How to get rid of gas in the stomach quickly and for a long time?

Physiology or pathology?

The digestion process begins in the mouth. This was at the top of the intestinal enzyme distribution.

Then, the healthy ingredients are distributed with blood circulation throughout the body and thus contribute to the creation of new cells and tissues as building material.

Digestion is a complex chemical process. Waste, gas accumulation is inevitable. But they are not needed at all.

Particles, particularly to the disorder, begin to come out with the consistency of gas due to the restoration of chemical reactions in the stomach during digestion.

The gas release standard per person is 16 times per day.

If this number is exceeded by up to 20-25 times, this is already a pathology, indicating problems in the gastrointestinal tract, increased formation and production of gas, when observed in humans:

• flatulence;
• sense of balance;
• painful sensations;
• cool;
• weakness;
• Migraine;
• Fear, uncertainty.

Gases must necessarily be present in the intestinal cavity, although not stagnant for a long time, do not accumulate in large volumes and are gradually released in feces. However, the permissible volume should not exceed 0.9 liters.

Ways to manifest flatulence

Flatulence in adults is also characterized as swelling or bloating, during which discomfort occurs in the abdominal area, accompanied by rumbling, belching, and sometimes constipation or diarrhea. Attacks of spasms and pain are possible. Flatulence can also occur with the constant release of gases that have an odor. The condition improves significantly after a person has bowel movements. As a rule, such disorders appear in the afternoon, when the digestive system is actively working.

If the accumulation of gases occurs in a certain part of the intestine, so-called local flatulence, pain is observed. When gases are retained at the bend of the intestine, where the spleen is, in addition to the standard manifestations, pain is felt on the left side and severe bloating. Gases in the liver area are manifested by a feeling of overeating and pain on the right side under the ribs and shoulder blade.

flatulence in adults

With flatulence, which occurs due to dysfunction of the small intestine, bloating is observed, while the colon is characterized by a feeling of fullness, distension on the sides. In addition to the standard manifestations, the patient experiences vomiting, shortness of breath, unpleasant belching, heart pain, rapid heartbeat, and general weakness.

Flatulence, which is observed over a long period of time, not only has a detrimental effect on human health (heart problems, insomnia, weakness), but also limits the ability to communicate with other people.

Common causes of bloating

Flatulence, one way or another, is associated with digestion. If the collection of gas in the abdominal cavity has become a constant, obsessive phenomenon, you may suspect the development of pathology in the abdominal cavity.

The most common causes of stairs include:

• IBS, irritable bowel syndrome;
• Intestinal infections (giardia, protigo);
• Intestinal obstruction;
• consumption of heavy meals, fatty and sugary dishes, fast food, which increase gas formation;
• indigestion disorder;
• Hangover;
• Taking certain medications (antibiotics);
• pregnancy;
• menstruation;
• Floor, or upon completion;
• Abuse of carbonated drinks, when there is an accumulation of gas that cannot be quickly removed naturally;
• Lightening with a gradual belly, which can occur after each meal.

In fact, due to gases in the abdominal cavity, it is observed after operative surgery to remove the gallbladder, especially laparoscopy and imperial cutting, as acute working methods that lead to the intersection of tissues, muscle fibers in the abdominal cavity. This causes large amounts of gas to accumulate.

Diseases that cause bloating

Abdominal soil, gas, nausea and urinary discomfort are factors in the improper functioning of the intestines and indicate the development of many diseases.

This happens that the stomach is firmly different in the navel or from the inside, gases increase in the intestines, especially after consuming certain foods. Food particles remain in the intestines 2-3 hours after eating, pour into the lower episodes, which are accompanied by bloating and gases.

What diseases lead to this problem:

1. Inflammation of the colon with inflammatory signals in the walls of the colon leading to culture, contractions (gas), difficulty passing stool. The main factors are pain, flatulence, constipation.
2. Intestinal inflammation, which is accompanied by diarrhea caused by poor absorption of food. Patients have sudden weight loss, hair loss, mood swings, gas and abdominal pain, severity of symptoms after drinking fresh cow's milk.
3. Gastritis with an inflammatory course in the gastric mucosa. Symptoms: constipation, congestion, decreased or increased acidity, impaired production of acidity.
4. Hemorrhoids in the winding, expanded hemorrhoids in the rectum, the appearance of blood stagnation in the pelvic area. Contribution to this muscle load, pregnancy, passive lifestyle. Dizziness, gas in the abdomen, burning, drilling in the anus, constipation, alternating with diarrhea are observed. Palpitations occur with hemorrhoids and pain in the sacrum.
5. Intestinal obstruction caused by stool that accumulates, hardens, and cannot be passed naturally. Triggering factors: frequent constipation, gastrointestinal diseases, chronic gastroenteritis, pancreatitis, cholecystitis.
6. Gynecological problems: menopause, ovarian cysts, onset of menstruation.

Bloating and gas formation: modern treatment options

Bloating is a very common and very unpleasant symptom that makes a person suffer even more than from abdominal pain. Bloating is a gas-related symptom. The sensation of excess gas in the gastrointestinal tract (GIT) is most often associated with increased tension in the wall of the hollow organ and can be a consequence of both actual excess formation (and/or impaired removal of gases from the GIT) and the result of high visceral sensitivity.

The subjective feeling of bloating (part of the symptom complex of flatulence syndrome) is usually accompanied by painful objective manifestations: an increase in abdominal circumference, loud rumbling (borborygms), sudden release of gases through the mouth (belching), accompanied by specific sound manifestations, uncontrolled release of foul-smelling gases (flatulence). All these symptoms cause psychological discomfort, feelings of shame and guilt, and negatively affect mental status, leading to restlessness, anxiety, depression, and phobic moods. If bloating and associated problems become persistent, a person’s normal lifestyle, family and social relationships are disrupted, the quality of life decreases, and the range of social and behavioral activity is narrowed. As a rule, gas-associated symptoms worsen during periods of psycho-emotional stress, with changes in climatic and time zones, and changes in nutritional patterns.

The symptom of bloating has no age limit [1] and is one of the most common, observed in more than 85% of gastroenterological patients [2]. Among patients with a functional gastrointestinal disorder (FGID), abdominal bloating is observed in approximately 24–97% of patients and, in addition, very often occurs in patients with gastroesophageal reflux disease (GERD), diseases of the pancreas and gallbladder, premenstrual syndrome, and impaired intestinal motility . Patients suffering from irritable bowel syndrome (IBS) with bloating are more likely to visit the doctor, and the impact of their disease on quality of life is more pronounced than the impact of IBS without bloating [3].

Abdominal bloating occasionally occurs in almost all people and, as a rule, is clearly related to dietary habits, i.e., consumption of foods with a high gas-forming potential. Thus, according to the results of a population study conducted in our country among a practically healthy contingent of respondents, it was found that over the last week signs of flatulence were noted by 28%, over the last month - 44%, over the last year - 62% of respondents [4].

The prevalence of functional bloating in adults in the United States ranges from 6% to 31%, with an average pooled prevalence estimate of 15.9%, and is more common in women (19.2%) than in men (10.5%) [5].

The high variability in the prevalence of bloating is associated, firstly, with different perceptions of the term. Patients and doctors interpret the content of this concept differently (as a variant of a subjective feeling of fullness and bloating of the abdomen; the appearance of hardness and tension in the anterior abdominal wall; excessive formation and discharge of gases; and as an objective increase in abdominal girth, and, finally, as a manifestation of any other dyspeptic complaints). Secondly, some patients suffering from bloating do not seek medical help for a long time, in particular, because of the moral and ethical complexes that accompany the excessive formation of gases in the intestines; on the contrary, other people ignore these symptoms, believing they are of little significance for overall health. All this not only complicates the epidemiological assessment of the syndrome, but also does not allow us to formulate diagnostic criteria convenient for clinical practice and objective assessment of the effectiveness of drug therapy.

In the new edition of the Rome IV criteria, functional abdominal bloating/distension still forms part of a large group of functional gastrointestinal disorders of the gastrointestinal tract-central nervous system interaction (Table 1) and is considered as a diagnosis per se in patients who do not meet the Rome criteria within the framework of other gastrointestinal tract disorders, although the possibility of mild abdominal pain and/or minimal bowel movements is acceptable.

Experts of the Rome IV criteria propose to combine functional abdominal bloating and distension into one concept, although they emphasize that these symptoms can be observed in isolation, do not correlate with each other and have different pathophysiological mechanisms of development [6].

Functional bloating differs from other cases of abdominal distension in its circadian rhythm: in typical cases it increases after meals (usually after eating certain so-called problem foods) and during the day and decreases or disappears at night. Problematic foods include sugars, more specifically oligo- and polysaccharides, which pass unchanged into the large intestine, where they are fermented by fermenting and proteolytic microorganisms. This process is accompanied by the release of gas. Excessive perception of intestinal gases forms the symptoms of the disease [7].

Key points in the conceptual understanding of the pathogenesis of functional abdominal bloating/distension include visceral hypersensitivity, gas formation in the colon, and changes in gastrointestinal motility. The mechanisms associated with visceral hypersensitivity are fueled by alert anticipation of perceived unpleasant events. In the dysregulation of the brain-gut axis, genetic predisposition, environmental factors, chronic stress, and disorders of the intestinal microflora play a role [8].

Currently, the main causes of functional bloating are considered: visceral hypersensitivity, colonic fermentation, excessive bacterial growth in the small intestine and changes in the metabolic potential of the colon microbiota, disruption of intestinal transit and rectal gas evacuation [9].

The study of the pathophysiological mechanisms of development of the symptom of functional abdominal distension, thanks to innovations in diagnostics, including abdominal induction plethysmography (which makes it possible to measure abdominal distension), allows us to consider an abnormal viscerosomatic reflex involving the diaphragm and muscles of the anterior abdominal wall as the main predictor of the formation of this symptom. The mechanism of this reflex is not yet known. Studies have shown that colonic fermentation, decreased rectal sensation, and impaired intestinal transit may contribute to abdominal distension in some patients [9, 10].

The diagnosis of functional swelling must be established with indispensable reliance on 3 key positions: 1) anamnesis and clinical picture; 2) a thorough physical examination; 3) exclusion of anxiety symptoms with the minimum required set of laboratory and instrumental tests [11].

Despite the significant prevalence of functional bloating/distension of the abdomen, there are no clearly developed treatment algorithms for this pathology. The list of methods for effective treatment of bloating and distension is very limited (Table 2).

Some dietary changes, such as avoiding carbonated drinks and foods that tend to cause gas, can help reduce the symptoms associated with bloating. The exclusion from the diet of poorly digestible and assimilated short-chain carbohydrates (fermentable carbohydrates; oligo-, di- and monosaccharides; polyols) also has a positive effect, that is, bloating decreases when following a diet that excludes the entry into the colon of intensively fermentable substrates, such as wheat products; fruits rich in fructose (for example, apples, pears); vegetables containing fructans (onions, asparagus, etc.); products containing raffinose (for example, legumes, beets), sorbitol (sugar-free chewing gum) [3].

Helps prevent bloating caused by eating problematic foods by taking alpha-galactosidase (Orlix, dietary supplement) with meals. Alpha-galactosidase provides enzymatic activity missing in the human body, breaking down oligosaccharides into simpler, easily digestible forms. As a result of the use of Orlix, the amount of fermentable substrates entering the colon is reduced and the overproduction of gas associated with nutrition is prevented [12, 13].

In addition, some improvement can be expected from moderate physical activity, which facilitates bowel movements and gas transport.

Reduces the severity of bloating and abdominal distension by taking prokinetics. Prokinetics, accelerating intestinal transit, promote the movement of gas through the intestine and its removal to the outside [14]. However, prokinetics (lubiprostone and linaclotide), recommended by experts of the Rome IV criteria, for the treatment of bloating are not registered in our country. Among the drugs available on the Russian pharmaceutical market, trimebutine (Trimedat) is a universal regulator of gastrointestinal motility. Trimebutine is an opiate receptor agonist, its modulating effect on gastrointestinal motility and analgesic effect are associated with a nonspecific effect on all classes of peripheral opiate receptors: μ, κ and δ. Trimebutine stimulates the evacuation function of the stomach, normalizes intestinal motility and gas transit, reduces visceral sensitivity, helps relieve the feeling of bloating and discomfort, and has a beneficial effect in both hypokinetic and hyperkinetic forms of disorders of motor activity of the gastrointestinal tract. In the treatment of flatulence, a course prescription of the drug Trimedat 200 mg three times a day 30 minutes before meals for 30 days or more is indicated [15].

Currently, the study of the role of disturbances in the intestinal bacterial flora in the occurrence of gastrointestinal tract is ongoing. Thus, it was found that there are some species differences in the microbiome of healthy people and patients with bloating. This has prompted numerous clinical studies to study the effectiveness of antibiotics, probiotics and prebiotics for flatulence. Two probiotics have been shown to reduce visceral sensitivity in animal models: Bifidobacterium infantis and Lactobacterium acidophilus.

In the treatment of disorders associated with high levels of gas in the gastrointestinal tract, antiflatulents, or defoamers, are traditionally used. A drug that reduces foaming in the intestinal lumen is simethicone, which is a high-molecular silicon-based polymer - dimethylsiloxane with the addition of silicon dioxide. According to its mechanism of action, simethicone is a surfactant that reduces the surface tension of gas bubbles in chyme and mucus in the intestinal lumen, leading to their rupture. In this case, a process of coalescence occurs - the fusion of gas bubbles and the destruction of foam, as a result of which free gas is able to be absorbed through the intestinal mucosa or evacuated along with the intestinal contents. The dose is selected individually depending on the severity of symptoms. The main use of defoamers in clinical practice is the symptomatic treatment of various gastrointestinal diseases accompanied by excessive gas formation [2].

It is known that antidepressants modulate visceral sensitivity, they are often recommended for patients with gastrointestinal tract, but to date, based on the results of clinical studies, impressions of their effectiveness have not been definitively determined [3].

As a result, we have to admit that bloating and distension of the abdomen are difficult to treat. As soon as the connection of these symptoms with organic diseases is excluded, it is reasonable to place emphasis on the functional nature of these conditions, and in treatment it is advisable to pay attention primarily to the implementation of a diet and taking the biologically active food supplement Orlix.

The active component of Orlix is ​​a natural enzyme - alpha-galactosidase (producer - the bacterium Aspergillus niger). 1 tablet contains 5 mg (corresponds to 150 units) of alpha-galactosidase. Does not contain GMOs, lactose, milk proteins, dyes, flavors and preservatives.

In order to study the effectiveness and tolerability of Orlix in patients with functional bloating/distension of the abdomen, an open, non-randomized, placebo-uncontrolled, multicenter study was conducted in Moscow city clinics.

Objectives of the clinical trial:

1. To study the possibility of correction of gas-associated symptoms after ingestion of problematic foods in patients with functional bloating/distension of the abdomen when consuming Orlix with meals.
2. Assessment of the tolerability of Orlix and its impact on quality of life.

Problematic foods:

• all types of beans (white, red, brown and their variants);
• lentils - all types;
• all types of cabbage (white, red);
• kohlrabi and Brussels sprouts;
• cauliflower and broccoli;
• salads of all kinds;
• onion garlic;
• carrots, parsley;
• flour and flour products (especially from wholemeal flour);
• pistachios and sesame;
• soybeans and soy products (soy milk, tofu).

Study design

The study involved 55 patients with complaints of flatulence (bloating, belching, increased passage of gas, a feeling of fullness in the abdomen, increased abdominal circumference) associated exclusively with the consumption of problematic foods, after excluding all other possible causes of gas-associated symptoms. Patients were examined according to a unified plan (general clinical analysis of blood, urine, stool, biochemical blood test, esogastroduodenoscopy, colonofibroscopy, ultrasound examination of the abdominal organs). At the end of the study, all patients underwent a repeat examination of general clinical and biochemical blood tests.

The average duration of complaints in patients included in the study was 3.5 years. The male to female ratio is 20:35. Average age 38 ± 5.5 years.

A prerequisite for patient inclusion in the study was the refusal to use any antiflatulent drugs and the continuation of taking problematic (gas-forming) products in the usual volume.

All patients included in the study took the dietary supplement Orlix with the first portion of problem food in a dose of 2–4 tablets for 2 months.

The effectiveness of Orlix was assessed based on the patient’s subjective assessment of the manifestations of flatulence at the beginning of the study, and then during the 1st and 2nd control studies (after one and two months of treatment, respectively) according to the severity of symptoms: 1st degree - all gases associated symptoms are completely eliminated, 2nd degree - mild symptoms of flatulence that do not bother the patient in everyday life, 3rd degree - improvement is observed, but in a mild form gas-associated symptoms persist, 4th degree - very little or no improvement.

As part of the overall assessment of the effectiveness of Orlix after 2 months of its use, based on a subjective assessment of the severity of symptoms of flatulence, patients were divided into 4 groups: 1st group - excellent - improvement of symptoms by 100% (corresponding to the assessment of the 1st degree), Group 2 - very good - improvement of symptoms by 50-80% (corresponding to a grade 2 assessment), Group 3 - moderate - improvement of symptoms by 30-50% (corresponding to a grade 3 assessment), 4th group - no changes - 0–30% (corresponds to a grade 4 assessment). All study statistics are based on patients' subjective assessment of gas-related symptoms after consuming problematic foods.

The effectiveness and safety of Orlix was also analyzed based on data from the SF-36 questionnaire to assess quality of life.

A study of anthropometric parameters (body weight and abdominal circumference) was carried out before the start of treatment and upon its completion.

Research results

Subjectively, already at the first control examination, 28 (50.9%) patients noted a complete elimination of the development of symptoms of flatulence after eating problematic foods while taking Orlix with meals; after 2 months of treatment, the number of patients with excellent effectiveness of Orlix increased to 32 (58.2 %).

Mild symptoms of flatulence persisted and did not bother the patient in everyday life in 19 (34.6%) patients at the end of the first month of treatment; subsequently, two of them noted the almost complete disappearance of gas-associated symptoms (with an increase in the single dose of Orlix to 3 tablets).

It is noteworthy that the number of patients who reported that, despite taking Orlix, they still had mild gas-associated symptoms, did not depend on the duration of treatment: 6 (10.9%) people at the 1st control and 5 ( 9.1%) at the end of observation. In one patient from this group, complete relief of abdominal bloating occurred when the single dose of Orlix was increased to 3 tablets.

Only 2 (3.6%) patients noted no improvement during the first month of treatment. One patient had the Orlix dose increased to 3 tablets per dose when consuming problematic foods, and against this background he noted a significant improvement. In another patient, increasing the dose of Orlix to 4 tablets per dose resulted in only minor relief of symptoms.

Thus, subjective improvement, despite continuing to take the usual amounts of problem foods, when using Orlix with meals was detected in 98.2% of patients (Table 3), and all of them noted the rapid onset of action of the biologically active food supplement when following the regimen taking Orlix with the first portions of food.

The overall assessment of the effect of Orlix after 2 months of its use, based on the patient’s subjective assessment of the severity of symptoms of flatulence, is presented in table. 4. An excellent effect was registered in 32 (58.2%) patients, a very good effect in 17 (30.9%), moderate improvement in symptoms was noted by 5 (9.1%) people. Only one patient in the study reported very little improvement in flatulence symptoms.

At the same time, not only subjective improvement was noted in patients; when studying the dynamics of anthropometric parameters, a tendency to a decrease in abdominal circumference was revealed, which was more pronounced in women while maintaining a constant body weight (Table 5).

When analyzing changes in the quality of life according to the nosologically nonspecific questionnaire SF-36 during treatment with Orlix, positive dynamics were also revealed: there was a significant improvement in the quality of life in almost all indicators of both physical and mental functioning. The mean physical functioning (PF) score increased from 85.1 ± 6.4 to 92.2 ± 2.1 points (p < 0.05); role physical functioning (RP) - from 51.3 ± 5.1 to 85.2 ± 2.3 points (p < 0.05); the general health (GH) score increased from 48.9 ± 8.4 to 61.21 ± 2.1 points (p < 0.05). Indicators of the psychological component of health changed as follows: vitality (VT): 54.6 ± 6.3 and 78.2 ± 4.9 points (p < 0.05); social functioning (SF) - 47.6 ± 11.2 and 68.8 ± 5.3 points (p < 0.05); role emotional functioning (RE) - 58.8 ± 8.4 and 70.2 ± 3.1 points (p < 0.05).

As part of the subjective assessment, the dosage of Orlix was statistically evaluated. At the beginning of the clinical study, a dosage of 2 tablets was prescribed to 32 (58.2%) patients, 3 tablets to 23 (41.8%) patients, a dosage of 4 tablets was not prescribed. During the first control, in 6 patients with the 3rd degree of severity of gas-associated symptoms, the dosage of Orlix was increased to 3 tablets and in 1 patient who did not notice an improvement in symptoms, the dose of the drug was increased to 4 tablets. However, increasing the dosage did not significantly affect the subjective feeling of the severity of flatulence symptoms. Thus, it was found that the dosage of Orlix is ​​less correlated with the severity of gas-associated symptoms, and more dependent on the amount of food eaten; usually it is enough to take 2-3 tablets during a normal lunch (Table 6).

The dynamics of the main parameters of general clinical and biochemical blood tests (ALT, bilirubin, glucose) in the direction of deterioration were not observed (Table 7).

All patients noted good tolerability while taking Orlix; no adverse reactions were recorded.

Discussion

The study included patients with functional bloating/distension. All of them noted the connection between the occurrence of gas-associated symptoms and the consumption of problematic foods, such as beans, lentils, all types of cabbage, as well as kohlrabi, broccoli, salads of all types, onions, garlic, carrots, parsley, whole wheat flour products, pistachios and sesame seeds, soybeans and soy products. These products are united by a high content of oligosaccharides (melibiose, raffinose, stachyose, verbascose), formed by galactose and fructose, in various ratios (Table 8), since soy contains a lot of them, they are also called “soy oligosaccharides”.

Galactose (from the Greek root γaλακτ-, “milk”) is one of the simple sugars, a monosaccharide from the hexose group. D-galactose is widespread in nature, it is part of oligosaccharides (melibiose, raffinose, stachyose), some glycosides, plant and bacterial polysaccharides (gums, mucus, galactans, pectins, hemicelluloses), in animals and humans - in the composition of lactose, group-specific polysaccharides, cerebrosides, keratosulfate, etc. Fructose (fruit sugar), C6H12O6 - monosaccharide, isomer of glucose. In its free form, fructose is present in almost all sweet fruits, and also makes up up to 80% of honey; as a monosaccharide unit it is part of sucrose and lactulose.

Soy oligosaccharides are widely used in the food industry (soft drinks, candies, cakes, industrially prepared wheat products, dairy products, infant milk powder, etc.), and are included in many pharmaceuticals.

But human digestive enzymes are not able to break down the chemical bond between two galactose molecules, so these oligosucroses are not absorbed in the small intestine, but are hydrolyzed by enzymes of colon microbes (which have a set of enzymes that utilize soy sugars) with the formation of organic acids and large amounts of gases: H2, CH4 , CO2 (hence the name of products containing such oligosaccharides - gas-forming, or problematic).

As a result of research, it was possible to isolate a unique bacterial enzyme - α-galactosidase, which hydrolyzes galactosidase compounds, breaking down oligosaccharides into simple carbohydrates without the formation of gases. Such enzymes are found in the bacteria Bacteroides fragilis, Bacteroides thetaiotaomicron and Streptomyces avermitilis.

Alpha-galactosidases (syn. melibiases) have “exoactivity”, i.e. they cleave off the terminal non-reducing residues of alpha-D-galactose from the oligosaccharide molecule, hydrolyzing complex sugars to monosaccharides: glucose and galactose, which are absorbed by the cells of the intestinal mucosa and are used in body as a source of energy.

The use of the enzyme alpha-galactosidase in nutrition provides enzymatic activity absent in the human body, limiting the entry of oligosaccharides into the large intestine in an undigested form, where they undergo anaerobic bacterial hydrolysis with the formation of gases.

When adding this enzyme in the form of a dietary supplement to Orlix food, we found its effect in a group of 55 people to be excellent in 58.2%, and very good in 30.9%. Thus, patient-reported improvement after taking Orlix occurred in the vast majority of patients (89.1%).

When analyzing changes in quality of life according to the SF-36 questionnaire during monotherapy with Orlix, a significant improvement in quality of life was revealed in terms of both physical and psychological functioning.

All patients while taking Orlix noted that it was well tolerated.

Conclusion

In patients with functional bloating, taking the dietary supplement Orlix (active substance alpha-galactosidase) provides high effectiveness in relieving gas-associated symptoms and improves quality of life. Recommended dosage of Orlix: 2-3 tablets with meals with the first portions of food when consuming gas-forming foods. It is important to note that the onset of action of Orlix is ​​immediate; flatulence does not occur when eating problematic foods. The dosage depends on the volume of problem foods eaten; 2-3 tablets are usually sufficient for average amounts of food. In the future, the patient can determine the optimal dose for himself.

Orlix is ​​safe to use and can be recommended for healthy people who consume gas-producing products.

Reducing gas production in the intestines may represent an effective therapeutic strategy to prevent the development and/or exacerbation of gas-related symptoms in any gastrointestinal disease (functional or organic) when their cause is at least in part due to hyperproduction of gas.

Literature

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2. Butorova L.I., Kolomoets A.N., Tarasova E.S. Excessive gas formation syndrome in the intestines: clinical significance and principles of therapy // Difficult Patient. 2005.
3. Functional disorders of the gastrointestinal tract. A practical approach based on clinical experience / Ed. B. E. Lacey, M. D. Crowell, D. C. DiBaiza. Per. from English edited by S. V. Demicheva. M.: GEOTAR-Media, 2021. 352 p.
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L. I. Butorova*, 1, Candidate of Medical Sciences N. G. Kadnikova** M. A. Osadchuk*, Doctor of Medical Sciences, Professor T. E. Plavnik*** G. M. Tokmulina*, Candidate of Medical Sciences

* Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after. I. M. Sechenova Ministry of Health of the Russian Federation, Moscow ** TsKBVL FMBA “Goluboe”, Goluboe *** State Budgetary Institution of Public Health No. 195 DZM, Moscow

1 Contact information

Bloating and gas formation: modern treatment options / L. I. Butorova, N. G. Kadnikova, M. A. Osadchuk, T. E. Plavnik, G. M. Tokmulina

For citation: Attending physician No. 2/2018; Page numbers in the issue: 61-66 Tags: excess gas formation, enzymatic preparation

Bloating due to changes in diet

Stomach cramps often occur in people who completely abstain from meat, that is, vegetarians. The body simply does not have time to get used to the new diet.

Begins to react inadequately with the manifestation of unpleasant symptoms: constipation, loose stools, diarrhea, nausea, vomiting, gurgling, gurgling of gases in the stomach.

Sometimes flatulence and colic lead to food allergies and the entry of allergens into the body. The products include the main ones: tangerines, strawberries, eggs, spices, honey, fish, meat. Skin allergy symptoms: rashes, eczema.

Gastrointestinal disorders sometimes occur:

• intestinal flatulence;
• symptoms of dysbiosis;
• constipation;
• nausea, vomiting;
• diarrhea;
• gas formation;
• pain in the peritoneal cavity.

If gas formation begins to bother you, you should reconsider your diet, giving up foods that contribute to increased bloating:

• salt;
• Oatmeal;
• milk;
• beer;
• mushrooms;
• fresh cow's milk;
• apricots;
• onion;
• vegetables;
• tomatoes;
• beer;
• broccoli;
• pears;
• cheeses;
• braised cabbage;
• apples;
• watermelon;
• Garlic;
• black bread;
• buckwheat grain;
• bananas;
• corn;
• cottage cheese;
• rice;
• pearl barley.

The stomach swells when the body is polluted

If a lot of harmful substances begin to accumulate in the digestive system, the body’s immunity decreases and it is no longer able to suppress negative effects or neutralize them fully.

In patients this is expressed in:

• severe malaise, weakness;
• fast fatiguability;
• colds;
• irritability;
• bad breath;
• bloating;
• increased amount of gases in the intestines.

For example, infection with Trichomonas and cryptosporidiosis can occur at home: by consuming poorly prepared food or raw water.

The entry of parasites into the body causes damage to the organs and systems of the digestive tract:

• Giardia paralyzes the mucous membrane of the gallbladder, which leads to flatulence and accumulation of gases in the abdomen, nausea, diarrhea, constipation, pain around the navel;
• Dysentery (amoeba) can affect the mucous membrane of the colon, it begins to secrete mucus and pus in large quantities, which clearly leads to indigestion, increased gas formation in the abdominal cavity, fever, abdominal colic, diarrhea, poisoning, even dehydration
• Staphylococcus, which affects the walls of the colon, leads to the following unpleasant symptoms: chills, fever, flatulence, a feeling of gas blockage in the abdomen, loose stools with blood, pus and mucus.

With dysbacteriosis and pathogenic microorganisms, gastritis and increased acidity occur. The reason for the development of pathogenic flora in the intestines and the accumulation of parasites may be insufficient use of penicillin antibiotics.

There is severe intoxication of the body, headaches and dizziness. Additionally, certain foods, such as vegetables, fruits and beans, can be eaten together to make these unpleasant symptoms worse.

Parasites contaminate not only the intestinal cavity, but the entire body.

Causes of gas formation in the gastrointestinal tract

Despite the fact that flatulence is classified as a problem associated with the gastrointestinal tract, there are initial stages that negatively affect the condition of the intestines, by eliminating which you can independently eliminate the accumulation of gases.

Physiological reasons

• Frequent consumption in the diet of foods that affect gas formation (brown bread, kvass, legumes, cabbage, fats). This leads to the fact that the intestines cannot cope with the timely removal of accumulated gases.
• If you frequently swallow air while eating, this happens when you eat hastily or smoke.
• Flatulence in most people is caused by problems with the gastrointestinal tract. But a similar phenomenon is also often observed after 50 years, when the intestinal walls atrophy, they weaken and become prominent, which contributes to the accumulation of gases.

During pregnancy

• In the third trimester, irregular gases often occur, accompanied by belching, constipation and heartburn. The reason for this is compression of the intestines due to an enlarged uterus.
• Progesterone, produced by the placenta to maintain pregnancy, has a relaxing effect, which causes gas retention.
• A woman expecting a baby increases the load on the pancreas and liver. This leads to digestive disorders and increased formation of gases.
• If the breakdown and absorption of substances by the body is impaired, insufficient fermentation of the esophageal fibers occurs, which provokes fecal retention and the inability to remove excess gases.

Infectious diseases

Inflammatory processes that occur under the influence of microorganisms (pathogenic) and affect the large and small intestines, leading to disruption of the digestive system. The result is the inability to move gases through the intestinal walls.

• Acute intestinal infections, in which diarrhea, nausea, vomiting and colic occur. The accumulation of gases occurs during rotavirus infection, dysentery, salmonellosis, gastritis and other gastrointestinal lesions.
• Intestinal candidiasis. When immunity decreases, fungal flora is activated, which is an ideal environment for flatulence.
• An intestinal infection caused by Giardia (single-celled parasites) that live in the lumen of the small intestine. If this cause of flatulence is present, the patient will lose a lot of weight, and there will be increased excitability and irritability.
• The presence of helminthiases in the body provokes swelling and bloating. In advanced forms, diarrhea with blood and rectal prolapse are characteristic.

Dysbacteriosis (changes in the normal intestinal flora) becomes the main cause of the development of infectious diseases that cause flatulence. There is a disruption of natural processes that go into the fermentation stage, thereby provoking gas formation.

Pathology of the large intestine

• Inflammatory processes for a long time, which were not treated in any way.
• In the presence of benign tumors, intestinal polyps, which slowly but progress. Constant flatulence, blood in the stool, acute fighting sensations can become the first signs of the development of cancer.
• With enlargement of the colon (congenital or acquired). The pain occurs both locally and diffusely, which makes it difficult to accurately determine the location of the anxiety in the gastrointestinal tract.
• When the structure of the intestinal wall is disrupted, it protrudes and the formation of air cysts. These are the reasons why the process of gas removal from the intestines slows down.

Diseases of the stomach and esophagus

• Flatulence can occur with lesions of the digestive tract (hernia, reflex disease).
• Gastritis with high acidity is also a cause of poor gas removal.

Purulent processes

• Peritonitis.
• Chronic appendicitis, abscess.

Problems with the genitourinary system

• Acute prostatitis negatively affects nearby organs, that is, the intestines.
• Severe form of pyelonephritis, renal colic, during which compression of the intestines occurs.

Endocrine system disorders

• Low thyroid hormone levels.
• Premenstrual syndrome.

causes and symptoms of flatulence

Causes of bloating due to digestive disorders

Improper digestion of food and disruption of processes occurring in the digestive tract are common causes of bloating.

Other factors:

1. Constipation, which can cause intestinal spasms, atony, inflammation of the sciatic nerve, liver and pancreas diseases. The body begins to react inadequately to a crowded intestine, which leads to stool retention. The digestion process continues, but the intestines are full, which leads to bloating and a feeling of compression of nearby organs.
2. Flatulence, causing an increase in the amount of gases 2 times more than normal, blood clots in the abdominal cavity. Severe spasmodic pain in the right hypochondrium. This is not dangerous at first, when poor chewing of food, swallowing air, emotional excitement or snacking on the go all contribute to the accumulation of gas. The main thing is not to start this process.
3. Premenstrual syndrome in women, often leading to IBS, diarrhea and other gastrointestinal diseases.
4. Diarrhea, which can be caused by nervous or mental stress. Alcohol or carbonated drinks may be involved, as well as diarrhea with pain in the lower abdomen, symptoms of diarrhea, nausea, vomiting, fever, gas, and a feeling of incomplete bowel movement. If you have diarrhea, you should follow a strict diet and avoid provoking foods: cold cuts, flour and confectionery products, oatmeal. You should include in your diet: rice, honey, boiled meat, fish, tea.

Babies often develop gas when their stomach becomes tight. Children become overly restless and squirm on their feet. As first aid, you can give activated carbon, Smecta, but taking into account the child’s weight (1 tablet per 10 kg, 2 times a day).

Symptomatic therapy for flatulence

The number of flatulence is reduced or even disappears after proper adjustments to a person’s diet are made. With the obligatory limitation of foods that contribute to bloating and gas formation. Also, when eating, you should be in a calm environment, do not smoke at this time, and chew thoroughly. Avoid dry food and include first courses in your diet once a day. Simple physical exercises will have a beneficial effect on the removal of gases in the intestines. Until the cause of the disorder is finally determined, you can save yourself with absorbents, carminatives and other drugs.

If frequent bloating is accompanied by severe pain, colic or abnormal bowel movements, immediately go to the hospital for consultation with a specialist.

What to do if alarming symptoms and discomfort accompanying bloating appear?

First of all, it is necessary to understand and identify the causes of gas formation and flatulence in the lower abdomen.

Perhaps the reason is a chronic disease or poor diet.

If bloating has become a daily obsessive phenomenon, this is already a cause for concern and a threat to the body.

Especially if there is prolonged diarrhea associated with dehydration.

It is important to quickly respond to unpleasant symptoms and, if necessary, consult a doctor.

You can relieve symptoms by taking sorbents or activated charcoal to reduce the amount of intestinal gas and remove toxins.

The most important thing is to recognize the problem associated with intestinal motility at the initial stage. Of course, in case of fluid congestion, you can take a laxative to quickly clear the intestines of stool. In particular, for constipation, taking raw vegetables, fruits, and herbal infusions is suitable.

It is necessary to review the diet, give up foods that cause the formation of large amounts of gas, smoking, alcohol, chewing gum, and carbonated drinks.

Often stress or tense nerves increase the accumulation of gases, so it may be time to see a psychologist. If there is a suspicion of cancer, then an oncologist.

If gases in the abdominal cavity are constantly disturbing, it is necessary to conduct research and other laboratory and instrumental examination methods.

Especially:

• Blood tests for the latent course of inflammatory processes in the digestive system;
• Ultrasound, x-ray to examine the peritoneal cavity;
• blood tests for biochemistry.

You cannot ignore alarming symptoms: vomiting, severe diarrhea, fever, rectal bleeding.

Causes of pain and bloating in the intestines

The described problems can appear even with a normal change in climate or time zone. Gastrointestinal dysfunctions are common when eating habits change. Abdominal bloating, accompanied by pain, can occur for reasons that are divided by origin into two groups:

• Food.
• Consequences of diseases.

If bloating is a consequence of a reaction to any product, its partial or complete exclusion from the daily portion will relieve discomfort in the stomach. In this case, no special treatment is required. The intestines are capable of reacting negatively to foods containing coarse biological, indigestible elements (fiber), foods that trigger the process of decay (flour), gluten-containing foods, milk and its derivatives. Excessive consumption of sweets and carbonated liquids also adversely affects the operation of the LCD system.

Food culture also affects the tendency to bloating. Quick snacks on the run, a love of fatty and spicy gastronomic delights, the caloric content of which exceeds the norm several times, evening and night overeating over time lead to the development of chronic bloating. Those who like to actively communicate while eating food are also at risk. Air is swallowed when talking, smoking, the presence of dental devices in the mouth (dentures, braces), and inflammatory throat diseases.

To reduce the risk of flatulence, it is recommended to follow several rules:

• do not eat a large number of different fruits at one time; it is better to replace dessert with them after the main course;
• fiber softens well during stewing or baking;
• It is better to soak legumes before cooking.

The second group of causes of flatulence refers to existing diseases that affect not only the gastrointestinal tract, but also the genitourinary system and glandular organs. The most dangerous pathology is the oncological process occurring in the colorectal system or in the corpus luteum of the ovary in women. Pain and swelling occur due to stagnation of bile, reduced production of certain types of enzymes or acids. Mechanical obstacles in the gastrointestinal tract (adhesions, kinks, narrowing, tumors) also lead to flatulence abnormalities. Inflammatory processes in the mucous membrane or blockage of vascular channels prevents the normal absorption of gases from the gastrointestinal tract.

Causes of pathology that do not belong to these groups are listed separately. Hormonal imbalances can contribute to the development of temporary bloating, for example, during the premenstrual period in women. The period of gestation in pregnant women also affects the functioning of all systems. Mechanical compression of the intestine occurs, which complicates its peristalsis. If you fall asleep in an awkward position, the canal loops may be compressed. After waking up and starting to be active, the flatulence disappears.

Cure for bloating - the right treatment

For gases and bloating, the main thing is to complete the correct treatment on time.

With the consent of the doctor, the following drugs can be used:

• Defoamers to destroy gas bubbles predominantly in the intestines:
• Simethicone;

Dimethicone;

• Espumisan;
• Bobotik;
• Disflatil;
• Antiflat;
• Lannacher.