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CLINICAL INTESTINAL GAS SYNDROMES
Journal article   Peer reviewed

CLINICAL INTESTINAL GAS SYNDROMES

Harris R. Clearfield
Primary care, v 23(3), pp 621-627
1996
PMID: 8888348

Abstract

The passage of oral or rectal gas may focus public attention on the perpetrator and easily lends itself to amusing stories, engendering the sense that being gaseous is inconsequential. The inability to belch (as encountered in the gas;enbloat syndrome occurring after repair of a hiatal hernia) or to pass flatus can produce problems that vary from mild to life threatening, however. Although everyone belches and passes flatus, many individuals feel sufficient discomfort to consult their physician. It is usual for such symptoms to stimulate a fear of cancer, and the patient's concern often prompts the physician to perform a variety of studies to reassure the patient (and the physician) that there is no serious disease. One interesting study 18 of patients 65 to 93 years of age found frequent abdominal pain (24.3%) and abdominal distention (19.7%) in this group, but only 23% of patients with functional symptoms sought medical attention. Symptoms such as belching, flatulence, abdominal distention, and gas pains often elicit a variety of pharmacologic and dietary measures that have not been subjected to scientific evaluation. The physician therefore is challenged with the task of determining whether gaseous symptoms are of dietary and motility origin or result from serious organic disorders. Strategies for evaluation and treatment require some understanding about how gas enters or is released in the gastrointestinal tract. Physicians should base dietary and pharmacologic approaches on the pathophysiology, but insufficient clinical and basic scientific attention has been directed to this topic, resulting in the frequent need to fall back on good clinical judgment.

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