2021 Expert Interpretation: Bloating and abdominal swelling

Author: DR David Johnson

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Dr David Johnson, a medical professor and gastrointestinal disease director from the Norfolk Eastern Virginian School of Medicine, Virginia, recently discussed a very common problem: abdominal bloating and abdominal correlation management.Let’s take a closer look at it:

The main characteristics of abdominal distension

Abdominal distension can be divided into two types: abdominal bloating and abdominal disability.The main characteristics of abdominal bloating are the accumulation of qi, increased abdominal pressure, and fullness, which is a conscious symptom of patients.In contrast, the abdominal swelling reflects objective abdominal circumference.

Abdominal qi and abdomen are very common, ranging from 16%to 31%in the general population.The prevalence of abdominal distension of intestinal syndrome (IBS) may reach 66%-90%, and abdominal distension is more common in constipation patients and women.

The impact of abdominal distension on life

DR David Johnson said that whether it is abdominal bloating or abdominal swelling, the impact on life is very significant.

Nearly 75%of patients with abdominal qi believe that their symptoms are medium to severe, and 50%of patients say that the symptoms of these abdominal distension have led to a decline in their daily life ability.Even some patients told Dr David Johnson that they felt like they were pregnant, or they had a balloon in their stomachs, and this made them unbearable.

What is even more surprising is that the development of the abdomen and the development of the abdomen are often not synchronized, and only about 50%-60%of patients with abdominal qi have abdominal swelling.

What caused this kind of situation?

When DR David Johnson talked with his patients with abdominal distension symptoms about potential pathology theory, most patients thought that their symptoms might be because the body created too many gases, but in fact, only a few patients with abdominal distension were so.EssenceRather than that this symptom is caused by a large amount of abdominal gas increased, it is caused by the patient’s own feelings.

DR David Johnson said that the excessive growth of small intestinal bacteria and the tolerance of carbohydrates, especially the intolerance of lactose and fructose, is the main pathophysiological factors of this disease.

The lack of lactase does not necessarily cause corresponding absorption, and not all individuals with low lactose intake will have corresponding symptoms.On the contrary, some symptoms that occur on some patients may be caused by some additional factors, such as genetic susceptible factors and internal organs.

Its pathogenesis is also very likely to be affected by the microbial group. In this case, we can see almost in all diseases.It has a profound impact on the causing qi and abdomen.

Patients with abnormal gastrointestinal exercise are common in abdominal distension, and they are particularly common among patients with mild gastric palsy. Their prevalence may be 50%or more.EssenceThis type of patients who have determined the dysfunction of the anus and rectal motion may be a problem with the function of emptying the gastrointestinal tract.Similarly, pelvic discharge discharge may also cause increased possibility of colon transmission delay.

Another syndrome related to abdominal distension is called abdominal disorders.This is a contradictory response, that is, when your bowel movement is down, the abdominal diaphragm has shrunk, and the abdominal wall is relaxed.Under normal circumstances, it is the corresponding relaxation of the diaphragm muscles while the abdominal muscle contraction. This can maintain the integrity of the axial function of the head and tail and avoid expansion. If this way of force is forcibly reversed, it may cause symptoms of bloating and abdominal swelling.

The occurrence of visceral allergies and abdominal distension also have obvious causal relationships: that is, the interaction of complex brain-intestinal-nerves and some related factors, such as anxiety, depression, physical disorder, and hyperglycemia.symptom.Many of these diseases are also affected by sleep quality, which is a problem that has recently discussed more.Sleep fragmentation will reduce the sensory threshold, and it will increase the superfluous response of the internal organs.

How to make a disease diagnosis?

Breathing test is a very simple diagnostic tool for assessing excessive growth of bacteria.We can try the breathing test of lactose and fructose. Of course, we can also consider the exhalation test of more common glucose and lactose. These tests are commercially operable and relatively easy to get.

Of course, we must not forget to consider cervical diarrhea. When doubting the disease, serum science tests can be performed.

When patients have signs of warning of physical condition early warning, they can check the upper mirror and abdominal imaging of the upper gastrointestinal tract. In fact, they should also consider changes related to gastrointestinal power and mild gastric palsy.For example, the motion examination of anal rectum is the best testing option for patients with suspected pelvic floor dysfunction. This may be combined with X -ray photography of defecation.

A series of treatment solutions

When mentioning the treatment plan, DR David Johnson said that he first thought of intervention through diet. It is recommended to evaluate whether there is really bloating and abdominal swelling through good diet records.

DR David Johnson believes that the use of artificial sweeteners is usually common causes of abdominal distension symptoms. These sweeteners usually contain unburonic carbohydrates. These carbohydrates ferment in the intestine and cause gas in the intestinal cavity.

Of course, we should also consider the effects of carbohydrates in fructose and FODMAPS (fermented hypogon, bicoseki, and monosaccharides), which may significantly increase the penetration load.

Many patients are worried about the effect of gluten. About 70%of non -abdominal gluten sensitive patients have symptoms of abdominal distension.But this situation does not necessarily be gluten itself, but related products containing gluten, especially wheat, barley, fructose and Fodmaps.Reducing these ingredients from the patient’s diet may be a very effective way to solve their chronic abdominal distension and abdominal bloating.

DR David Johnson emphasized: We should also remember that carbohydrates may be mixed in our daily diet through the form of high fruit sugar corn syrup.

Although it is easy to identify Fodmaps foods for clinicians, this is a difficult concept for patients.Studies by Dr. Bill Chey and his colleagues show that if patients with abdominal bloating and abdominal swelling want to discuss the plan for Fodmaps foods in the treatment of abdominal distension, it is best to let the nutritionist also participate.

Probiotics do not have much effect on alleviating symptoms of abdominal distension.

Antibiotics have been proven to be effective in the treatment of abdominal distension, especially Liffu Shiming 550mg, 3 times/day, venous input, 14 days, but it is still difficult to get the authorized payment of medical insurance. Except for those who have IBS and diarrhea, those who have IBS and diarrheapatient.Some experts believe that the combination of anti -spasm and La Liga oil may be a more reasonable choice.

If you are treating a patient with constipation, then the promotion agent will be another choice, because promoting the secretion agent can effectively improve the transfer efficiency of feces.

There are also a lot of alternative therapy, such as: Mint oil is a good way to try, because it has almost no shortcomings. For patients with abdominal diaphragm expansion, biological feedback treatment may be very useful.DR David Johnson said he personally found that diaphragm breathing is good for some patients.There are also some evidence that hypnotic therapy can bring some improvements.

Step -by -step summary

First of all, the first step to deal with bloating and abdominal swelling is to determine the potential cause, which will help determine the direction of the test.

Second, pay attention to the additional and further directional testing of the early warning signal and the symptoms of early warning, whether it is respiratory testing or invasive testing.

Third, evaluate the diet and drug use of the onset, the factors and behavior of the surgical surgery.

Finally, according to your doubtful pathogenic views, start specific related treatment, whether it is inactivated by carbohydrates or Fodmaps alternative diet intervention, behavioral therapy, anxiety, or the treatment of sleep drugs, or other intervention therapy.

Write in the last words

I sincerely hope that this discussion will provide you with useful insights on the symptoms of abdominal bloating and abdominal swelling. This is not only a problem that medical institutions usually encounter, but also a problem that makes patients feel very frustrated.

References: David A. Johnson, MD. BLOATING and Distent:

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