Bloating is the main complaint of many patients going to the hospital, and it is also a problem that everyone may encounter at any time. When people feel bloating, it is often speculated that it may be indigestion, because of the bloating caused by improper eating. Most of these conditions, from a medical point of view, fall under the category of functional bloating, with a prevalence of more than 22%. So, often bloating, will it be a signal of disease? What are the real causes of bloating that need to be looked for? Let's solve your doubts now.
Bloating, which can be divided into abdominal flatulence and abdominal puffing, these 2 symptoms often appear at the same time, the main manifestations are gas retention, abdominal pressure, fullness, abdominal swelling, abdominal swelling, and an increase in abdominal circumference can also be observed. Common causes of bloating include food intolerance, changes in the gut microbiota, visceral sensory disturbances, delayed intestinal transit, and visceral and somatic reflex abnormalities. Common causes of functional bloating include high visceral sensitivity, abnormal intestinal gas transmission, decreased intestinal exhaust, fermentation of food in the colon to produce related substances, intestinal bacterial overgrowth, abnormal diaphragm reflexes, and altered intestinal flora. If the visceral and somatic reflexes that begin in the intestine are opened and expanded by the influence of gas, liquid, and solids, causing abnormal contractions of the diaphragm, and accompanied by abnormal relaxation of the abdominal wall muscles, abdominal bulging will occur.
The diagnosis of functional bloating or abdominal distension requires 5 points. 1st, at least 1 day a week on average, feels flatulence or abdominal bulging. Second, abdominal flatulence and abdominal bulging are the main gastrointestinal symptoms. Third, to exclude irritable bowel syndrome, functional constipation, functional diarrhea, and postprandial distress syndrome. Fourth, symptoms appear at least 6 months ago. Fifth, symptoms have been active in the last 3 months. From these diagnostic points, we can see that bloating is mainly a subjective feeling, and may be accompanied by objective signs of abdominal bulging.
Functional bloating, typically worsened during the day, is more pronounced, especially after eating, but can be alleviated at night after rest. To determine whether bloating is a sign of disease, it is necessary to exclude the influence of dietary factors, such as dairy products, fructose, fiber, difficult to absorb sugars, and also consider the influence of bowel habits. At the same time, it is more important to observe the accompanying manifestations of abdominal distention, such as blood in the stool, anemia, weight loss, obvious abdominal pain, abdominal mass, especially in adults over 40 years old, if the bloating is accompanied by other manifestations, colonoscopy and other examinations should be carried out in time to determine whether the abdominal distension is related to organic diseases or changes in the morphology of the digestive tract.
Functional bloating usually needs to be differentiated from 3 common disorders. 1st, functional dyspepsia, a disease characterized by the appearance of fullness in the upper abdomen after a meal, however, not accompanied by a bulge in the abdomen, or a fullness in the lower abdomen. Second, functional constipation, the main manifestations are reduced defecation, persistent difficulty in defecation, incomplete defecation, can be accompanied by bowel sounds or increased exhaustion. 3rd, irritable bowel syndrome, characterized by chronic or recurrent abdominal pain, diarrhea, bowel habits and abnormal stool morphology, accompanied by daytime bloating and a decrease in bloating after rest. It is worth noting that 90% of patients with irritable bowel syndrome will be accompanied by symptoms of bloating.
Bloating can also be affected by psychological factors, such as stress or anxiety, which can cause bloating. In diabetic patients, when gastroparesis occurs, the contraction rate of the muscles of the gastrointestinal tract decreases, which can also cause bloating. Pathological anorexia, excessive swallowing of air, can lead to bloating. Changes in pelvic floor function can lead to bloating during defecation. Therefore, people who often have bloating need to go through a variety of tests to find the real cause of bloating.
Dietary factors are a common factor that causes bloating. For example, short-chain carbohydrates such as fructose and mannitol can increase the water in the small intestine through osmosis, leading to bloating. Lactose, which stays in the intestine for a long time, promotes the fermentation rate of the intestine, increases the production of intestinal gas, and leads to bloating. Currently, some meal replacement foods, such as energy bars, may contain fructosans or gluten, which can cause bloating. Lactose intolerant people, after drinking milk, macromolecular lactose, under the action of osmotic pressure, so that the large intestine accumulates too much water, bacteria will carry out lactose fermentation, produce carbon dioxide and methane and other gases, will cause bloating, increased exhaustion, osmotic diarrhea. Therefore, when dealing with bloating, you can first try to change the diet structure, and if other symptoms are accompanied, you need to seek medical examination in time.
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