Деякі причини симптомів, пов'язаних з газами
Cause | Suggestive Findings | Diagnostic Approach |
|---|---|---|
Belching | ||
Aerophagia (swallowing air) | With or without awareness of swallowing air Sometimes in patients who smoke or chew gum excessively Sometimes in patients who have esophageal reflux or ill-fitting dentures | Clinical evaluation |
Gas from carbonated beverages | Beverage consumption usually obvious based on history | Clinical evaluation |
Voluntary | Patient usually admits when questioned | Clinical evaluation |
Distention or bloating | ||
Aerophagia | See Belching | Clinical evaluation |
Chronic, recurrent bloating or distention associated with a change in frequency of bowel movements or consistency of stool No red flag findings Typically beginning during adolescence and the 20s | Clinical evaluation Examination of stool Blood tests | |
Gastroparesis | Nausea, abdominal pain, sometimes vomiting Early satiety Sometimes in patients known to have a causative disorder | Upper endoscopy and/or nuclear scanning that evaluates stomach emptying |
Long-standing symptoms In patients who are thin but still very concerned about excess body weight, particularly young women | Clinical evaluation | |
Constipation if chronic | A long history of hard, infrequent bowel movements | Clinical evaluation Anorectal manometry |
Nongastrointestinal disorders (eg, ovarian cancer or colon cancer) | New, persistent bloating in middle-aged or older adults For colon cancer, sometimes blood in stool (blood may be visible or detected during an examination) | For ovarian cancer, pelvic ultrasonography For colon cancer, colonoscopy |
Flatus | ||
Dietary substances, including beans, dairy products, vegetables, onions, celery, carrots, Brussels sprouts, fruits (eg, raisins, bananas, apricots, prune juice), and complex carbohydrates (eg, pretzels, bagels, wheat germ) | Symptoms that develop mainly after consuming food that can cause gas | Clinical evaluation Trial of elimination |
Disaccharidase deficiency | Bloating, cramps, and diarrhea after consuming milk products | Breath tests |
Symptoms of anemia, steatorrhea, loss of appetite, diarrhea For celiac disease, weakness, symptoms that often begin during childhood For tropical sprue, nausea, abdominal cramps, weight loss | Blood tests Biopsy of the small intestine | |
Pancreatic insufficiency | Diarrhea, steatorrhea Usually a known history of pancreatic disease | Abdominal CT Sometimes MRI/MRCP, endoscopic ultrasonography, or ERCP Stool for fecal elastase |
ERCP = endoscopic retrograde cholangiopancreatography; MRCP = magnetic resonance cholangiopancreatography. | ||