Flatulence
Flatulence: Excerpt from Signs & Symptoms: A 2-in-1 Reference for Nurses
A sensation of gaseous abdominal fullness, flatulence can result from GI disorders, abdominal surgery, excessive intake of certain foods, and stress. It may be accompanied by belching, discomfort, and excessive passage of flatus.
Flatulence reflects slowed intestinal motility, which hampers the passage of gas; excessive swallowing of air (aerophagia), commonly brought on by stress; or increased intraluminal gas production due to an excess of fermentable substrates, such as digested, unabsorbed carbohydrates and proteins.
Although generally not considered a serious symptom, flatulence — and accompanying expulsion of flatus — may cause the patient embarrassment and discomfort.
History
Determine how long the patient has noticed the flatulence. Find out if he passes an excessive amount of flatus. Also, ask about frequent belching or snoring, and observe for overly rapid speech. These signs are all possible clues to aerophagia.
In addition, be sure to ask the patient if he’s undergoing unusual emotional stress because this can cause aerophagia or irritable bowel syndrome. Obtain a medical history, focusing on GI disorders and systemic illnesses such as scleroderma. These can cause malabsorption syndrome.
Physical assessment
Inspect the patient’s abdomen for distention, and auscultate for abnormal bowel sounds. Percuss for increased tympany due to gas accumulation, and palpate for tenderness and masses.
Medical causes
Cirrhosis
With cirrhosis, flatulence typically develops early and insidiously, along with anorexia, dyspepsia, nausea, vomiting, diarrhea or constipation, dull right-upper-quadrant pain, hepatomegaly, splenomegaly, fatigue, and malaise.
Colon cancer
Obstruction of the colon by a tumor may cause flatulence; acute obstruction also produces abdominal distention and tympany on percussion. Abdominal pain may be present, accompanied by anorexia, weight loss, malaise, and altered bowel habits (constipation, diarrhea, or a change in the timing, frequency, or consistency of stools).
Crohn’s disease
With Crohn’s disease, flatulence accompanies other acute inflammatory signs and symptoms that mimic those of appendicitis: abdominal pain, cramps, and tenderness; diarrhea; low-grade fever; nausea; and melena.
Irritable bowel syndrome
The effects of irritable bowel syndrome include chronic flatulence, belching, and excessive flatus. Chronic constipation is typical, although the patient may also experience diurnal diarrhea. Intermittent lower abdominal pain characteristically abates with defecation or passage of flatus.
Lactose intolerance
With lactose intolerance, flatulence develops within several hours after the ingestion of dairy products. Accompanying signs and symptoms include cramping, abdominal pain and, possibly, diarrhea.
CULTURAL CUE:Lactose intolerance is common in many ethnic groups, including Mexican-Americans, Blacks, Native Americans, Asians, and Ashkenazi Jews.
Malabsorption syndromes
Malabsorption syndromes may cause flatulence. Associated findings vary considerably, depending on which dietary constituent isn’t absorbed but may include abdominal pain, anorexia, weight loss, and passage of bulky, oily, malodorous, or slightly watery stools. Severe malabsorption may also cause muscle wasting and weakness as well as skeletal pain, edema, ecchymoses, and ulceration of the tongue.
Other causes
Abdominal surgery
When peristalsis returns after postoperative paralytic ileus, gas accumulation in hypomotile areas produces flatulence.
Special considerations
Prepare the patient for diagnostic studies, such as blood tests, stool analysis, upper GI series, barium enema, and endoscopy. To aid expulsion of excessive flatus, position the patient on his left side. To prevent gas buildup, encourage frequent repositioning, ambulation, and normal fluid intake, as permitted. If these measures aren’t effective, try inserting a rectal tube into his anus to relieve flatus, or administering an enema, suppository, antiflatulent, or anticholinergic. As appropriate, provide the patient with a diet plan that excludes gaseous foods.
Pediatric pointers
The common childhood complaint of stomachache commonly results from flatulence. Children may also be more sensitive than adults to flatus-producing foods. They’re also generally more prone to aerophagia, especially during eating.
Geriatric pointers
In elderly patients, increased flatulence may result from poor dentition, leading to poor mastication of food, poor dietary intake, and decreased GI motility. However, disease must first be ruled out.
Patient counseling
To reduce flatulence, advise your patient to eat slowly, avoid overeating, and avoid drinking large amounts of liquids with meals. He should also avoid foods and beverages that contain excess air, including souffles, carbonated drinks, and milk shakes. If he’s lactose intolerant, tell him to avoid milk, cheese, ice cream, and other dairy products. Flatulence can also be reduced by avoiding gas-forming vegetables and fruits, such as broccoli and prunes, and eliminating fatty foods.
Pictures
Book Source Details
- Book Title: Signs & Symptoms: A 2-in-1 Reference for Nurses
- Author(s): Springhouse
- Year of Publication: 2007
- Copyright Details: Signs & Symptoms: A 2-in-1 Reference for Nurses, Copyright © 2007 Lippincott Williams & Wilkins.
More About Flatulence
More Medical Textbooks Online about Flatulence
Review other book chapters online related to Flatulence:
Medical Books Excerpts
- FLATULENCE
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
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- Dyspepsia
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
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- Dyspepsia
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Flatulence
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Dyspepsia
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
- Flatulence
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
- Dyspepsia
- "Nursing: Interpreting Signs and Symptoms" (2007)
- [ read ]
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Abdominal distention (Nursing: Interpreting Signs and Symptoms)
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