Flatulence
Flatulence: Excerpt from Professional Guide to Signs & Symptoms (Fifth Edition)
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), often 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 and physical examination
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, which can cause malabsorption syndrome. Then 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
Flatulence typically develops early and insidiously in cirrhosis 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; an acute obstruction also produces abdominal distention and tympany on percussion. Other findings may include abdominal pain, anorexia, weight loss, malaise, and altered bowel habits (constipation, diarrhea, or a change in the timing, frequency, or consistency of stools).
Crohn’s disease
In this 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 this disorder 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
In this disorder, flatulence develops within several hours after the ingestion of dairy products. Accompanying signs and symptoms include abdominal pain and cramping and, possibly, diarrhea.
Malabsorption syndrome
Findings vary considerably, depending on which dietary constituent isn’t absorbed, but may include flatulence, 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, ecchymosis, and ulceration of the tongue.
Other causes
Abdominal surgery
When peristalsis returns after postoperative paralytic ileus, gas accumulation in hypomotile areas produces flatulence.
Herb Alert
Some herbal products, such as garlic, can cause 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, a suppository, an antiflatulent, or an anticholinergic. As appropriate, provide the patient with a diet plan that excludes gaseous foods. (See Antiflatulence diet.)
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, pathology must first be ruled out.
Pictures
Book Source Details
- Book Title: Professional Guide to Signs & Symptoms (Fifth Edition)
- Author(s): Springhouse
- Year of Publication: 2006
- Copyright Details: Professional Guide to Signs & Symptoms (Fifth Edition), Copyright © 2006 Lippincott Williams & Wilkins.
More About Flatulence
More Medical Textbooks Online about Flatulence
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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)
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- Flatulence
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
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- Dyspepsia
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
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- Flatulence
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
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- Dyspepsia
- "Nursing: Interpreting Signs and Symptoms" (2007)
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Abdominal distention (Signs & Symptoms: A 2-in-1 Reference for Nurses)
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