BELCHING, BLOATING, AND FLATULENCE - HOW TO HELP PATIENTS WHO HAVE TROUBLESOME ABDOMINAL GAS

Gaseous belching, bloating, and flatulence are common complaints. Thes e symptoms may herald the onset of important and treatable gastrointes tinal diseases or may represent functional bowel disorders. The clinic al challenge is to identify a cause so as to exclude serious gastroint estinal diseases and provide symptomatic relief. Detailed history taki ng and examination provide the basis for appropriate testing that may provide vital clues. Among otherwise healthy patients, intolerance to lactose or other food items is a common source of symptoms. This cause can be evaluated noninvasively using the breath hydrogen test. A clea r understanding of the underlying pathophysiology paves the way for a rational approach to treatment, such as withdrawal of an offending foo d item, enzyme supplementation, simple reassurance, or psychotherapy.