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Upper belly bloating: Seriously Bloated: Warning Signs You Shouldn’t Ignore – Health Answers


Seriously Bloated: Warning Signs You Shouldn’t Ignore – Health Answers

4. Pancreatic cancer tends to be very aggressive with low survival rates. The combination of bloating associated with jaundice (yellowing of the eyes and skin), weight loss, poor appetite, and upper abdominal pain that radiates to the back is a worrisome constellation of symptoms and may indicate pancreatic cancer. Newly onset diabetes, in association with bloating, weight loss, and abdominal pain, may also be a sign of pancreatic cancer.

What to do if you’re concerned about pancreatic cancer:

Fortunately, pancreatic cancer is not a common cause of bloating. But if you do have it, early diagnosis is the key to ensuring a good outcome. Seek immediate medical evaluation if you are experiencing the above constellation of symptoms.

5. Stomach cancer is usually asymptomatic early on, or causes vague symptoms like bloating, indigestion, and a feeling of fullness in the upper abdomen. Like pancreatic cancer, it may have already reached an advanced stage at diagnosis, in which case there will likely be additional symptoms of weight loss, nausea, and abdominal pain.

What to do if you’re concerned about stomach cancer:

Infection with the bacteria Helicobacter pylori is probably the most significant risk factor for developing stomach cancer, so it’s a good idea to be tested for H. pylori if you think you may be at risk. Nitrates and nitrites in smoked and processed meats are also risk factors for stomach cancer, and in a small number of patients, stomach cancer is genetic.

6. Liver disease is often benign. But cancer from distant organs can spread to the liver. When cancer cells get into the bloodstream, they eventually get filtered through the liver. Bloating that’s accompanied by ascites and jaundice may be a sign of cancer that’s spread to the liver or of primary liver cancer, which can develop in people with a history of hepatitis or heavy alcohol use.

What to do if you’re concerned about liver disease:

If you think you may have liver disease, seek medical attention for a thorough physical exam, an ultrasound of the liver and abdomen, and a blood test that evaluates liver function to confirm the diagnosis. Some liver disease can be treated through dietary changes: more green leafy vegetables, legumes, and other plants, and less animal protein and starchy, sugary foods. Some cases require prescription medication.

7. Diverticulitis refers to infection or inflammation of small pothole-type lesions that can develop in the colon called diverticulae. Diverticulitis usually occurs in people over age 50, and is often accompanied by abdominal pain and tenderness, loss of appetite, fever, and constipation or diarrhea.

What to do if you’re concerned about diverticulitis:

Bouts of diverticulitis can be treated in a number of ways: bowel rest (nothing to eat or drink), a liquid diet, antibiotics (if severe pain, fever, or an elevated white blood cell count are present), and analgesia (pain management). Severe tenderness may prompt a CAT scan to exclude an abscess. Worst-case scenario includes drainage of any abscesses, or surgery to remove a severely affected area. The longer your stool sits in the diverticular orifices, the greater the risk of developing diverticulitis — so constipation is definitely to be avoided. Once the acute episode of diverticulitis is over, a high-fiber diet can help keep you regular and avoid future complications.

8. Pelvic inflammatory disease (PID) occurs when the uterine lining, fallopian tubes, or ovaries become infected, usually from sexually transmitted diseases like chlamydia or gonorrhea.It can also occur during childbirth, abortion, or miscarriage, or with insertion of an intrauterine device. Bloating accompanied by fever, pain, and tenderness in the pelvic area, plus a vaginal discharge, is very suggestive of PID.

What to do if you’re concerned about PID:

A careful pelvic exam and treatment with antibiotics are essential for PID. Untreated, it can lead to infertility and ectopic pregnancies (a pregnancy that implants and grows in the fallopian tubes rather than in the uterus and can cause life-threatening tubal rupture). If you’re having bloating, vaginal bleeding or discharge, and lower back or pelvic pain and think you may be pregnant, you should seek immediate medical attention to exclude PID.

9. Crohn’s disease is an autoimmune disorder that affects the GI tract, usually in the small intestine or colon. The lag time between initial symptoms and diagnosis can be years, and bloating is one of the early symptoms. Crohn’s can cause narrowing of the intestines and ultimately lead to a bowel obstruction, resulting in severe bloating, weight loss, and nausea and vomiting after meals. Diarrhea with blood is typical when Crohn’s occurs in the colon. There may be other symptoms present outside of the GI tract, including mouth ulcers, joint pain, skin lesions, and inflammation in the eyes.

What to do if you’re concerned about Crohn’s disease:

Diagnosis is often the most challenging aspect of Crohn’s disease. X-rays and even colonoscopy may not show the inflammation, which usually occurs at the end of the small intestine (the ileum), an area not within easy reach of the endoscope. More sophisticated imaging techniques such as a CAT scan, MRI, or video capsule endoscopy (a tiny ingestible micro-camera in a pill) may be required. Like its sister disease ulcerative colitis, dietary changes, supplements, and more potent prescription drugs all play a role in getting the inflammation and bloating associated with Crohn’s under control.

The good news is that most people with bloating don’t have cancer, infection, or inflammation. If you’re not sure whether your bloating is serious, it’s always better to err on the side of seeking medical attention rather than ignoring it and hoping for the best.

Robynne Chutkan, MD, FASGE, is the author of The Bloat Cure: 101 Solutions for Real and Lasting Relief, The Microbiome Solution, and Gutbliss. Dr. Chutkan has been on faculty at Georgetown MedStar Hospital in Washington, DC, since 1997. In 2004, she founded the Digestive Center for Women, an integrative practice that incorporates nutritional optimization, exercise physiology, biofeedback, and stress reduction as part of the therapeutic approach to digestive disorders.

All About Liver Disease: Fatty Liver, Hepatitis, Cirrhosis, and More

Previously known as primary biliary cirrhosis, primary biliary cholangitis (PBC) is a rare disease that slowly destroys the small bile ducts of the liver. It is believed to be an autoimmune disease that may be triggered in susceptible individuals by such things as exposure to tobacco smoke and other toxic chemicals.

Signs and symptoms of primary biliary cholangitis include fatigue, severe itching, dry mouth and eyes, high cholesterol, jaundice, and abdominal pain.

While there is no cure for PBC, there are a growing number of options for managing symptoms and possibly slowing the disease’s progression.

Learn More About Primary Biliary Cholangitis

What Are the Risk Factors for Liver Disease?

The two most common forms of liver disease in the United States right now are both forms of fatty liver disease — alcohol-related liver disease and nonalcoholic fatty liver disease, according to Dr. Lindenmeyer. As its name suggests, alcohol-related liver disease is linked with heavy alcohol ingestion, she says, while nonalcoholic fatty liver disease is linked with metabolic syndrome.

Risk factors for liver disease include the following:

  • Metabolic syndrome, which is a term for a group of risk factors including high triglycerides, high levels of blood sugar, low levels of HDL (good cholesterol), high blood pressure, and carrying extra weight around your midsection
  • Excessive alcohol use
  • Chronic liver infections such chronic hepatitis B or C
  • Genetic or acquired medical conditions that make liver disease more likely
  • Autoimmune-associated disorders of the liver

What Are the Symptoms of Liver Disease?

At the beginning of the spectrum of liver disease, it can be asymptomatic, says Lindenmeyer. Take hepatitis C, for example, she says: “The majority of people who have hepatitis C have no idea, because they don’t have symptoms,” she says. “This is why we recommend screening for hepatitis C for the baby boomer cohort, or everyone born between 1945 and 1965.”

Early symptoms of cirrhosis may include feeling tired or weak, loss of appetite, weight loss, nausea and vomiting, and pain in the upper right side of your abdomen. With more advanced liver disease, as well as liver failure, symptoms include fluid accumulation in the abdomen or legs, yellowing of the skin or eyes, fatigue, mental confusion, and bleeding in the gastrointestinal tract, says Lindenmeyer.

How Is Liver Disease Diagnosed?

Screening for liver disease typically starts with blood tests that check what is called liver biochemistries, or tests of the liver function, says Lindenmeyer.

“If those are abnormal, then frequently we follow that up with an imaging study of the liver, whether it be an ultrasound, a CT scan, or an MRI,” she says. A specialized ultrasound device called FibroScan can give an estimate of the amount of scarring and fatty buildup in the liver.

It’s important to note that sometimes people who have liver disease may have no evidence of abnormalities in their blood, says Lindenmeyer.

In some cases, a liver biopsy may be necessary to see how much scarring is in the liver.

Given that hepatitis C is often asymptomatic, screening baby boomers is critical for early diagnosis, says Lindenmeyer. “We have excellent medications for hepatitis C that have excellent cure rates. It’s something that can halt the progression of liver disease and potentially even improve the liver once it’s been treated,” she says.

People who have a history of alcohol abuse or are known to drink alcohol excessively should have their liver function tested, along with those with a history of liver disease, as well as people at risk for having a genetically inherited form of liver disease, says Lindenmeyer.

Current treatment guidelines don’t mandate that people with metabolic syndrome be screened for liver disease, but a liver function test is often done as part of their monitoring for medications they are taking, says Lindenmeyer. “If the results are found to be abnormal, we recommend that those patients be screened with liver imaging,” she says.

How Is Liver Disease Treated?

Although every form of liver disease is different, early diagnosis and subsequent treatment and lifestyle changes improve your chances for preserving normal liver function, says Lindenmeyer.

“Liver disease in general is very treatable if you catch it early and prevent ongoing insult to the liver over time,” she says. For any alcohol-related liver disease, it is essential to stop consuming alcohol right away to avoid any further damage to the liver, says Lindenmeyer.

For people with hepatitis C, early diagnosis and treatment can halt the progression of liver disease or even improve liver function, she says.

“If you can diagnose fatty liver disease without the presence of advanced inflammation or scarring, there’s a lot of evidence that you can improve your liver inflammation and reduce fat with multiple interventions,” says Lindenmeyer. Strategies include weight loss and tight control of the metabolic risk factors, including diabetes and dyslipidemia (abnormal cholesterol and triglyceride levels).

Treatment varies according to the kind of liver disease you have, says Lindenmeyer. “There are antiviral medications for hepatitis B and C; there is no treatment for hepatitis A,” she says. “It’s important to maintain your vaccination status to prevent getting infected with hepatitis A or B,” she says, adding that there is no vaccine for hepatitis C.

The Food and Drug Administration has not approved medical therapies for fatty liver disease, but there are a number of experimental therapies, says Lindenmeyer. “This is something we typically manage with lifestyle modifications and weight loss,” she says.

Hemochromatosis can be treated by removing blood periodically. “It sounds like a medieval therapy, but it actually works very well for this specific liver disease,” says Lindenmeyer. There are also medications to remove excess iron.

What Happens if Liver Disease Goes Untreated?

Untreated liver disease can result in cirrhosis and end-stage liver disease, which carries its own spectrum of complications, according to Lindenmeyer. “Once patients have cirrhosis, or end stages scarring of the liver, they’re at risk for developing what’s called portal hypertension,” she says.

Portal hypertension is a high pressure system in the liver that causes complications that can be associated with ascites (the accumulation of fluid in the abdomen) and edema (the buildup of fluid in extremities), as well as gastrointestinal bleeding. (12)

Confusion can result from advanced or end-stage liver disease and infections, says Lindenmeyer. This happens when the liver isn’t adequately removing toxins from your blood and they build up in the brain.

Does Liver Disease Raise the Risk of Liver Cancer?

Beyond the complications related to portal hypertension, anyone with cirrhosis is at risk for developing liver cancer, says Lindenmeyer. Because of that risk, people diagnosed with cirrhosis should be screened for cancer with imaging studies every six months.

Other types of liver disease are also linked to a higher risk of developing liver cancer, including NAFLD, hemochromatosis, and chronic hepatitis B and C. (13)

Tips to Keep Your Liver Healthy

If you have liver disease or you’re at risk for liver disease because of a family history or underlying medical condition, it’s essential to make and keep regular appointments with your liver doctor or primary care doctor and take your medications as directed, says Lindenmeyer.

Other tips to keep your liver healthy include:

  • Limit your alcohol consumption. Follow the recommendations for alcohol consumption, which are different for men and women, says Lindenmeyer. “For men, drink no more than two alcoholic drinks per day and for women, no more than one,” she says.
  • Maintain a normal weight. Keeping your body weight in a healthy range can reduce your risk of developing fatty liver disease. Adopt an exercise regimen that includes cardiovascular and strength training, says Lindenmeyer. Not only will this help with weight management and other chronic conditions, there’s even some research that suggests aerobic exercise could help protect the liver by preventing liver inflammation. (14)
  • Improve your diet. “The Mediterranean diet has been shown to be beneficial for patients with fatty liver disease,” says Lindenmeyer. Drinking coffee has been linked to benefits for people with fatty liver disease as well, she adds.

What Is Uterine Cancer? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Uterine cancer is generally diagnosed through several types of examinations.

Pelvic Exam During a pelvic exam, your doctor will insert two fingers into the vagina while pressing the other hand down on the abdomen to feel for abnormalities in the uterus and the ovaries. A speculum is inserted into the vagina to visually inspect the area.

Transvaginal Ultrasound In this exam, a wandlike device known as a transducer is inserted into the vagina to create a video image of the thickness of the uterine lining and determine if there are irregularities.

Hysteroscopy During this test, a lighted tube, or hysteroscope, is inserted into the vagina to examine the uterus and uterine lining.

Endometrial Biopsy This procedure is performed to remove tissue from the uterine lining to be examined and analyzed by a laboratory.

Dilation and Curettage This test may be performed if questions remain after the uterine lining is biopsied. Tissue removed from the lining of the uterus is analyzed for cancer cells.

RELATED: Speaking Menstruation: A Glossary of Terms Used to Describe Symptoms, Tests, Treatments, and More

Stages and Prognosis of Uterine Cancer

Like most cancers, the degree to which uterine cancer has advanced is classified by stages. All cancers are more curable the earlier they are discovered. Uterine cancer has four stages: (6)

Stage 1 The cancer has not spread beyond the uterus

Stage 2 The cancer has spread from the uterus to the cervix

Stage 3 The cancer has spread from the uterus to the vagina, ovaries, or lymph nodes

Stage 4 The cancer has spread to the bladder, rectum, or other organs.

When diagnosed early, women with uterine cancer have a very good prognosis, according to the American Cancer Society. For endometrial adenocarcinoma, the most common type of uterine cancer, for example, those diagnosed at stage 1A, the earliest stage, have a five-year survival rate of 88 percent. Those diagnosed with the latest stage, 4B, have a 15 percent survival rate.

RELATED: Menopause Awareness Month: October 2020

What You Need to Know About Hepatitis

Hepatitis means inflammation of the liver, and it is most often caused by viral infections. Some types of hepatitis will cause discomfort but eventually go away, while others, like chronic hepatitis C, can be deadly.

Viral types of hepatitis — A, B,C, D, and E — are contracted in various ways. Other non-viral causes of hepatitis relate to toxic exposures and autoimmune disease.

Hepatitis C is the leading cause of liver cancer and also the number one reason for liver transplants in the United States. More than 1.2 million Americans are affected by hepatitis B, and over 3 million have chronic hepatitis C, though many don’t know they are infected.

“The liver is responsible for filtering from the bloodstream harmful substances such as dead cells, toxins, fats, hormones, and a yellowish substance called bilirubin, a byproduct of the breakdown of old red blood cells,” says Rashmi Gulati, MD, medical director of Patients Medical in New York City.

“If the liver is inflamed, tender, and enlarged, it becomes unable to function normally. As a result, toxins that would normally be filtered out by the liver build up in the body, and certain nutrients are not processed and stored as they should be.

Types of Hepatitis

Of the viral causes of hepatitis, hepatitis A, B, and C are the most common. There are also two other forms known as hepatitis D and hepatitis E.

Hepatitis C is the most serious of the more common viral types, says Dr. Gulati. Hepatitis C causes more than 16,000 U.S. deaths annually, according to the Centers for Disease Control and Prevention (CDC).

“About 85 percent of hepatitis C infections lead to chronic liver disease,” Gulati says. “The virus causes slowly progressing, but ultimately devastating damage to the liver.”

Both hepatitis A and B also can be dangerous. “Hepatitis A virus can cause acute liver disease, but can heal within a few months. It can cause high spiking fevers and is more severe in adults than in children,” says Gulati.

“Hepatitis B virus has an 85 percent recovery rate, while 15 percent develop cirrhosis or cancer of the liver.”

Of the rarer viral types, hepatitis D sometimes appears in conjunction with hepatitis B, making for a deadly combination. Hepatitis E is more common outside the United States and appears to put pregnant women at the greatest risk.

Toxic hepatitis is not caused by a virus, but occurs as a result of exposure to toxins like drugs and alcohol. And autoimmune hepatitis happens when the body’s immune system goes awry and attacks its own liver without the presence of a virus.

How Hepatitis Is Transmitted

Hepatitis A is usually spread from person to person or by ingesting food or water that is contaminated with the virus. In some cases, raw shellfish from polluted waters can also spread the disease.

Hepatitis B and C are usually spread through infected blood or other bodily fluids.

Doctors, dentists, and nurses, as well as staff and patients at blood banks, dialysis clinics, and pathology laboratories, are at a greater risk of developing these kinds of hepatitis due to accidental blood exposure.

Drug users who share needles are at high risk of contracting hepatitis B and C, as are those who have unprotected sex with an infected person.

Signs and Symptoms of Hepatitis

If you contract hepatitis, it may present in a way that is similar to a nasty bout of a flu, says Dr. Gulati. Common symptoms of hepatitis include:

  • Fever
  • Weakness
  • Nausea
  • Vomiting
  • Headache
  • Appetite loss
  • Muscle aches
  • Joint pains
  • Drowsiness

Other warning signs to look out for include dark urine, light, clay-colored stools, abdominal discomfort, and jaundice, the yellowing of the whites of the eyes or the skin due to an accumulation of bilirubin.

If you have hepatitis, a simple blood test will show elevated liver enzymes. Additional blood tests can help identify which virus, if any, is to blame.

What To Do About Hepatitis

If you have hepatitis A or B, in most cases you’ll get better with a doctor’s care and supportive treatment without specific anti-viral treatments.

Hepatitis C and other chronic forms will probably affect your life more profoundly, but you can do a lot to manage the condition and keep it under control.

If someone in your home has hepatitis, it is also important to take appropriate precautions to avoid spreading the disease.

For hepatitis A, handwashing is extremely important. For hepatitis B and C, care should be taken to avoid contact with the blood of the infected individual, even the microscopic amounts that hide in toothbrushes and on razors, so never share these items.

Treatment can suppress or even eradicate hepatitis C. Older treatments for hepatitis C are combination antiviral therapy with pegylated interferon and ribavirin.

The treatment came with difficult side effects, and was effective for only about 40 to 80 percent of patients, depending on the type of hepatitis C they carried.

Newer drugs approved by the FDA in 2013 and 2014 are more effective, curing the viral infection for 90 percent of patients or more. New antiviral medications to treat hepatitis C include simeprevir (Olysio) and sofosbuvir (Sovaldi), and combination therapies include Harvoni and Viekira Pak.

Preventing Hepatitis

Vaccinations are available for hepatitis A and B for at-risk individuals, such as health care workers.

“For hepatitis A, vaccination for those patients with risk of exposure or known exposure can prevent transmission of the disease,” says Kimberly Brown, MD, chief of the division of gastroenterology and hepatology at Henry Ford Hospital in Detroit.

“Patients who live with someone with hepatitis B, have a sexual partner with hepatitis B, are born to a mother with hepatitis B, or are health care workers should be vaccinated [against hepatitis B]. Since there is no vaccination for hepatitis C, patients need to be aware that avoiding blood-to-blood contact with infected individuals is critical.”

The best approach is to take all precautions to avoid hepatitis. This includes avoiding sexual or blood contact with someone who may be infected and discussing your concerns with your doctor if you feel that you may be at risk.

Pancreatic Cancer Symptoms: Subtle and Easy to Miss

Pancreatic cancer affects the pancreas, a small organ located between the stomach and the spine.

It is notoriously difficult to detect early because its most noticeable symptoms, such as jaundice, typically appear only in the later stages of the disease.

Pancreatic cancer is the third most common cause of cancer-related deaths, with a five-year survival rate of 8.5 percent, according to the National Cancer Institute (NCI). (1)

One reason for the high mortality rate is that the disease is often diagnosed only after it has spread outside the pancreas. Treatment options for advanced pancreatic cancer are limited and less likely to be successful.

The lack of unique signs and symptoms of pancreatic cancer during the early stages of the disease — especially symptoms that are distinguishable from those of other, more prevalent illnesses — makes ongoing scientific efforts to develop a reliable detection test especially vital.

Two Parts of the Pancreas Typically Affected by Cancer

The pancreas has two main parts. One is called the exocrine component, comprised of ducts and small sacs at the end of ducts. These produce enzymes that help the body digest food, especially fats.

The other part of the pancreas is the endocrine component. These include small clumps of cells located throughout the pancreas that secrete hormones like insulin, which helps control blood glucose levels.

Symptoms of pancreatic cancer vary depending on what part of the pancreas has developed cancer.

RELATED: A Diabetes Diagnosis After Age 50 May Be an Early Sign of Pancreatic Cancer in Black, Latino People

Exocrine Pancreatic Cancer: More Common and More Symptomatic

Cancers affecting the exocrine cells are much more likely to produce symptoms than those affecting the endocrine cells. Among the most common symptoms of exocrine pancreatic cancer are those caused by a backup of bilirubin, a dark yellow-brown substance excreted by the liver as part of a digestive liquid called bile. Normally this liquid travels through the common bile duct, through the pancreas, and into the intestines and then out of the body in stool. In pancreatic cancer, this process can go awry.

Among the symptoms related to problems with bilirubin are:

  • Jaundice The majority of people with exocrine pancreatic cancer develop jaundice — a yellowing of the skin and eyes — as one of their earliest symptoms, according to the American Cancer Society (ACS). If pancreatic cancer blocks the common bile duct, it can cause bilirubin to build up, producing jaundice. Jaundice can also be a sign of pancreatic cancer that has metastasized to the liver. Although jaundice is a common pancreatic cancer sign, more common reason for this symptom are gallstones or hepatitis.
  • Dark Urine and Itchy Skin The increase in bilirubin levels can lead to a buildup of substances normally broken down in the body and excreted. The result can be symptoms such as dark urine and itchy skin.
  • Stool Trouble Bilirubin gives stool its brown color; if it’s not reaching the intestine because of a blockage in the common bile duct, stool may be abnormally pale. Bilirubin also helps break down fat during digestion, so common bile-duct blockages sometimes lead to greasy-looking stool that may float in the toilet.

Other possible symptoms of exocrine pancreatic cancer include:

  • Pain in the belly or back due to the cancer pressing on nearby organs or spreading to nerves
  • Unintentional weight loss
  • Unexplained loss of appetite
  • Digestive problems, including nausea and vomiting, caused by stomach blockage
  • Enlargement of the liver or the gallbladder (due to bile buildup)
  • Unevenness in the fatty tissue beneath the skin due to the release of pancreatic enzymes
  • Diabetes (In rare cases, pancreatic cancer may destroy the insulin-producing cells of the pancreas.)
  • Deep vein thrombosis (DVT), a blood clot in a large vein, often in the leg, which can result in pain, swelling, redness, and a feeling of warmth

Endocrine Pancreatic Cancers — a Rarer Breed

Pancreatic neuroendocrine tumors (PNETs), or islet cell tumors, are an uncommon type of pancreatic cancer, accounting for less than 5 percent of all pancreatic cancers. This type of pancreatic cancer affects hormone-producing cells found in the pancreas.

While they can be life-threatening, pancreatic PNETs tend to be less dangerous than pancreatic exocrine cancer.

Malignant neuroendocrine cells cause the pancreas to overproduce hormones. Excesses of different types of hormones result in different kinds of symptoms.

Among the types of PNETs are:

  • Gastrinomas These tumors secrete a hormone that instructs the stomach to make acid. Too much leads to pain, nausea, and appetite loss, as well as other more severe symptoms, like bleeding ulcers.
  • Glucagonomas By producing a hormone that increases glucose in blood, these tumors can sometimes cause diabetes. Most people with this disease visit the doctor because of an odd, blistering rash that pops up in different places on the skin.
  • Insulinomas These tumors secrete insulin, sometimes leading to low blood sugar and dizziness, weakness, confusion, sweating, and rapid heartbeat.
  • VIPomas Named for the substance they secret, vasoactive intestinal peptide (VIP), these tumors can cause severe diarrhea.
  • PPomas Pancreatic polypeptide (PP) is the problematic secretion here; too much can cause abdominal pain and liver enlargement.
  • Carcinoid Tumors These growths make serotonin or its predecessor, 5-HTP (5-hydroxytryptophan). Symptoms include flushing, diarrhea, wheezing, and a rapid heart rate.
  • Nonfunctioning Neuroendocrine Tumors These don’t make excess amounts of hormones. Symptoms resemble those of pancreatic exocrine cancer, such as jaundice. (2)

Managing Symptoms: Critical to Care Throughout

Pancreatic cancer symptoms can vary from person and person and evolve over time. Coping with pancreatic cancer symptoms — and the side effects of treatment — can be a struggle. Some patients may need assistance dealing with pain, fatigue, and nausea, for instance, while others might benefit from help grappling with the emotional aspects of the disease.

The Pancreatic Cancer Action Network (PanCAN), a leading national nonprofit, emphasizes the importance of symptom management and supportive (palliative) care at diagnosis, during and after cancer treatment, and as a focus in and of itself.

Palliative care providers include doctors, other members of the healthcare team, supportive care specialists, other medical specialists, and hospice organizations. (3)

Upper or Lower Stomach Bloating: The Differences

Sometimes when you feel bloated, you can feel a distinction between the upper and lower part of your stomach. This can actually be helpful in determining what cause might be behind your stomach bloating. Read more about the differences between upper and lower stomach bloating.

Upper Stomach Bloating

If you’re experiencing upper abdominal bloating, there are a number of potential causes behind the symptoms. These causes include:


It is incredibly common to experience gas in the digestive system. When the gas is causing a full and bloated feeling in the upper abdomen, it is most likely because of swallowed air. Air can be swallowed in a number of ways – chewing gum, eating or drinking too quickly, drinking through a straw, and smoking, among a number of other things can cause air to be swallowed.

Gastroesophageal reflux (GERD)

Better known as acid reflux, this is a condition caused by excess stomach acid that can move up into the esophagus and cause heartburn among other symptoms. It is common for GERD to be associated with a feeling of fullness in the upper abdomen.

Crohn’s disease

An autoimmune digestive disease, Crohn’s disease is not fully understood, but causes many different digestive symptoms. One of them is bloating, and this bloating is especially likely to be experienced in the upper abdomen. Crohn’s disease may also cause constipation or diarrhea, gas, and other symptoms like fever and exhaustion.

Lower Stomach Bloating

Bloating in the lower abdomen likewise has several different possible reasons. Lower stomach bloating may be caused by:


While gas may cause upper abdomen bloating when swallowed, if the gas is in the intestines, it is likely to cause bloating in the lower abdomen. Most often, this happens when you eat something that is complex to digest and releases gas throughout the digestive process. Dairy is an especially common culprit.


When your body begins to have trouble passing food all the way through the digestive system, you are likely to become constipated. This causes bloating and swelling in the lower part of the abdomen because you cannot pass stool, and it accumulates in your intestines.

Bacterial overgrowth

Bacteria are essential for our digestive systems to work properly, but when they begin to reproduce too quickly, they can cause problems. When too many bacteria begin to grow in the small intestine, it can causes bloating, diarrhea, and even weight loss.

Irritable bowel syndrome (IBS)

This disease is one of the most common digestive diseases in the US. It causes irritation of the large intestine, which results in a number of symptoms. Along with bloating, patients may experience diarrhea, constipation, cramps, and abdominal pain.

The difference between upper abdominal bloating and lower abdominal bloating may help you figure out what is causing your symptoms. To learn about relieving symptoms, learn about how to reduce bloating.



belly bloat is a very common problem. When this problem occurs, the stomach
feels bloated and tight. This is usually due to gas filling in the
gastrointestinal tract. In this case, the stomach appears larger than usual and
sometimes there is pain in the stomach. There is also a problem of bloating due
to fluid retention.



To Spot The Difference And Reverse Both !

order to create a plan that best fits your needs, it’s important to first
pinpoint what you’re experiencing: are you bloated or are you experiencing
belly fat ? what causes each and how you can reverse them.

In this video, you
will be able to understand easily and i thanks “autumn bates” for
making this video that they have made a good enlightening video and i will
request my readers to watch youtube videos of “autumn bates” and
subscribe to their youtube channel.




– upper belly bloat due to constipation, food allergy
etc. When feces are collected in the large intestine, there is a problem of
blotting and discomfort. Apart from this, there is also the problem of blotting
when the stool collects more gas in the stomach.


Soft drinks, soda, tea, caffeine or eating too much salt and sugar or lack of
fiber also cause bloating problems.


from this, some women have bloating problems before and after menstruation due
to hormonal changes and water retention.


You should also know about upper stomach fat roll | upper belly fat


are telling you ways to get rid of this very common problem, with the help of
which you can get relief from the problem of upper belly bloat immediately.




the following remedies for quick relief from upper belly bloat.


On Upper Belly Bloat


who remain physically active, their intestines are also active, due to which
the excess gas and feces comes out of their stomach easily. If constipation is
the problem, it is very important to keep moving the intestines. Hence, walk in
case of gas problem. This will give you instant relief from gas.


Yogasan On Upper Belly Bloat


Yogasanas put pressure on the abdominal muscles in such a way that the excess
gas is easily released. This gives relief from blotting. Apart from this, by
doing swots (a type of exercise), it is also easy to release gas.


Pipermint Oil Capsules On Upper Belly Bloat


peppermint oil capsules also relieves indigestion and gas. It is commonly used
to treat Irritable Bowel Syndrome, but you can consume it even if you have a
problem of bloating. 


You should also know about Upper belly bloat


relaxes the muscles of the intestines, so that gas and feces come out easily.
To take it, the instructions given on the packet should be read carefully.
People who have problems with chest irritation, they should abstain from taking
Pipermint. Peppermint Capsules is available in the medical store or online.


The Abdomen When Upper Belly Bloat


the abdomen brings activeness in the intestines. Massage of the large intestine
is especially beneficial. For this, place your hands just above the right hip
bone and massage it in circular motion while giving light pressure.


Oils Are Beneficial For Upper Belly Bloat


a 2016 study, 116 people who had stomach problems were asked to take
supplements with fennel and curcumin essential oils. The study found that after
consuming it for 30 days, they got a lot of benefit. But one thing is worth noting
that essential oil supplements should not be consumed without doctor’s advice.


A Shower With Hot Water When You Have Upper Belly Bloat


a bath with warm water provides relief from bloated stomach. This relaxes the
body and reduces stress, which makes the gastrointestinal tract work well and
provides relief from blotting.




who often have problems with upper belly bloat, they should make the following
changes in their lifestyle.


Fiber Intake In Breakfast


get rid of constipation and upper belly bloat, increase fiber intake by eating,
especially at breakfast. Men should consume 35 grams of fiber daily and women
25 grams. But one thing is worth noting that the consumption of too much fiber
or sudden increase in fiber also causes gas and bloating problems. Consuming
more than 70 grams of fiber in a day has a negative effect on the stomach.
Therefore, it is important to increase the amount of fiber gradually, so that
the body gets time to adjust.


Reduce Soda Intake


Soda and carbonated drinks
contain gas, which can cause stomach bloat. Carbon dioxide present in soda can
increase the problem of blotting. Due to the sugar and artificial sweetener
present in the food, there is also a problem of upper belly bloat. To avoid
this, drink as much water as possible. Your problem will be solved.


Do Not Consume Chewing Gum


Due to the sugar present in
chewing gum, some people have a problem of blotting. Apart from this, while
chewing chewing gum, it also absorbs air, which causes upper belly bloat and
gas. Take ginger or peppermint tablet instead of chewing gum.


Be Physically Active


Exercise excretes the stool
and gas from the colon and also keeps the stomach clean. Exercise causes excess
sodium to be released from the body through sweat, which reduces water
retention. It is important to drink sufficient amount of water before and after
exercise, so that there is no shortage of water in the body.


Eat At Regular Intervals


Many people have the problem
of blotting after eating too much food. To avoid this, keep eating at regular
intervals. By doing this, the digestive system will work in a smooth manner.
Apart from this, by hastening food or drinking water from straw, the air also
gets into the stomach, which produces gas and causes bloating. To avoid this,
eat food slowly and do not drink water in between meals.


Use Of Probiotics


Probiotics are good bacteria
that live in the intestine. Consuming probiotics supplements helps control the
bacteria that produce gas in the stomach.


Decrease The Salt Content


Consuming more salt increases
water retention in the body. Due to which the stomach and other parts of the
body swell. Therefore, reduce the amount of salt in the food.


Get Checked


Sometimes there is a problem
of upper belly bloat due to some disease. If the problem of upper belly bloat
persists even after taking all measures, then check with the doctor.


Create A Food Diary


Sometimes, due to allergies
to a particular type of food, there is also a problem of bloating and gas. So
if you are allergic to any kind of food, then note it in the diary as soon as
you know. For example, people who are allergic to lactose present in milk and
dairy products. They have a problem of blotting, because their stomach is not
able to digest the sugar present in dairy products.


Apart from this, people who
are allergic to gluten also have a problem of blotting. Therefore, people who
have any problem immediately after eating, then keep a track by eating a diary.
This will make it easy for you to find out what is causing the problem of


Focus On Medicines


Some medicines and
supplements, such as iron, etc. also cause constipation and indigestion. On the
contrary, potassium helps to get rid of the problem of blotting by balancing
the amount of sodium in the body. There are also problems of upper belly bloat
due to the side effects of some medicines. If you have such problem after
eating medicine, then discus it with doctor. They will tell you other options.

Friends, today you know about
the treatment due to the problem of upper belly bloat, but friends, I advise
you to first consult a doctor.

You should also know about some
magical tips and tricks


90,000 Bloating and gas in children and adults: causes and treatment

Bloating is almost impossible to miss. He is literally bursting in different directions, he becomes more visually, rumbling sounds are heard, there is a feeling that the abdomen is about to burst. Perhaps the most unpleasant symptom among all that complex is the release of accumulated digestive gases, in order to restrain which, you have to make every effort.

Causes of bloating

Flatulence, as this condition is otherwise called, can occur for a variety of reasons, many of which are quite serious. Bloating and gas formation occur due to the presence of:

  • chronic pancreatitis – an acute lack of nutritional enzymes produced by the pancreas. Since food has nothing to digest, it accumulates in the stomach, creating a feeling of severity of bloating after eating;
  • irritable bowel syndrome – a person has bloating and abdominal pain due to changes in bowel movements;
  • dysbiosis – a disease characterized by malfunctions in the area of ​​microflora, due to which pathogenic microorganisms on the walls of the mucous membrane begin to produce gases that interfere with the full functioning of the gastrointestinal tract;
  • individual lactose intolerance – the diagnosis is also associated with enzyme deficiency: the patient lacks milk sugar, which contributes to the full assimilation of lactose.In the presence of this syndrome, intestinal flatulence can occur at any age, but it is diagnosed most often before the age of 5-8 months;
  • intestinal obstruction is a rather serious disease that is diagnosed early. In this case, flatulence is associated with the growth of polyps or the formation of a tumor in the intestinal region. In most cases, requires surgery;
  • celiac disease is an extremely rare disease, but it still occurs. According to statistics, in our country only 1 person in 1000 is exposed to it.Celiac disease is associated with a partial or complete inability to break down gluten, as a result of which toxic compounds are created in the body that negatively affect the intestinal surface. If a patient is diagnosed with a similar diagnosis, then, first of all, he is prescribed a diet for flatulence, based on the complete elimination of gluten from the diet. This includes sausages and sausages, barley. Wheat, rye, oatmeal, pasta made from ordinary flour, baked goods, ready-made sweets, store-bought yoghurts and curds, etc.Also, a gastroenterologist may prescribe enzymatic drugs designed to break down the gluten that enters the body.

Often, one of the causes of bloating is improper diet and abuse of foods that do not bring any benefit to the body.

  • Frequent consumption of various carbonated drinks such as Coca-Cola and sparkling mineral water. Bloating in the lower abdomen, which occurs for this reason, usually goes away on its own and quickly enough: gases are absorbed into the body through the intestinal wall, and then removed from it without additional help.
  • Too large portions of food. Nutritionists around the world categorically do not recommend eating huge portions. Hurriedly absorbing food, swallowing it quickly instead of chewing normally, is harmful to the digestive process. For this reason, bloating and gas formation require a simple treatment – just change your approach to nutrition.
  • Abundance in the diet of foods that cause fermentation, which, in turn, stimulates bloating and gas formation in an adult or child.The solution to this problem is not difficult: it is necessary to limit the consumption of sweets, pastries, legumes, potatoes and other foods known for their starch content and fast carbohydrates.
  • Eating foods incompatible with each other. So, for example, any fruit should be separated from the main meal: they should be eaten about 1 hour before or 2 hours after breakfast, lunch or dinner.

Treatment of bloating

Bloating requires treatment in a complex, since it is necessary to eliminate not only the annoying symptom, but also the cause, otherwise the situation will repeat itself.

Any appointments should be made by a specialist – a gastroenterologist or therapist. As a rule, the standard scheme always includes the intake of enterosorbents, which allow the gases accumulated in it to be removed from the body as soon as possible. Since these drugs cannot independently distinguish harmful compounds from useful ones, they cannot be taken for a long time.

Depending on the patient’s history and the causes of bloating, intestines, non-toxic defoamers used even at a very young age, enzymatic agents, probiotics that restore the damaged intestinal microflora may be prescribed. The specialist will also definitely recommend adhering to a diet for some time that does not burden the work of the gastrointestinal tract system.

It is very important to find the cause as quickly as possible in order to alleviate the patient’s condition as soon as possible. Therefore, it is necessary to contact only experienced therapists and gastroenterologists. You will meet such people within the walls of JSC “Medicine” (the clinic of Academician Roitberg) – a multifunctional medical center located in the very center of Moscow. The building is located at 10 2nd Tverskoy-Yamskaya lane, next to the Mayakovskaya metro station.

Here they will quickly select a medicine for bloating, which will solve your specific cause, since the main principle of this clinic is an attentive and individual approach to each patient.

You can sign up for a consultation, diagnosis and treatment by calling the round-the-clock phone +7 (495) 775-73-60 or by using the feedback form on the website of the medical center https://www. medicina.ru.

Answers to the most common questions

  • What foods that cause bloating should you avoid?
    You need to eat in a variety of ways, and in the absence of individual food intolerances, you can eat everything.However, you should be careful about the consumption of sweets, white and black bread, baked goods, legumes, white cabbage, starchy foods.
  • Severe flatulence. What to do?
    Consult a doctor for a medication. Only a specialist, based on your history, can decide which drug to prescribe. It can be syrups, suspensions, pills for bloating.
  • What causes bloating in women during pregnancy?
    Indeed, this symptom is popular in women carrying a baby, especially in the first trimester.This is mostly due to unstable hormonal levels and is considered completely normal. However, it is necessary to inform your gynecologist about this, since he can prescribe drugs that relieve the tone of the uterus and alleviate the condition of a pregnant woman.

Treatment of bloating in Ufa

Frequent bloating may indicate the development of serious medical conditions. In order not to worry in vain or miss the progression of the disease, make an appointment with a gastroenterologist.

The formation of gases in the intestines is a natural process, the only question is their volume. The daily rate is about 600 ml of gas, while with flatulence, this figure increases to several liters. The most striking symptom of gastrointestinal problems is bloating.

In the process of gas formation, ammonia, hydrogen sulfide, carbon dioxide, oxygen, methane, hydrogen and dozens of other compounds are formed. The sooner you start treating bloating, the sooner you will get rid of the discomfort.

Main reasons

This symptom is not specific, therefore, complaints of flatulence are not enough to make a diagnosis. Increased gas production as a variant of the norm can be considered if it is caused by non-compliance with the diet or swallowing air. That is why doctors strongly recommend quitting smoking, talking while eating, snacking on the go, and wearing poor quality prostheses.

Excessive gas formation may indicate the development of:

In addition to the reasons listed above, flatulence can be associated with lactose and gluten intolerance, irritable bowel syndrome, adnexitis, uterine fibroids, or ectopic pregnancy.

How to treat?

Treatment for bloating depends on the underlying cause. The doctor may prescribe enterosorbents, defoamers or gastric acid enzymes to the patient to facilitate the digestion of carbohydrates and proteins.

In addition to drug therapy, it is necessary to normalize nutrition by eliminating from the diet foods that provoke gas formation – carbonated drinks, beer, legumes, milk and baked goods.

Don’t waste time and money on unnecessary examinations.Make an appointment with a gastroenterologist and start treatment under the guidance of a qualified specialist!

Bloating and gas – causes, symptoms and treatment of flatulence after eating

Views: 6 332

Date of last update: 08/26/2021

Average Read Time: 5 minutes

Bloating (flatulence or flatulence in the abdomen) is a fairly common condition that can develop as a reaction to an improper diet and an unbalanced diet. But it can also be a sign of dyspepsia – a digestive disorder due to improper gastric motility, as a result of which food lingers in it, causing a feeling of fullness, bloating and other symptoms.

Signs of bloating

Symptoms in the digestive system

With flatulence, the functioning of the entire digestive system is disrupted. The gases accumulated in the intestines interfere with the normal movement of food, which causes heartburn, belching, and an unpleasant taste in the mouth.In addition, gas during bloating leads to an increase in the intestinal lumen, to which it reacts with stabbing or aching pains, often in the form of contractions. The discharge of gases eases the discomfort for a while, but only until their next “portion” accumulates and causes the next cycle. This condition may be accompanied by upset stools (constipation or diarrhea), nausea, and decreased or no appetite.

Manifestations in children

In newborns and infants, flatulence is manifested quite clearly. The child becomes irritable and moody, often wakes up. Appetite is impaired, bloating after eating increases. During feeding, the baby may greedily grasp the nipple or breast, but immediately release it. Frequent regurgitation with milk or mixture and air may occur.

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Causes of bloating in a healthy person

  • Swallowing air during eating and drinking

Temporary bloating and gas are common when eating disorders are not correct.Snacks “on the go” and talking while eating lead to the fact that air enters the stomach along with food.

Carbonated drinks, gum and smoking also contribute to this.

It should be understood that the air itself does not pose any threat – in a healthy person, it partially leaves the stomach in the form of belching, and the rest enters the intestines, from where it is excreted naturally.

  • Eating certain foods

Such favorite and “safe” sweets are one of the most frequent provocateurs of bloating. Easily digestible carbohydrates, which are part of baked goods, cookies, sweets and other goodies, cause the fermentation process, in which gases are released. Bloating after eating, if sweets were present on the menu, is a fairly characteristic sign of flatulence caused by fermentation.

Foods containing starch and coarse fiber (potatoes, legumes, rye bread, cabbage, etc.) can also lead to gas formation.

Folk remedy for heartburn – regular soda – is not as safe as it seems.The gases formed in the stomach when baking soda reacts with hydrochloric acid can easily provoke symptoms of flatulence and aggravate the situation.

  • Influence of intestinal microflora

Microorganisms that inhabit the human intestine are essential for the normalization and maintenance of the correct digestion process. But even a slight “skew” in the composition of the microflora can cause bacteria that emit methane, hydrogen, hydrogen sulfide and carbon dioxide to prevail, and then, naturally, bloating occurs.

  • Psychological factors

The stomach and intestines are controlled and controlled by the nervous system in the same way as all other organs. It is not surprising that during stress, excessive psychoemotional stress and overwork, the work of these organs can be disrupted, as a result of which increased gas production is observed.

Changes in a woman’s body during pregnancy are the most common cause of increased gas production that occurs during this period.The growth of the fetus and the enlargement of the uterus lead to squeezing of the intestinal walls, which disrupts the natural flow of gases.

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How to deal with bloating?

Elimination of flatulence is a complex process. Treatment is developed and applied after the cause of the bloating has been identified and may include the following measures to address the source of the problem and relieve symptoms of the condition.

Lifestyle correction

Bloating after eating is often caused by poor food hygiene. A calm environment during breakfast and lunch, leisurely chewing food, excluding carbonated drinks and chewing gum from the diet, quitting smoking – these measures will help prevent air from entering the stomach.

Diet correction

If gas formation is caused by the consumption of provocative foods (potatoes, muffins, sweets, whole milk, legumes, cabbage, etc.), eliminating them from the diet will help eliminate this problem.

Fractional nutrition – the daily amount of food, divided into 5-6 small portions – also helps to normalize digestion and treat increased gas production.

90,000 18 Ways To Deal With Bloating

12 September 2018

Bloating is a common problem that usually occurs due to a build-up of gas in the gastrointestinal tract. Bloating visually increases the size of the abdomen and makes it tender or even painful. Exercise, nutritional supplements, and massage can help reduce bloating quickly, and simple lifestyle changes can prevent the condition from recurring.

The following tips will help people at home quickly deal with pain and discomfort from bloating:


Physical activity will cause your intestines to contract more frequently, which will help release excess gas.

2. Yoga

Certain yoga postures can tense the abdominal muscles in such a way as to stimulate the release of excess gas from the gastrointestinal tract. For example, poses such as balasana (baby pose), ananda balasana (happy baby pose), and squat pose are suitable for you.

3. Peppermint

Peppermint Capsules may be helpful for upset stomach and associated gas.

4. Special medicines to combat excessive gas formation

Anti-gas preparations will help remove excess air from the digestive tract. For example, “Simethicon” copes with its task well.

5. Massage of the abdominal cavity

Such a massage will improve the normal functioning of the intestines. However, you should properly study the course of the massage, and in case of pain, immediately stop it.

6. Essential oils

A 2016 study showed that a mixture of fennel and turmeric essential oil can effectively fight gases in the digestive tract.However, you should consult your doctor before using essential oils.

7. Warm bath

Lying in warm water can help relieve abdominal pain. Relaxation will reduce stress levels and help you cope with gas more quickly.

All these tips will help you solve the problem urgently. The following will list the methods that work in the long term.

8. Consuming more fiber

It helps prevent constipation and bloating.The daily intake of fiber for women is 25 g, and for men – 38 g. However, if you consume more than 70 g per day, you will get the opposite effect.

9. Refusal of carbonated water

Carbonated drinks contribute to the accumulation of gases in the stomach. The carbon dioxide used in the production of this water, as well as sugar and artificial sweeteners, can cause bloating.

10. Taboo on chewing gum

Substances in the gum and swallowing large amounts of oxygen while chewing provoke the formation of gases.

11. Increase your daily physical activity

Exercise will help you make bowel movements more regular and free your digestive tract from excess gas and water.

12. Regular Eating

Many people experience bloating immediately after eating large amounts of food at one time. It is better to divide your meals into small portions and eat more often, so the digestive system will work better.

13. Use of probiotics

Probiotics will help regulate bacteria in the colon that produce gas and cause bloating.

14. Reducing salt intake

Excess sodium forces the body to retain water. This can cause a feeling of bloated belly.

15. Eliminate any kind of disease

In some cases, gas production is a consequence of the disease. Therefore, it is better to get tested and make sure that everything is okay with you.

16. Switching to a diet low in FODMAPs

A study showed that such a diet helped relieve bloating, flatulence and abdominal pain in 74% of participants with irritable bowel syndrome

17.Keeping a food diary

Some people may have food intolerances. Keeping a food diary can help you figure out what food your body is reacting to.

18. Avoid food additives and medications that can cause gas problems

Some supplements, such as iron, can cause constipation and other symptoms of dyspepsia, which in turn causes bloating. In addition, various medications can be the culprit for increased gas production.It is necessary to carefully study the possible side effects in the instructions.

← Back 90,000 About polyclinic №2 named after Semashko

Bloating is caused by increased gas production in the intestines, which is accompanied by inadequate elimination of gas naturally. By itself, this manifestation is not considered a disease. It only indicates certain dysfunctions or pathologies of the intestine.

The comprehensive therapeutic program of the Semashko polyclinic provides for laboratory and apparatus examination, diagnostics based on the results obtained, the development of an individual course, which will not only relieve bloating and increased gas production, but also eliminate the causes of these manifestations.At your service are consultations of therapists, gastroenterologists, and if necessary – an infectious disease specialist, neurologist, surgeon.

Bloating: causes of

Increased gas production with insufficient removal of gases from the intestine is manifested:

  • feeling of fullness in the abdomen;

  • bursting of the abdominal cavity;

  • discomfort.

Some patients experience rumbling in the abdomen, flatulence, belching, nausea.Often, patients with bloating and gas production complain of pain caused by stretching of the intestinal walls and upset stools. In some cases, in order to get rid of unpleasant conditions, it is enough to maintain a diet: exclude from the diet foods that cause gas and bloating. However, in some patients, these symptoms signal more complex diseases:

  • food allergies;

  • dysbiosis;

  • deficiency of digestive enzymes;

  • dysfunctions of the digestive system;

  • deterioration of local blood circulation;

  • mechanical obstruction in the intestine as a result of adhesive processes;

  • genetic abnormalities.

The task of the specialists of the polyclinic №2 named after Semashko consider the identification of the causes, bloating, a clear identification of conditions caused by malnutrition from those that indicate complex anatomical pathologies.

Bloating and gas: treatment

Before prescribing a remedy for bloating, a gastroenterologist must determine the causes of increased gz formation. For this, the patient is invited to undergo an examination.Diagnostic procedures include:

  • examination and palpation of the patient’s abdomen;

  • laboratory tests of blood and feces;

  • hardware procedures: ultrasound, CT if necessary.

Based on the test results, the specialist prescribes treatment for the patient, which helps to normalize the functioning of the digestive system and relieve the patient from such an unpleasant diagnosis as flatulence.

Contacting the polyclinic them. Semashko, you can be sure that you will receive qualified medical care, which will be provided in a timely manner, with high service and modern methods. Make an appointment with a gastroenterologist right now on our website.

Which doctor should I contact:

Gastroenterologist Modestova A.V.
Gastroenterologist Tsemakhovich M.M. 90,000 Bloating: What Foods Should You Avoid?

https://rsport. ria.ru/20201122/zhivot-1585778953.html

Bloating: Which foods should be avoided?

Bloating: What foods should be avoided? – RIA Novosti Sport, 22.11.2020

Bloating: what foods should be excluded?

Nutritionist Elena Kalen listed foods that can cause bloating. RIA Novosti Sport, 22.11.2020

2020-11-22T15: 00

2020-11-22T15: 00

2020-11-22T15: 00

healthy life




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MOSCOW, Nov 22 – RIA Novosti. Nutritionist Elena Kalen has listed foods that can cause bloating, and she says that when choosing foods, you must pay attention to the composition. If artificial sweeteners are present (aspartame, sucralose and sorbitol, which are very difficult to digest), then unpleasant sensations in the abdominal area will definitely appear. Their consumption must be eliminated or reduced to a minimum, the specialist recommends.Bloating can be caused by dairy products, lactose, whole grains (since fiber promotes gas), and legumes and lentils that contain oligosaccharides. Instead of high fructose foods like melons, eat kiwi fruits that contain actinidin. Is a natural enzyme that helps break down proteins and prevents bloating. Preservatives, salt and monosodium glutamate are equally popular causes of bloating.


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nutrition, health, intestines

MOSCOW, November 22 – RIA Novosti. Nutritionist Elena Kalen listed foods that can cause bloating.

According to her, when choosing products, it is imperative to pay attention to the composition.If artificial sweeteners are present (aspartame, sucralose and sorbitol, which are very difficult to digest), then unpleasant sensations in the abdominal area will definitely appear. Their consumption must be eliminated or reduced to a minimum, the specialist recommends.

Bloating can be caused by dairy products, lactose, whole grains (since fiber promotes gas), and legumes and lentils that contain oligosaccharides.

“Starch and sugar in some fruits and vegetables build up gas in the intestines.These are cabbage (white cabbage, Brussels sprouts, cauliflower), carrots, apricots, and prunes. Can’t part with your favorite product? Try steaming it, “Elena Kalen wrote on her Instagram.

Instead of fructose-rich foods such as melons, it is better to eat kiwi, which contains actinidin, a natural enzyme that helps break down proteins and prevents bloating.

November 22, 2020, 14:05 AM A nutritionist told who it is harmful to eat garlic

Preservatives, salt and monosodium glutamate are equally popular causes of bloating.

“Chips, crackers, breakfast cereals are real bombs that are ready to explode in your digestive tract. There is one recipe – switch to healthy food. Instead of fast food, eat meat, instead of soda, drink pure water with lemon, mint or cucumber,” said Elena Kalen.

Intestinal gas and bloating

O.V. Shvets, Ph.D. D., Association of Dietitians of Ukraine, Kiev

PDF Article

Patients with symptoms, probably associated with increased gas production in the digestive tract, often seek advice from other than a gastroenterologist.Family doctors are also often faced with complaints from patients about belching, bloating, diffuse abdominal pain and flatulence. Usually, patients consider them to be the result of excessive gas formation, which, it should be noted, does not always correspond to reality.

An increase in the amount of intestinal gas can be associated with excessive swallowing of air, an increase in gas production as a result of malabsorption of nutrients, a decrease in the absorption of the formed gas, or an increase in its volume due to changes in atmospheric pressure.

Pathophysiological mechanisms

Volume and composition of intestinal gas

Several studies have been conducted to better understand the nature of bloating syndromes. Their goal was to compare the volume and composition of intestinal gas in people with and without symptoms.

The volume of intestinal gas is approximately 200 ml (both on an empty stomach and after meals), not significantly differing in persons with flatulence and without specific complaints [1].

More than 99% of the gas mixture emitted by the intestines is nitrogen (N 2 ), oxygen (O 2 ), carbon dioxide (CO 2 ), hydrogen (H 2 ) and methane (CH 4 ).Nitrogen is the dominant gas in the intestinal lumen. Oxygen is present here in an insignificant amount, and the concentrations of CO 2 , H 2 and CH 4 vary widely in different people [2].

The composition of the gas mixture differs significantly in different parts of the digestive tract. For example, gastric gas contains high concentrations of N 2 and O 2 , close to those of atmospheric air. The large intestine contains much less O 2 and significantly more CH 4 .

Major intestinal gases are odorless. Minor components of flatus, which provide its specific smell, include sulfur-containing substances — methaneethiol, dimethyl sulfide, hydrogen sulfide, as well as short-chain fatty acids, skatoles, indoles, aromatic amines, and ammonia [3].

Origin of intestinal gas

Swallowing atmospheric air – aerophagy – provides the bulk of gastric gas. Each act of swallowing is accompanied by the ingress of several milliliters of air into the stomach.When swallowing large pieces of food, a much larger amount of the atmospheric gas mixture enters with it.

Aerophagia can be a manifestation of anxiety states, its intensity increases with the use of chewing gum and smoking. The main part of the swallowed air is evacuated with belching [4].

Air entering the stomach during swallowing is the main source of N 2 and O 2 , which are part of the intestinal gas. Body position significantly affects the amount of gas that passes from the stomach into the small intestine.The horizontal position of the body promotes the movement of gas into the duodenum, since it is located above the level of the liquid contents of the stomach and above the esophageal-gastric junction.

Intraluminal gas formation. Three of the five key gases (CO 2 , H 2 and CH 4 ) are formed in the intestinal lumen:

  • CO 2 is formed as a result of the digestion of fats and proteins in the upper parts of the digestive tract, during bacterial fermentation of the intraluminal contents, as well as as a result of the reaction of acid and bicarbonates [5].Most of the carbon dioxide is generated in the upper small intestine and is probably absorbed before entering the colon. An increase in the proportion of CO 2 in flatus may be a consequence of the use of certain nutrients, for example, indigestible carbohydrates [6];
  • H 2 is simultaneously produced and consumed by intestinal bacteria mainly in the lumen of the colon [7]. Carbohydrates and food proteins are the main sources of hydrogen production.In healthy people, certain foods high in oligosaccharides, such as stachyose, raffinose (found in legumes) and indigestible starch (found in wheat, cornmeal, oatmeal, and potatoes) are not fully digested in the lumen of the small intestine, leading to increased production H 2 [8].

The consumption of hydrogen by bacteria increases with the production of methane, sulfate compounds and acetate [9]. H 2 is excreted in the exhaled air (after absorption and entry into the blood), as well as in the composition of flatus.

Malabsorption of carbohydrates in the lumen of the small intestine leads to their entry into the colon and an increase in the production of H 2 . This is the basis of the principle of hydrogen breath tests to detect the malabsorption of a number of carbohydrates.

  • CH 4 , like H 2 , is a product of bacterial metabolism. The main producer of CH 4 is the bacterium Methanobrevibacter smithii. M. smithii catalyzes the reaction 4H 2 + CO 2 → CH 4 + 2H 2 O, which reduces the volume of gas in the intestinal lumen.CH 4 can be absorbed, enter the portal bloodstream and be excreted with exhaled air or excreted as part of the flatus.

The level of CH production 4 is determined by the presence of methanogenic bacteria and depends on a number of external and genetic factors. The presence of bile acids in the colon can also be an important factor in the regulation of methanogenesis [10].

Main reasons for the increase in intestinal gas volume

Abdominal pain, flatulence and flatulence are common symptoms associated with increased production and volume of intestinal gas or visceral hypersensitivity at normal volume. Table 1 shows the conditions that cause an increase in the volume of intestinal gas.

Clinical manifestations associated with the presence of gas in different parts of the digestive system


Belching is understood as the sonorous expulsion of air from the esophagus or stomach into the pharynx. It can be voluntary and involuntary. The latter usually occurs during or shortly after eating due to the return of swallowed air during the expansion of the stomach.Belching is considered a disorder when it becomes overwhelming and distressing.

There are two main types of belching: supra-gastric and gastric.

With supragastric type of belching , air returns to the pharynx from the esophagus, and not from the stomach. Syneradiographic studies demonstrate that patients relax the upper esophageal sphincter, swallow a certain amount of air, and then regurgitate it before entering the stomach [11].In some patients, negative intrathoracic pressure develops, possibly due to inhalation with a closed glottis, followed by relaxation of the upper esophageal sphincter and the ingress of air into the esophagus (as in Fig. 1). In another part of the patients, the synchronous contraction of the muscles of the pharynx, palate and tongue also ensures that air enters the lumen of the esophagus [12].

Gastric belching appears when the intragastric air is expelled, which returns to the esophagus when the lower esophageal sphincter is temporarily relaxed (Fig.2). This can be due to the use of certain foods that help to relax the sphincter – chocolate, mint, fats [13]. Gastric belching can occur up to 25-30 times a day, it is physiological and involuntary.

Subjects who burp often experience habitual swallowing of air (aerophagia). The latter mainly enters the esophagus, from where it burps out (supragastric belching). Often, such a “habitual” belching can be incorrectly perceived as a symptom of a gastroenterological disease.

Pronounced frequent belching is more characteristic of the supragastric type. If this symptom is the only one, then it is more often associated with psychological and behavioral reasons. It is noteworthy that belching is practically absent at night, and appears only during the day, when a person pays attention to it.

Quite often, belching is associated with gastroesophageal reflux disease (GERD) and functional dyspepsia. As a rule, this symptom is not the main one. Supragastric belching can provoke reflux and heartburn in some patients.

Diagnostics. Belching is a functional symptom, in which case the diagnosis is based on anamnesis. Objective observation makes it possible to clarify the situation. Frequent belching, which is the only symptom, is usually of the supragastric type. Sometimes episodes with a frequency of up to 20 regurgitation per minute are observed.

The presence of alarming symptoms, such as weight loss, abdominal pain, dysphagia, heartburn and regurgitation, requires additional examination: upper endoscopy, computed tomography or other imaging studies.

According to Rome IV criteria, belching disorders are defined as having a significant effect on daily life and occurring more frequently than 3 days a week [14].

The diagnosis of supragastric belching is more likely in the presence of frequent recurrent episodes, which is not typical for the gastric variant. Intraluminal impedance measurement also makes it possible to differentiate between two types of belching.

Treatment. Explaining the nature of the onset of symptoms and convincing the patient that they are benign is an important component of therapy.Behavioral interventions may include cessation of smoking, chewing gum, carbonated drinks, and swallowing large pieces of food and liquids.

Specific therapy is indicated for patients with manifestations of anxiety and depression. Patients with symptoms of GERD require adequate pathogenetic therapy.

The results of small empirical studies demonstrate successful treatment of abnormal belching using diaphragmatic breathing [15].With its help, a decrease in postprandial intragastric pressure, an increase in pressure in the zone of the esophageal-gastric junction and restoration of the pressure gradient are achieved (Fig. 3).

The muscle relaxant baclofen (10 mg 3 times a day) can be used for refractory belching. The effect of the drug is explained by a decrease in episodes of relaxation of the lower esophageal sphincter and the number of swallowing movements. Baclofen can be effective for both types of belching. However, due to its frequent side effects, it is used only when other therapeutic approaches are ineffective [16].


The volume of gas excreted daily through the rectum ranges from 500 to 1500 ml [17]. The frequency of expulsion of flatus in healthy subjects can differ by a factor of 10–20 [18].

Although excessive flatulence and foul gas odors are common concerns for patients, they are rarely signs of serious illness. The acrid smell of flatus is due to the presence of sulfur-containing components. A number of reasons can cause excess flatulence, including:

  • disorders of intestinal motility and intestinal microbiota composition;
  • nutritional factors: increased consumption of foods containing lactose, fructose, sorbitol, as well as vegetables, legumes and fruits containing indigestible starches, and carbonated drinks;
  • Psychological factors can cause an overreaction to the normal passage of flatus.

Diagnostics. The main directions of diagnostic search are the study of anamnesis; reproduction of the patient’s usual diet with an emphasis on the use of certain foods and drinks; physical examination.

Anxiety symptoms in a patient with flatulence:

  • nocturnal abdominal pain;
  • decrease in body weight;
  • hematoshizia;
  • fever;
  • diarrhea or steatorrhea;
  • nausea;
  • significant tension of the anterior abdominal wall, organomegaly, splash murmur during abdominal auscultation.

Additional investigations in patients with flatulence are usually performed when anxiety symptoms are present. For example, the first-onset flatulence, accompanied by diarrhea and abdominal pain, requires the exclusion of malabsorption (Table 1).

In such situations, valuable diagnostic information can be obtained through studies of feces for fat content, identification of parasites and protozoa, performing a hydrogen breath test to establish lactose intolerance and bacterial overgrowth syndrome (SIBO), enzyme immunoassay to determine markers of celiac disease and endoscopic studies. If the patient has no alarming symptoms, it is advisable to refrain from conducting additional research.

Treatment. In order to reduce the severity of flatulence, therapeutic approaches should be individualized. Most often they include the following areas.

  1. Eliminating the cause of excessive flatulence is the most effective and at the same time the most difficult task. In subjects with lactose intolerance, the use of lactose-containing products should be limited (no more than 12 g of lactose at a time, this amount of lactose is contained in 200 ml of milk) or the use of lactase preparations should be recommended.If SIBO is confirmed, it is recommended to take the antibacterial drug rifaximin (Alpha Normix) at a dose of 1200-1600 mg for 10-14 days.
  2. Diet Optimization – Patients are advised to avoid foods that cause excess gas (cabbage, onions, broccoli, Brussels sprouts, wheat and potatoes). If these restrictions do not provide a sufficient effect, a diet low in fructans, oligo-, di- and monosaccharides, and polyols (FODMAP) should be considered. Such dietary interventions include three stages — maximum restriction of FODMAP (Table 2), partial re-consumption of foods, and prolonged self-control. Implementing such a diet is challenging and requires the supervision of a qualified nutritionist.
  3. Taking carminative drugs (simethicone, activated carbon). Unfortunately, conclusive evidence of the effectiveness of such funds has not yet been obtained [19, 20], so their use is impractical.
  4. The use of bismuth subsalicylate reduces the intensity of the odor generated by the presence of sulfates and other substances [21].However, long-term use may be associated with side effects due to toxicity.

Bloating and distension of the abdomen

Bloating is understood as a feeling of abdominal fullness, pressure, excess gas. By stretching the abdomen, patients mean its increase in size. A number of other causes also lead to abdominal enlargement, including ascites, abdominal obesity, giant ovarian and mesenteric cysts, and intestinal obstruction. Such conditions should be excluded with physical and additional examinations.

The prevalence of bloating and distension in the general population is 20-30%. At the same time, up to 96% of patients with irritable bowel syndrome (IBS) report the presence of bloating and consider it one of the main symptoms [22, 23]. These symptoms can be a manifestation of both organic pathology (SIBO, celiac disease, lactose intolerance) and functional diseases. Among the latter, in addition to IBS, functional constipation, functional diarrhea, and functional abdominal distension / distension are common.

The pathogenesis of bloating is not yet fully understood and is likely multifactorial. The amount and type of intestinal gas, osmotic pressure, the presence of fluid in the intestinal lumen, the composition of the microbiota, the state of motility and disorders of visceral sensitivity are the main determinants that determine the subjective feeling of bloating and distension of the abdomen in a patient.

The appearance of bloating and its severity is most often associated by patients with an increase in gas formation in the intestine.However, in the studies conducted, a direct relationship between the volume of intraintestinal gas and symptoms has not been established. In one of the studies, the composition and amount of gas in patients in the main group and in the control group did not have statistically significant differences (176 and 199 ml, respectively) [24]. At the same time, there are data that allow considering the violation of the transit of intraintestinal gas as a cause of bloating and distension of the abdomen in some patients [25].

Other studies have considered the hypothesis regarding the leading role of hypersensitivity to stretching and excessive activation of motor function with a normal amount of intestinal gas in patients with chronic complaints of bloating [26].

Gut microbiota is also involved in the pathophysiological processes of bloating. Possible mechanisms are intestinal dysbiosis, impaired interaction of flora with epithelial structures, the intestinal immune system, and the central nervous system [27].

Diagnostics. Bloating and distension of the abdomen can be caused by organic causes or functional gastroenterological diseases. The clinical diagnosis of functional distention / distension is based on diagnostic criteria (Rome Consensus IV) and exclusion of organic causes in additional investigations.

History and physical examination allow to accurately determine the range of possible causes of symptoms and identify patients with anxiety symptoms. When studying the anamnesis, it is necessary to clarify the features of the onset of the disease, the relationship of symptoms with diet (in particular with the use of wheat products, dairy products, dietary fiber, indigestible starch), the variability of symptoms on different days, the presence of other functional symptoms – constipation, diarrhea, abdominal pain and postprandial overflow.

A characteristic feature of functional bloating is the diurnal dynamics of symptoms. Patients may notice worsening in the afternoon, especially after eating, and a decrease in symptoms at night. Abdominal pain and intestinal transit disturbances may also occur, but are not the dominant symptoms.

Basic diagnostic tests include a limited list of studies: complete blood count, determination of serological markers of celiac disease.In addition, it is advisable to conduct a hydrogen breath test to exclude SIBO and lactose intolerance. For the first time, persistent abdominal distension in middle-aged and older women requires an ultrasound examination of the pelvic organs to exclude ovarian pathology.

Additional studies are carried out in patients with anxiety symptoms or pathology based on the results of basic tests. For example, if you have anemia, diarrhea, or involuntary weight loss, endoscopy and imaging of the pancreas are recommended to rule out malabsorption.

Diagnostic criteria for functional abdominal distension / distension. In accordance with the recommendations of the Rome Consensus IV [28], the following two symptoms are required to establish a diagnosis (within the last 3 months with onset at least 6 months before the diagnosis):

  1. recurrent bloating / distension of the abdomen, on average, at least 1 time per week, which prevail over other symptoms;
  2. Lack of sufficient criteria for the diagnosis of functional constipation, functional diarrhea, or postprandial distress syndrome.

Treatment. Diet and Lifestyle Modifications — Approaches similar to those used in patients with IBS are used. It is recommended to limit the consumption of foods that stimulate gas formation as much as possible (legumes, onions, celery, carrots, raisins, bananas, apricots, plums, Brussels sprouts, wheat germ, baguettes). If this stage is ineffective, it should be recommended to limit the use of foods containing a large amount of FODMAPs (Table 2), as well as refusal to consume carbonated drinks. Light exercise and prolonged upright posture after meals can also reduce bloating in some patients.

Influence on the cause of bloating involves the exclusion of taking drugs that slow down intestinal motility: anticholinergic agents, opiates, calcium channel blockers. Restricting lactose-containing foods or taking lactase preparations are recommended.

In the presence of SIBO, previous intestinal infections associated with the onset of symptoms, the use of rifaximin is effective.Rifaximin (Alpha Normix) is a selective intestinal nonabsorbable broad-spectrum antibiotic, active against gram-negative and gram-positive microorganisms, anaerobic and aerobic bacteria, with proven efficacy in SIBO and bloating in IBS patients. The drug has a high safety profile comparable to placebo due to low absorption, and does not have systemic side effects. Rifaximin acts only in the gastrointestinal tract and is excreted mainly in the faeces.Its effect on normal intestinal microflora is limited by the period of use, the drug does not cause the development of clinically significant resistance. In addition, in recent years, it has been established that rifaximin has probiotic properties, in particular, it increases the amount of beneficial Lactobacillus and Faecalibacterium prausnitzii. In this regard, rifaximin (Alpha Normix) has recently been considered not even as a selective intestinal antibiotic, but as an intestinal eubiotic.Table 3 shows the results of studies of the effectiveness of taking rifaximin (Alpha Normix) in relation to general symptoms of functional intestinal disorders and in particular bloating [29].

There was a significant improvement in the condition in patients with abdominal distension during the first and repeated (second) administration of rifaximin (Alpha Normix) [30]. The drug is recommended to be taken at a dose of 1200-1600 mg / day for 10-14 days.

With regard to other therapeutic approaches, to date, no convincing evidence has been obtained in favor of the use of carminatives (simethicone) and absorbents (activated carbon).


The total volume of gas in the intestinal lumen is 200 ml on an empty stomach and after meals both in healthy individuals and in patients with complaints of bloating. Nitrogen, oxygen, carbon dioxide and methane account for over 99% of the intestinal gas mixture. The increase in intestinal gas volume may be associated with excessive swallowing of air, malabsorption with increased intraluminal gas production, and decreased absorption as a result of intestinal obstruction.

Belching is considered a pathological symptom when it is persistent and bothersome.The main types of belching are supra-gastric and gastric. About half of GERD patients complain of belching, and it also often occurs with functional dyspepsia. The most effective treatments for patients with very frequent belching are behavioral therapy, diaphragmatic breathing, and diet correction. With a combination of GERD and belching, it is necessary to use drugs that inhibit the secretion of hydrochloric acid.

Bloating and distension of the abdomen can be caused by functional and organic disorders.The cause is determined by physical examination, assessment of medical history and results of basic diagnostic tests. Additional studies are indicated in the presence of alarming symptoms or pathology based on the results of basic diagnostic tests.

Treatment for functional bloating / distension of the abdomen includes dietary advice for limiting gas-stimulating foods. If they are not effective enough, a low FODMAP diet can be used.The use of rifaximin (Alpha Normix) is advisable and justified in the presence of SIBO and with the onset of a functional intestinal disorder after an intestinal infection.

References are being revised.

Thematic issue “Gastroenterology. Hepatology. Coloproctology “No. 1 (51), lutiy 2019 p.

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