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Gas Pains

Irritable bowel syndrome is characterized by crampy abdominal pain and bowel irregularity. Intestinal gas is likely one of the factors that can elicit motility disorders that result in crampy abdominal discomfort. Patients with irritable bowel syndrome respond to tube infusion of small amounts of air into the small bowel with considerably more discomfort than found in controls given the same quantities of infused air. This suggests that patients with irritable bowel syndrome have an exaggerated motility response to small amounts of intestinal gas, however, the sensitivity may be the result of heightened central perception. A direct relationship between the total quantity of bowel gas and irritable bowel symptoms has

If gas accumulates in the hepatic flexure, discomfort may be experienced in the right upper quadrant (hepatic flexure syndrome), which could be confused with biliary tract disease. The frequent recurrences, absence of liver function abnormalities, and negative markers for inflammation such as fever and leukocytosis should differentiate the two disorders. Cholycystectomy will not relieve the discomfort if a patient with gallstones is experiencing the hepatic flexure syndrome. Persistent discomfort of the right upper quadrant after gallbladder surgery unfortunately has been labeled the postcholycystectomy syndrome. Accumulation of gas in the splenic flexure could result in discomfort of the left upper quadrant (splenic flexure syndrome), which may radiate to the precordial area, simulating cardiac disease. Symptom relief by passage of flatus or defecation and lack of symptom relationship to exertion should help in differentiating these conditions. Patients with significant accumulation of gastric gas may experience high epigastric or low substernal pressure that also could mimic angina pectoris. The postprandial occurrence, relief with belching, and bloating, abdominal distention, blooted, gas, gassy, flatulance, flatulence, flatus


Persistent abdominal discomfort warrants appropriate studies to exclude organic disease. If a functional cause seems likely, efforts to reduce the swallowing of air and the generating of colonic gas can be helpful. The patient should avoid sucking on hard candies, chewing gum, ingesting carbonated beverages, and eating gas-forming foods such as broccoli, cabbage, cauliflower, and brown beans. Although a lactose tolerance test can be performed, a brief trial of strict avoidance of milk products should be considered. Anticholinergic agents to..