FLATULENCE AND ERUCTATION
Eructation is the usually noisy release through the mouth of the air contained in the esophagus and stomach. Generally, this occurs after meals, when the stomach is more full, and the transit from the esophagus down to the stomach is more relaxed.
Flatulence is the voluntary or involuntary release of the air contained in the final portion of the intestine.
Why does it occur?
The air released in eructation comes from what was swallowed, the reflex for its release being normal when pressure on the stomach is excessive.
Some people swallow air excessively during meals and when chewing gum, smoking, speaking with a dry mouth, suffering from a congested nose, sleeping with the mouth open, suffering from heartburn, experiencing difficulty breathing, suffering from excessive anxiety, and many other conditions. Aerophagia, the excessive intake of air, results not only in excessive eructation, but also in abdominal distension and discomfort, in addition to flatulence.
It’s been calculated that a normal person releases from half to 1 liter of gases a day. This air comes from what was swallowed and not belched, and, to some extent, by the fermentation performed by the bacteria of the large intestine flora. Recent studies have shown that alterations of peristalsis – the motions of mixing and propelling foods and feces – lead to a deficient intestinal mix of solids, fluids and gases, and the gases thus separate from these and appear as flatulence.
When is it abnormal?
Seldom do eructation and flatulence, individually, indicate a disease. Cases of eructation associated with difficulty swallowing, heartburn, vomiting or weight loss must be investigated to seek alterations in the esophagus or stomach.
It’s hard to quantify the gas eliminated by an individual; therefore, it’s even harder to claim its excess.
Certain cases of excessive flatulence, usually accompanied by diarrhea, occur along with alimentary intolerance, the most common type being intolerance to lactose (animal milk and its derivatives). When flatulence seems to be normal, in particular when associated with persistently soft or fluid feces, the doctor may investigate and treat some absorption difficulty, as, for example, that related to gluten (component of wheat and some other cereals), known as celiac sprue.
However, when poor absorption is not identified, it’s necessary to explain the existence of the gases, and medications that relieve the most unpleasant symptoms can be used.
Many people with sensation of excessive eructation or flatulence suffer from functional diseases of the digestive apparatus. In these situations, the problems occur along with non-specific symptoms of abdominal distension or pain with or without diarrhea. The complaints notwithstanding, barely is an objective cause found for these conditions, which doesn’t prevent some sorts of treatment from alleviating the symptoms.
How to treat or prevent it?
At first, the likelihood that the belches or flatuses are being caused by excessive air intake should be evaluated. To do so, one must avoid to eat too fast or while talking, to chew gum, drink beverage with gas, smoke, and drink with a pipe. Conscious people suffering from aerophagia can be warned in order to change such habits so as to avoid the symptoms. Nasal obstruction and neurological alterations that impair normal intake are also causes of excessive air intake.
The digestion of some foods by intestinal bacteria leads to a greater gas production than others do. The fermentation in the bowel that leads to gas production may originate from lactose (available in milk and derivatives), fructose (available in fruit), some vegetal fibers and carbohydrates available in wheat, oats, corn and potato. Usually, the gas derived from fermentation of vegetables tends to be odorless, while that resulting from the digestion of meat is smelly.
After the initial attempt at changing the nutritional behaviors described above, a diet with gradual restriction of a number of foods is tried out. The exclusion of foods from the diet must be gradual so that one can identify which food is responsible for the undesired symptoms in a particular individual. A lot of care is needed in these tests, as commonly the individuals complain that everything they eat is noxious, which occurs more due to a neurotic feeling than to a digestive reality.
As a rule, one attempts to begin with a diet free of milk and its derivatives. Setting this cause aside, one attempts to exclude foods that knowingly cause gas production, such as black beans, cauliflower, broccoli, cabbage, onion, rosé wine, and eggs, to name a few.
People with alterations that impede the suitable absorption of certain substances, as intolerance to lactose or gluten, experience a great increase in gas production when ingesting these substances. There are people who spontaneously observe the foods that cause them discomfort and solve the problem by avoiding those foods. Others need medical evaluation so that a diet plan can be put together, in addition to undergoing tests, if necessary, in order to diagnose the foods causing the symptoms.
Are there medications?
There’s no medication that has been proven to reduce the production or release of gases through the mouth or anus. Many traditionally used drugs either have no effects whatsoever or their result is dismal.
In cases of intolerance to lactose, a supplement with lactose (digestive ferment deficient in these people) is taken prior to meals containing milk to excellent results in symptom relief.
Questions you can ask your doctor about:
what are eructation and flatulence?
Is the need for eliminating too many gases a disorder?
Are there foods that worsen the quantity or odor of the gases?
Are there drugs that really prevent emission of gases?