chest is so narrow that. along the anterior vertical lines (l. parasternal, l. mammillaris, axillaris anterior) we do not find dullness of the liver at all, and only along the posterior axillary and scapular line can we detect a zone of dullness.
As is known, disappearance of liver dullness is one of the signs of inflammation of the peritoneum, to which clinicians, in the event of its sudden appearance, attach great diagnostic importance. But, no matter how great the paresis and bloating of the intestines during peritonitis, if there is no accumulation of gases in the abdominal cavity (pneumatosis peritonealis - with perforation of the stomach or duodenum, with ulcers, with perforation of the intestines, with typhoid fever, in case of injury, with the development of putrefactive processes in the exudate) it is always, nevertheless, possible to find dullness of the liver behind; on the contrary, with significant pneumoperitoneum it disappears, and this is a differential sign of acute peritonitis from pneumotosis.
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