Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
We all produce gas in our intestines, especially our colons, or, at least,
our intestinal bacteria produce it, from undigested food. We are fortunate
because the overwhelming majority of the gas that is formed by the bacteria is
used up by other bacteria in the intestine.
Some people are more fortunate than others. All of the gas produced in their
intestines is used up by bacteria, and they pass gas (fart) very little, that
is, unless they eat foods that bacteria can use to form lots of gas—like
beans—that overwhelm even the most ardent, gas–devouring bacteria. A small
amount of intestinal gas is absorbed into the blood from the intestine and is
eliminated in the breath. The gas that is not used up by bacteria or eliminated
in the breath must be passed. Passing gas relies on the functioning of the
intestinal muscles. The gas distends the intestine, and the intestinal muscles
respond by contracting and pushing the gas further along the intestine until the
gas is finally expelled. Sometimes this process fails.
I recently underwent removal of a portion of my sigmoid colon for
diverticulitis. The surgery was done laparoscopically and went very well. There
were no complications, and my discomfort was easily controlled with medication.
Manipulation of the intestines during surgery "stuns" the intestinal muscles,
and they usually stop working for a time. Before patients can eat after surgery,
their intestinal muscles must start working. The signs that the muscles are
working is the presence of abdominal gurgling (borborygmi) and the passing of
gas. Laparoscopic surgery stuns the intestine less than "open" (large
incisional) surgery, and the intestinal muscles usually recover quickly.
The ability to belch is almost universal. Belching, also
known as burping (medically referred to as eructation), is the act of expelling gas from the stomach out through the
mouth. The usual cause of belching is a distended (inflated) stomach caused by
swallowed air. The distention of the stomach causes abdominal discomfort, and the
belching expels the air and relieves the discomfort. The common reasons for
swallowing large amounts of air (aerophagia) are gulping food or drink too
rapidly, anxiety, and carbonated beverages. People are often unaware that they
are swallowing air. "Burping" infants during bottle or
breastfeeding is important in order to expel air in
the stomach that has been swallowed with the formula or milk.
Excessive air in the stomach is not the only cause of belching. For some
people, belching becomes a habit and does not reflect the amount of air in their
stomachs. For others, belching is a response to any type of abdominal discomfort
and not just to discomfort due to increased gas. Everyone knows that when they
have mild abdominal discomfort, belching often relieves the problem. This is
because excessive air in the stomach often is the cause of mild abdominal
discomfort. As a result, people belch whenever mild abdominal discomfort is felt
regardless of its cause.
Belching is not the simple act that many people think it is. Belching requires the coordination of several activities.
The larynx must be closed-off so that any liquid or food that might return with the air from the stomach won't get into the lungs.
This is accomplished by voluntarily raising the larynx as is done when swallowing.
Raising the larynx also relaxes the upper esophageal sphincter so that air can pass more easily from the esophagus into the throat.
The lower esophageal sphincter must open so that air can pass from the stomach into the esophagus.
While all this is occurring, the
diaphragm descends just as it does when a breath is taken.
This increases abdominal pressure and decreases pressure in the chest.
The changes in pressure promote the flow of air from the stomach in the abdomen to the esophagus in the chest.
One unusual type of belching has been described in aerophagic individuals who swallow air. It has been demonstrated that during some of their belches, room air enters the esophagus and is immediately expelled, giving rise to a belch. This in and out flow of air also is likely to be the explanation for the ability of many people to belch at will, even when there is little or no air in the stomach.
If the problem causing the discomfort is not excessive air in the stomach, then belching
does not provide relief from the discomfort. When belching does not ease the discomfort, the
belching should be taken as a sign that something may be wrong within the abdomen
and the cause of the discomfort should be sought. Belching by itself, however,
does not help the physician determine what may be wrong because belching can
occur in virtually any abdominal disease or condition that causes abdominal discomfort.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Diverticulitis symptoms include: abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Treatment methods include prescription medications, and in some cases, diverticulitis surgery.
There are many types of ovarian cancer, epithelial carcinoma is the most common. Women with a family history of ovarian cancer have an increased risk of developing the disease. Some ovarian cancer symptoms include abdominal pain, nausea, diarrhea, constipation, and abnormal vaginal bleeding, however, they usually do not present until the disease has progressed. Early diagnosis is important for successful treatment.
In lactose intolerance, the digestive system cannot digest lactose (the main sugar in milk). Symptoms of lactose intolerance include diarrhea, flatulence, abdominal pain, abdominal bloating, abdominal distention, and nausea. There are several tests to diagnose lactose intolerance. Treatment is generally made with dietary changes, supplements, and adaptation to small amounts of milk.
IBS (irritable bowel syndrome) is a common gastrointestinal disorder involving abnormal gut contractions (motility) characterized by abdominal pain,
bloating, mucous in stools, and irregular bowel habits with alternating diarrhea
and constipation, symptoms that tend to be chronic and to wax and wane over the
years. Treatment options include medication and lifestyle changes such as diet, exercise, and stress management to control symptoms. Also called spastic colitis, mucus colitis, nervous colon syndrome.
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Signs and symptoms of celiac disease include malabsorbption (diarrhea, foul smelling gas, bloating, and increased amounts of fat in the stool) and malnutrition (weight loss, edema, anemia, bruising easily, neuropathy, and infertility). Treatment for celiac disease is a gluten free diet, and at times if necessary, medications
Gallbladder (gall bladder) pain can be caused by gallbladder disease such as gallstones or cholecystitis. Causes of gallbladder pain can be caused from biliary colic. Biliary colic is pain caused by gallstones trapped in the bile ducts. Cholecystitis is inflammation of the
gallbladder. Symptoms of gallbladder disease include nausea, vomiting, abdominal bloating and belching, sweating, and shortness of breath. Treatment of gallbladder pain depends on the cause.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine. There are many conditions associated with small intestinal bacterial overgrowth, to include: diabetes, scleroderma, Crohn's disease, and others. There is a striking similarity between the symptoms of irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome. Symptoms of SIBO include: excess gas, abdominal bloating, diarrhea, and abdominal pain.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Gastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Patients with celiac disease are required to eat a gluten-free diet. Gluten is found in rye, barley, and wheat. Gluten damages the intestine in patients with celiac disease. Some mediations contain gluten, so careful monitoring of products consumed is imperative. Patients with celiac disease are also at risk for developing nutritional deficiencies. The information in this article contains both foods that contain gluten, and foods that do not contain gluten.
Hirschsprung's disease (Hirschsprung), is a disease of the nerve cells of of the large intestine. The primary symptom of Hirschsprung's disease is constipation. Hirschsprung's disease is diagnosed through barium enema, and treatment is surgery.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Irritable bowel syndrome (IBS) in children is a functional gastrointestinal disorder with symptoms of abdominal pain, bloating, diarrhea or constipation. The cause of IBS is unknown, however, certain foods, stress, anxiety, and depression may contribute to the symptoms of IBS. There is no cure for IBS in children; however, medications, dietary changes, and stress management may relieve symptoms.
Irritable bowel syndrome (IBS) is a functional disease that can affect the quality of those who suffer from this condition. Individuals with IBS can make lifestyle changes that may modify or control the number and severity of episodes. Certain foods, medications, and hormone levels may trigger IBS episodes. Learn how to prevent the number and severity of IBS episodes of diarrhea and constipation.
While the patient's history and physical examination are the building blocks
of making a medical diagnosis, the ability to peer inside the body can be a
powerful tool. Ultrasound is an imaging technique that provides that
ability to medical practitioners.
What is an ultrasound?
Ultrasound produces sound waves that are beamed into the body causing return
echoes that are recorded to "visualize" structures beneath the skin. The ability
to measure different echoes reflected from a variety of tissues allows a shadow
picture to be constructed. The technology is especially accurate at seeing the
interface between solid and fluid filled spaces. These are actually the same
principles that allow SONAR on boats to see the bottom of the ocean.
What is ultrasonography?
Ultrasonography is body imaging using ultrasound in medical diagnosis. A
skilled ultrasound technician is able to...
We all produce gas in our intestines, especially our colons, or, at least,
our intestinal 
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