Latest Treatment of Flatulence
Larly flatulence, and sometimes diarrhea and vomiting (18). The most often-used dose of pectin was 15 g day. Some authors suggest that such a dose of pectin included in the diet is optimal (19). Ershoff and Wells (20) demonstrated that pectin derivatives, such as pectic acid, galacturonic acid or polygalacturonic acid, at levels of 5 of diet did not affect serum and liver cholesterol concentrations in cholesterol fed rats. Likewise, methylated polygalacturonic acid had no hypo-cholesterolemic activity. Thus it would appear that only intact pectin has hypo-cholesterolemic activity, which is partially determined by its methoxyl content.
Special Concerns Safety and efficacy in children less than 12 years of age have not been established. Side Effects At site of injection Pain and thrombophlebitis. GI Diarrhea, N&V, flatulence, abdominal distention, glossitis. CNS Fatigue, malaise, headache. GU Dysuria, urinary retention. Miscellaneous Itching, chest pain, edema, facial swelling, erythema, chills, tightness in throat, epistaxis, substernal pain, mucosal bleeding, candidiasis. Drug Interactions See also Anti-Infectives and Penicillins. How Supplied See Content
Postoperatively, direct nursing care toward providing comfort, preventing complications from major abdominal surgery, and promoting the return of bowel function. Monitor vital signs and drainage from wounds and drains for signs of hemorrhage and infection. A nasogastric (NG) tube connected to low intermittent or continuous suction is usually present for gastric decompression until bowel sounds return. Note the amount and color of the gastric drainage, as well as the presence of abdominal distension.
The signs and symptoms are directly related to the serum calcium level. In some patients, hypercalcemia is discovered upon routine physical examination. Evaluate the patient's neuromuscular status for muscle weakness, hypoflexia, and decreased muscle tone. Observe for signs of confusion. Hypercalcemia slows GI transit time therefore, assess the patient for abdominal distension, hypoactive bowel sounds, and paralytic ileus. Strain the urine for renal calculi. Assess for fluid volume deficit by checking skin turgor and mucous membranes. Auscultate the apical pulse to determine heart irregularities.
Evaluation of a newborn in whom EV infection is a possible cause of illness should include a thorough history with specific attention to maternal symptoms suggestive of EV infection (e.g., fever and abdominal pain) as well as viral-like symptoms in other close contacts. Examination should include global assessment of well-being, with special attention to organ systems targeted by EVs, including the cardiovascular system (blood pressure, heart rate, perfusion, cyanosis, heart tones, edema) respiratory system (respiratory distress, apnea) central nervous system (lethargy, irritability, bulging fontanelle, focal abnormalities, hypotonia or hypertonia) liver (jaundice, hepatomegaly, liver tenderness, splenomegaly, abdominal distension) and coagulation system (petechiae ecchymoses or bleeding from the umbilicus, mucosa, or phlebotomy sites). Presence of a macular or maculopapular rash may be a clue to an EV infection.
Fennel and fennel seeds are a classic household remedy used as a cure for flatulence. It was important to Greeks and Romans and included in the Capitulare de villis as well as in the Hortulus of Walahfried Strabo (809 ad). It was reputed to ward off evil spirits. In his 16th century herbal, Leonhard Fuchs recommends the aerial parts and the seeds for stimulating lactation and as a diuretic. The seeds are also reported to be useful if one has a weak stomach. Another of Fuch's uses is for the macerated root if one puts it in honey it protects one against angry dogs (sic) (Fuchs 2001).
Peppermint, Mentha x piperita, is a very widely cultivated medicinal and aromatic plant, and is particularly important for the production of menthol, which is used as a flavouring agent. Its medical uses are to treat flatulence and gastrointestinal cramps. The species is also used to flavour chocolate
I ntestinal obstruction occurs when a blockage obstructs the normal flow of contents through the intestinal tract. Obstruction of the intestine causes the bowel to become vulnerable to ischemia. The intestinal mucosal barrier can be damaged, thus allowing intestinal bacteria to invade the intestinal wall and causing fluid exudation, which leads to hypovolemia and dehydration. About 7 L of fluid per day is secreted into the small intestine and stomach and usually reabsorbed. During obstruction, however, fluid accumulates, causing abdominal distension and pressure on the mucosal wall, which can lead to peritonitis and perforation. Obstructions can be partial or complete. The most common type of intestinal obstruction is one of the small intestine from fibrous adhesions.
Intestinal obstructions can occur at any age, in all races and ethnicities, and in both sexes but are more common in patients who have undergone major abdominal surgery or have congenital abnormalities of the bowel. When it occurs in a child, the obstruction is most likely to be an intussusception. Although small bowel obstructions in children are uncommon, the diagnosis should be considered for any child with persistent vomiting, abdominal distension, and abdominal pain
Metformin is generally well tolerated and safe. Gastrointestinal side effects (diarrhea, flatulence, abdominal discomfort, anorexia, nausea, and metallic taste) predominate and are commonly dose-related. Dose reduction, administration with food, or an extended-release formulation can improve drug tolerance. Over 50 of individuals tolerate the maximum daily dose of metformin, but 5-10 of people need to discontinue the drug altogether.65
A-Glucosidase inhibitors are associated with significant gastrointestinal side effects that affect over 50 of individuals. Increased colonic gas production due to fermentation of unabsorbed carbohydrate cause abdominal bloating, cramping, increased flatulence, or diarrhea. Individuals with acute or chronic diseases involving the gastrointestinal tract should not be prescribed a-glucosidase inhibitors. Renal impairment (serum creatinine 2.0 mgdL_ 1) and hepatic dysfunction are contraindications to a-glucosidase inhibitor therapy.
Throughout the tropics and is an important element of popular medicine in many countries. For example, in Cuba it was shown in a poll conducted in the 1980s to be one of the most widely used medicinal plants. The pharmaceutical uses are extremely diverse, but its use as a carminative (to treat flatulence) and for other gastrointestinal disorders seems to be most relevant, owing to the presence of essential oil.
The wormwort or wormseed is also known under its alternative Latin name, Teloxys ambrosioides, or its Aztec name, epazotl (modern mexican Spanish epazote). It is another species with a long tradition of uses. Fascinatingly, it is used both as a spice for a variety of dishes, especially ones with Mexican black beans (frijoles), and as a medicine for gastrointestinal parasites. The name seems to be derived from the Nahua term for skunk, epatl, and relates to the rather unpleasant smell of the plant (some liken it to the urine of a skunk). As long ago as the 16 th century, Fray Bernardino de Sahagun mentioned epazotl as a food. Today it is one of the most popular spices and is used medicinally as a vermifuge (to treat worms) as well as to reduce flatulence. It was included in many pharmacopoeias, including the ones of Mexico, the United States, and many European countries, but because of the toxic side effects (mostly of the essential oil) and a lack of evidence in support of its...
Abdominal distension and tenderness in the epigastrium are common. Fever and tachycardia are often present. Guarding, rebound tenderness, and hypoactive or absent bowel sounds indicate peritoneal irritation. Deep palpation of abdominal organs should be avoided in the setting of suspected pancreatitis.
Additional Side Effects CV Vasodilation, pallor. Oral Dry mouth, stomatitis. GI GI pain, peptic ulcers, nausea, dyspepsia, flatulence, GI fullness, excessive thirst, GI bleeding (higher risk in geriatric clients), perforation. CNS Headache, nervousness, abnormal thinking, depression, euphoria. Hypersensitivity Bronchospasm, anaphylaxis. Miscellaneous Purpura, asthma, abnormal vision, abnormal liver function.
Special Concerns Cardiovascular collapse, acute CHF, acute MI, and other conditions characterized by hypoxia have been associated with lactic acidosis, which may also be caused by metformin. Use of oral hypoglycemic agents may increase the risk of cardiovascular mortality. Although hypoglycemia does not usually occur with metformin, it may result with deficient caloric intake, with strenuous exercise not supplemented by increased intake of calories, or when metformin is taken with sulfonylureas or alcohol. Because of age-related decreases in renal function, use with caution as age increases. Safety and efficacy have not been determined in children. Side Effects Metabolic Lactic acidosis (fatal in approximately 50 of cases). Oral Unpleasant or metallic taste. GI Diarrhea, N&V, abdominal bloating, flatulence, anorexia. He-matologic Asymptomatic subnormal serum vitamin B12 levels. Drug Interactions None reported that would interact with dental therapy or oral health. How Supplied Tablet...
One interesting finding, noted in both the University of Minnesota and the Arizona series, was an improvement in continence after surgery. In the Minnesota series, 67 of the 104 patients were incontinent to solid or liquid stool prior to surgery 56 of these individuals underwent rec-tosigmoidectomy as a sole procedure and 26 (46 ) regained full control. The remaining 11 patients had levatoroplasty at the time of rec-tosigmoidectomy and 10 improved (91 ) with seven becoming fully continent (64 ). In the Arizona series, 54 of 72 patients were incontinent to feces and all patients were incontinent to flatus prior to surgery. Following surgery, which included perineal excision of the rectum and posterior levator approximation to re-create the anorectal angle, 48 patients (67 ) had regained continence of both flatus and feces. A study at the Cleveland Clinic Florida analyzed 20 consecutive elderly patients of a mean age of 82 years who underwent perineal rectosigmoidectomy for...
The lateral cutaneous nerve is a purely sensory branch arising from the lumbar plexus (L2-L3). It passes obliquely across the iliac muscle, and enters the thigh under the lateral part of the inguinal ligament. It supplies the skin over the anterolateral aspect of the thigh. Meralgia paresthetica is a condition caused by entrapment of this nerve as it passes through the opening between the inguinal ligament and its attachment 1 - 2 cm medial to the anterior superior iliac spine. Numbness is the earliest and most common symptom. Patients also complain of pain, paresthesias (tingling and burning) and often touch - pain - temperature hyp-esthesia over the anterolateral aspect of the thigh. The condition occurs particularly in obese individuals who wear constricting garments (e.g., belts, tight jeans, corsets and camping gear). Intra-abdominal or intra-pelvic processes may directly impinge on the nerve during its long course the condition can also be due to abdominal distension (as a...
Giardiasis is self-limiting in most people. The short-lived acute phase is characterised by flatulence with sometimes sulphurous belching and abdominal distension with cramps. Diarrhoea is initially frequent and watery but later becomes bulky, sometimes frothy, greasy and offensive. Stools may float on water. Blood Cryptosporidium is a common cause of acute self-limiting gastroenteritis, symptoms commencing on average 3-14 days post-infection. Symptoms include a 'flulike illness, diarrhoea, malaise, abdominal pain, anorexia, nausea, flatulence, malabsorption, vomiting, mild fever and weight loss (Fayer and Ungar, 1986). From 2 to more than 20 bowel motions a day have been noted, with stools being described as watery, light-coloured, malodorous and containing mucus (Case-more, 1987). Severe, cramping (colicky) abdominal pain is experienced by about two-thirds of patients and vomiting, anorexia, abdominal distension, flatulence and significant weight loss occur in fewer than 50 of...
If the trachea and esophagus fail to completely separate by 35 days of gestation, it can result in one of several anomalies. The most commonly seen type (85 ) is that of a blind upper esophageal pouch and a distal esophageal segment which is connected to the trachea (Type C). It usually presents as abdominal distension, feeding intolerance, and pneumonia in the newborn. As many as half of these cases may be associated with other components of the VATER complex of anomalies (vertebral, anal, tracheoesophageal, and radial renal). Treatment involves closure of the fistula with primary anastomosis of the esophagus without tension. In the unstable infant, repair is delayed and initial treatment is G tube placement with division of the TE fistula.
Uses Prevention of disseminated Mycobacterium avium complex (MAC) disease in clients with advanced HIV infection. Contraindications Hypersensitiv-ity to rifabutin or other rifamycins (e.g., rifampin). Use in clients with active tuberculosis. Lactation. Special Concerns Safety and efficacy have not been determined in children, although the drug has been used in HIV-positive children. Side Effects Oral Taste perversion, discolored saliva (brownish-orange). GI Anorexia, abdominal pain, diarrhea, dyspepsia, eructation, flatulence, N&V. Respiratory Chest pain, chest pressure or pain with dyspnea. CNS Insomnia, seizures, paresthesia, aphasia, confusion. Musculoskeletal Asthenia, myalgia, arthralgia, myo-sitis. Body as a whole Fever, headache, generalized pain, flu-like syndrome. Dermatologic Rash, skin discoloration. Hematologic Neutro-penia, leukopenia, anemia, eosino-philia, thrombocytopenia. Miscella
Sphincteric function internal and external anal sphincters. The internal anal sphincter measures 30 mm in length and 5 mm in thickness, and comprises smooth muscle fibres of the circular or inner muscle layer of the rectum. Rectal sensation, allowing discrimination between flatus and faeces. Mechanical factors Anorectal angle about 90 angle between the long axes of the anal canal and rectum in the resting state, maintained by the puborectalis sling. Flutter valve.
I rritable bowel syndrome (IBS), sometimes called spastic colon, is the most common digestive disorder in the United States. with a prevalence as high as 10 to 20 in the population. It is a poorly understood syndrome of diarrhea, constipation, flatus, and abdominal pain that causes a great deal of stress and embarrassment to its victims. People often suffer with it for years before seeking medical attention.
A 21-year-old male, involved in a motor vehicle accident, was admitted to a local hospital with pain in the left abdominal region. Vital signs were normal physical examination was essentially negative, except for severe tenderness in the periumbilical area. The patient's abdomen was flat and soft. Bowel sounds were normal. X-ray studies of the abdomen, in the flat and upright position, revealed no evidence of abnormality. The intestinal gas pattern was normal. The hepatic, splenic, renal, and psoas outlines were unremarkable. There was no evidence of free abdominal air or fluid. Approximately 28 h later, he was DOA at another hospital. At autopsy, 2000 mL of purulent material was found in the peritoneal cavity. Fifty centimeters from the duodenum, there was a 2 x 2-cm laceration of the proximal jejunum, with communication with the peritoneal cavity. The mesentery showed a 3 x 5-cm contusion and recent thrombi of the superior mesenteric veins.
Splinting, chest burns, tight chest or abdominal dressings) Abdominal distension obesity, ascites, bowel obstruction Disorders of respiratory muscles severe hypokalemia, Amyotrophic lateral sclerosis, Guillain-Barr syndrome, poliomyelitis, myasthenia gravis, drugs (curare, succinylcholine)
Orlistat alters fat metabolism by inhibiting pancreatic lipases with consequent increased fecal fat excretion. Long-term trials confirm orlistat's ability to promote approximately 10 weight loss 120,121 , and to help prevent weight regain 122 . Main side effects are discomforting gastrointestinal symptoms such as excessive borborygmi, cramps, flatus, etc. Orlistat also may produce an improvement in lipid profile unexplained by the degree of weight loss 123 . It is FDA approved for long-term use.
Special Concerns Use with caution in infants up to 1 month of age, in clients with GI disease, liver or renal disease, or a history of allergy or asthma. Safety and efficacy of topical products have not been established in children less than 12 years of age. Side Effects Oral Candidiasis. GI N&V, diarrhea, bloody diarrhea, abdominal pain, GI disturbances, te-nesmus, flatulence, bloating, anorexia, weight loss, esophagitis. Nonspecific colitis, pseudomembranous colitis (may be severe). Allergic Morbilliform rash (most common). Also, maculopapular rash, urticaria, pruritus, fever, hypotension. Rarely, polyarteritis, anaphylaxis, erythema multiforme. Hematologic Leukope-nia, neutropenia, eosinophilia, thrombocytopenia, agranulocytosis. Miscellaneous Superinfection. Also sore throat, fatigue, urinary frequency, headache.
A number of enzymes are utilized as digestive aids (Table 13.1), and the majority have been derived from animal (pancreatic extract), microbial (e.g., Aspergillus oryzae), and plant (e.g., barley) sources 155 . Amylases are enzymes that catalyze the hydrolysis of a(1-4)-glycosidic linkages of polysaccharides such as starch and glycogen to yield dextrins, oligosaccharides, maltose, and glucose. Amylases are secreted by the pancreas and salivary glands in humans. They are classified according to the manner in which the gly-sosidic bond is hydrolyzed. a-Amylases hydrolyze endo a(1-4) glycosidic linkages, randomly yielding dextrins, oligosaccharides, and monosaccharides (glucose), which are easier to digest 156 . Amylase is administered as a digestive aid to improve digestion of dietary carbohydrate. Cellulase is not produced by humans and is administered as a digestive supplement to alleviate flatulence and to improve overall digestion, especially Invertase is utilized as a digestive aid...
Post-operative Day Number Problem List Antibiotic day number and hyperalimentation day number if applicable. List each surgical problem separately (eg, status-post appendectomy, hypokalemia). Subjective Describe how the patient feels in the patient's own words, and give observations about the patient. Indicate any new patient complaints, note the adequacy of pain relief, and passing of flatus or bowel movements. Type of food the patient is tolerating (eg, nothing, clear liquids, regular diet). Objective
Sufficiently to cause symptoms or even life-threatening hypoglycemia. Side Effects GI Abdominal pain, diarrhea, flatulence. GI side effects may be severe and be confused with paralytic ileus. Drug Interactions Charcoal l Effect of acarbose Digestive enzymes l Effect of acar-bose
GI Abdominal pain, nausea, dyspepsia, constipation, diarrhea, flatulence, acid regurgitation, esoph-ageal ulcer, vomiting, dysphagia, abdominal distention, gastritis. Miscellaneous Musculoskeletal pain, headache, rash and erythema (rare). Drug Interactions Antacids l Absorption of alendro-nate
(3) high-amplitude propagating contractions (HAPCs). In humans, reproduction of these motility patterns are more difficult to demonstrate, and reports in the literature have yielded varying results. In general, the most common recognizable events are the high-amplitude propagating contraction, which are associated with either the conscious sensation of urgency or the passage of flatus. Moreover, the absence of HAPCs may serve as a marker of colonic motor dysfunction. The frequency of these contractions varies among individuals and is more common in young children. The contractions usually start in the cecum or ascending colon and are propagated into the sigmoid colon at a rate of 1 cm minute.
Rare situations occur in which enzyme therapy is used in conventional medicine. These conditions include pancreatitis, cystic fibrosis, and Gaucher disease. An enzyme known as lactase is given for people who cannot tolerate dairy products (lactose-intolerance). People with excessive gas may find relief from Beano, an enzyme (alpha-galactosidase) that improves the digestion of high-fiber foods, such as beans, peas, and whole grains.
Ventral hernias are the result of failed abdominal closure. Older age, obesity, pulmonary complications, abdominal distension, male gender, wound infections, type of incision and closure, and male gender have all been implicated as risk factors for incisional hernias. Incisional hernias occur in 2-10 of patients following laparotomy. Midline incisions may be at higher risk than transverse incisions for herniation. Wounds complicated by infection are 5 times as likely to be complicated by hernias. Primary incisional hernia repairs may recur in as many as 30-50 of repairs. Mesh repairs are reported to have recurrence rates of 10 . Small incisional hernias may be repaired primarily however, mesh repairs are frequently indicated. Adequate repair can be performed open or laparoscopically. In patients who have lost the right of abdominal domain, progressive pneumoperitoneum (sequential insufflation of air into the peritoneal cavity) may be useful.9
Special Concerns Use with caution, if at all, during lactation. Give a lower initial dose in liver impairment. Safety and efficacy have not been determined in children less than 2 years of age. Side Effects Most commonly, headache, somnolence, fatigue, and dry mouth. GI Altered salivation, gastritis, dyspepsia, stomatitis, tooth ache, thirst, altered taste, flatulence. CNS Hypoesthesia, hyperkinesia, migraine, anxiety, depression, agitation, paroniria, amnesia, impaired concentration. Ophthalmologic Altered lacrimation, conjunctivitis, blurred vision, eye pain, blepharo-spasm. Respiratory Upper respiratory infection, epistaxis, pharyngitis, dyspnea, coughing, rhinitis, sinusitis, sneezing, bronchitis, bronchospasm, hemoptysis, laryngitis. Body as a whole Asthenia, increased sweating, flushing, malaise, rigors, fever, dry skin, aggravated allergy, pruritus, purpura. Musculoskeletal Back chest pain, leg cramps, arthralgia, myalgia. GU Breast pain, menorrha-gia, dysmenorrhea, vaginitis....
Special Concerns When given with sulfonylurea or insulin, miglitol causes further decrease in blood sugar and increased risk of hypogly-cemia. Safety and efficacy have not been determined in children. Side Effects GI Flatulence, diarrhea, abdominal pain, soft stools, abdominal discomfort. Dermatolog-ic Skin rash (transient). Drug Interactions No drug interactions reported that would impact on dental health or the dental process. How Supplied Tablets 25 mg, 50 mg, 100 mg
Intestinal atresia is commonly caused by fetal mesenteric vascular accidents and presents at birth as bilious emesis, progressive abdominal distension, and failure to pass meconium. Workup includes contrast enema as well as suction rectal biopsy to exclude Hirschsprung's disease. There are four types of intestinal atresia. Type I is mucosal atresia only. Type II involves atretic ends connected by a fibrous band of tissue. Type IIIA, the most common type, has two atretic ends of bowel separated by a V shaped defect in the mesentery. In Type IIIB, the distal atretic bowel receives blood from the ileocolic or right colic arteries, also referred to as the apple peel type. Type IV involves multiple atretic segments. Surgical therapy of intestinal atre-sia should be pursued urgently and involves resection of the affected bowel with primary anastomosis.
P-Galactosidase-deficient populations have difficulty in consuming milk and other lactose-containing products, as ingestion of lactose can result in abdominal pain, diarrhea, and flatulence. Intestinal P-galactosidase insufficiency is also thought to be a possible etiology for infantile colic. P-Galactosidase has been widely studied, with incidence of its occurrence reported in animal organs, plants, and microorganisms 168 . Microbial P-galactosidases are most extensively utilized for commercial purposes, owing to their high levels of production and desirable physicochemical properties (e.g., pH and temperature optima) 169 . The principal enzymes exploited commercially are obtained from GRAS-listed yeasts and fungi such as Kluyveromyces lactis and Aspergillus oryzae 170 . The P-galactosidase enzyme derived from Aspergillus oryzae is an extracellular protein. The enzyme has a molecular mass of 105 kDa, is a homodimer, and is glycosylated. The enzyme has a pH optimum of 4.5 and also...
The coloanal anastomosis remained well healed and supple, but bowel function was unsatisfactory with poor control of flatus, rectal discomfort, and prolonged efforts to evacuate stool. A permanent ileostomy was established 5 26 81. The patient was last assessed, 26 years after the diagnosis of chori-onic carcinoma. There was no evidence of recurrent disease.
Defaecation is triggered by filling of the rectum from the sigmoid colon, leading to rectal distension. Reflex relaxation of the internal anal sphincter allows sampling of rectal contents and differentiation between flatus and faeces. Relaxation is mediated via stretch activation of descending inhibitory motor pathways, which stimulate the intrinsic inhibitory motor neurons to motor