(Belching, Bloating, Flatulence)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Intestinal gas facts
- The usual cause of belching is excessive gas in the stomach that comes from swallowed air. However, discomfort in the abdomen for any reason also may cause belching. Therefore, belching does not always indicate the presence of excessive gas in the stomach.
- Bloating is the subjective feeling that the abdomen is full but does not necessarily mean that the abdomen is enlarged. Distention is the objective enlargement of the abdomen.
- Continuous distention of the abdomen usually is caused by fluid, tumors, enlarged organs, or fat within the abdomen.
- Intermittent distention of the abdomen may be caused by excessive formation of intestinal gas, as well as physical or functional obstruction of the intestines.
- Belching and flatulence (farting or passing gas) are virtually universal. The maximum number of farts for a normal person is 20 per day.
- Flatulence results from the production of gas by bacteria within the intestines when they digest sugars and polysaccharides.
- Excessive production of gas and increased flatulence may occur because of:
- the greater ability of some bacteria to produce gas;
- maldigestion or malabsorption of sugars and polysaccharides; and
- bacterial overgrowth of the small intestine.
- Belching, bloating/distention, and flatulence are evaluated with a medical history, simple abdominal X-rays, small intestinal X-rays, gastric emptying studies, ultrasound examination, computerized tomography (CT), magnetic resonance imaging (MRI), tests for maldigestion and malabsorption, and hydrogen breath tests.
- The treatment of excessive intestinal gas depends on the underlying cause and may include dietary changes, medications that reduce the production of gas (for example, antibiotics), and medications that stimulate the muscles of the small intestine.
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