Natural Remedies For Abdominal Distension

Ultimate Flatulence Cure

Joseph Arnolds latest natural flatulence treatment book for both men and women? This book is a new and unique solution you need to put a stop to your flatulence and gas problems. With this 55-page eBook, you learn how to eliminate your matter step by step from the comfort of your home. Ultimate Flatulence Cure has treated for thousands of people in over 75 countries. Your flatulence is most likely to be the result of problems with your diet, your lifestyle or general health, or some combination of these factors. Only when addressed holistically is the problem going to be taken out of the equation altogether, and this guide will help do that.

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Abdominal distension bloating

The principal causes of abdominal distension arc far. flatus, faeces, fluid aiul fetus (Table 5.10). Increasing abdominal girlh is usually due to adiposity and should alert the clinician to the possibility of alcohol abuse. Its development in a patient who is otherwise becoming thinner suggests intra-abdominal disease. Painless abdominal distension in women may be the presenting symptom of an ovarian cyst or of an undisclosed pregnancy. It is also a feature of pseudo obstruction, i.e. non-mechanical obstruction, often seen in neuropathy affecting the gastrointestinal tract, and in elderly patients Causes of abdominal distension Flatus Dysmotility-like Nausea, belching, premature satiety, bloating and abdominal distension taking drugs with anticholinergic effects, such as tricyclic antidepressants. Painless abdominal distension and constipation from early childhood in the absence of faecal soiling suggests the possibility of Hirschsprung's disease. Fluctuating abdominal swelling which...

Flatulence Diarrhea and Irritable Bowel Syndrome

Anti Reflux Surgery

Problems related to flatulence, diarrhea, and irritable bowel syndrome (IBS) are very common among adult patients with or without GERD.38 It is therefore to be expected that many patients will have these symptoms both before and after anti-reflux surgery. In a study from our institution, diarrhea was present in 14 of patients before surgery and 29 after. Other symptoms included bloating (3 preoperative, 19 postoperative), constipation (15 and 18 , respectively), and abdominal pain (2 and 8 , respectively) (Figure 9.1).39 Flatulence has been reported in 12-88 of patients after anti-reflux surgery.40,41 It has been suggested that this flatulence is attributable to the patient's inability to belch and subsequent passage of more gas into and then through the gastrointestinal tract.42 Most of these studies are retrospective and at risk for recall bias, because many only surveyed patients after surgery and asked them to recall how they were before the surgery. In general, the suggested...

Wind flatulence

Repeated belching, excessive or offensive rectal flatus, abdominal distension and even borborygmi (audible bowel sounds) may all be called wind', a term which the patient should be asked to clarify. Belching often results from air swallowing (aerophagy) which occurs without the patient's awareness. Belching itself is of no major significance, although it may indicate anxiety, and sometimes occurs in an attempt to relieve abdominal pain or discomfort. The normal volume of flatus per rectum varies greatly from person to person, in the range of 200-2000 ml per day. It consists of a mixture of gases derived principally from swallowed air together with gases derived from colonic bacterial fermentation of poorly absorbed carbohydrates. Excessive flatus is particularly troublesome in lactase deficiency and intestinal malabsorption. Absence of flatus is a feature of intestinal obstruction. Borborygmi result from the movement of fluid and gas along the bowel though often no more than a source...

History of Medical and Surgical Anti Reflux Therapy

Chronic peptic ulcer of the esophagus was first related to hiatal hernia in the early 1940s and only dietary therapy was recommended.12 The pathophysiologic mechanism of an ineffective anti-reflux mechanism resulting from hiatal hernia was suggested by Allison13,14 in 1948, who noted improvement after surgical correction of the hernia in seven patients. The relationship between hiatal hernia-associated dysfunction of the esophagogastric junction and symptoms of heartburn was then conclusively made by Allison15 in 1951 when he described the syndrome of heartburn, gastric flatulence, and postural regurgitation, and attributed it to reflux esophagitis. The understanding of this relationship ushered in the era of physiologic therapy for GERD.

Key application In dyspepsia German Commission E

Dill seeds contain up to 5 volatile oil (about half of which is carvone), flavonoids, coumarins, xanthones and triterpenes. The yield of the oil from Indian A. sowa varies from 1.3 to 3.5 . Carvone is the major constituent (19.569.7 ). The oil from seeds is used for flatulence in children and enters into the preparations of gripe water. The oil is also antimicrobial and antifungal.

Development Of 5aReductase Inhibitors

As discussed, although other approaches to androgen ablation and androgen inhibition (antiandrogens) have been evaluated in the past, these methods produced only a moderate desired impact and had many side effects, thus limiting their use (14). Typical antiandrogen (e.g., flutamide) side effects include onset of erectile dysfunction, impairment in libido and ejaculation, gastrointestinal distress, nausea, flatulence, gynecomastia, breast pain, diminished energy levels, impairment in spermatogenesis, and decreased muscle mass. In contrast, because mature (postpubertal) patients with 5 a-reductase deficiency did not appear to have impaired sexual function or diminished external mascu-linization, the 5 a-reductase enzyme was a logical target for treating men with clinically significant BPH. The potential blockade of 5a-reductase seemed to provide hope for decreasing prostate growth and minimizing side effects.

Display 241 Inserting the Pilocarpine Ocular System

When these drugs are used orally they occasionally result in excessive salivation, abdominal cramping, flatus, and sometimes diarrhea. The patient is informed that these reactions will continue until tolerance develops, usually within a few weeks. Until tolerance develops, the nurse ensures that proper facilities, such as a bedside commode, bedpan, or bathroom, are readily available. The patient is encouraged to ambulate to assist the passing of flatus. If needed, a rectal tube may be used to assist in the passing of flatus. The nurse keeps a record of the fluid intake and output and the number, consistency, and frequency of stools if diarrhea is present. The primary health care provider is informed if diarrhea is excessive because this may be an indication of toxicity.

Clinical Focus Box 262

Intestinal pseudoobstruction is characterized by symptoms of intestinal obstruction in the absence of a mechanical obstruction. The mechanisms for controlling orderly propulsive motility fail while the intestinal lumen is free from obstruction. This syndrome may result from abnormalities of the muscles or ENS. Its general symptoms of colicky abdominal pain, nausea and vomiting, and abdominal distension simulate mechanical obstruction.

Clinical Focus Box 263

Incontinence is an inappropriate leakage of feces and flatus to a degree that it disables the patient by disrupting routine daily activities. As discussed earlier, the mechanisms for maintaining continence involve the coordinated interactions of several different components. Consequently, sensory malfunction, incompetence of the internal anal sphincter, or disorders of neuromuscular mechanisms of the external sphincter and pelvic floor muscles

Adverse Reactions

Laxative use, especially high doses or use over a long time, can cause diarrhea and a loss of water and electrolytes. For some patients, this may be a serious adverse effect. Laxatives may also cause abdominal pain or discomfort, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps, and weakness. Prolonged use of a laxative can result in serious electrolyte imbalances, as well as the laxative habit, that is, a dependency on a laxative to have a bowel movement. Some of these products contain tartrazine, which may cause allergic-type reactions (including bronchial asthma) in susceptible individuals.

Effects of Inulin Type Fructans on Risk of Neonatal Necrotizing Enterocolitis

Despite significant advances in neonatal practice, neonatal necrotizing enterocolitis (NEC), a gastrointestinal disease in preterm infants characterized by abdominal distension, gastrointestinal bleeding, mucosal ulcerations, and intestinal pneumatosis remains a major cause of gastrointestinal emergency in neonatal intensive care units and the first cause of death in extremely premature infants. Its physiopathology remains unclear and several factors including immaturity of the intestine, enteral feeding, and bacterial colonization may be involved.209 Thus, it has been hypothesized that the intestinal injury in NEC may be result of synergy of the three risk factors, in which feeding results in colonization of the uniquely susceptible premature intestine with pathogenic bacteria, resulting in exaggerated inflammatory response. 210 In addition, and as none of the preventive treatments, i.e., antibiotic therapy, prophylactic aspects, and parenteral feeding, is considered fully...

A3 Guidelines For Investigating Food Borne Illness Al General Information

(2) Enzymes and other deficiency conditions in which the complete absence or abnormal function of an enzyme or substrate of a specific metabolic process will result in the abnormal processing of certain food. An example is lactase deficiency. In individuals who are deficient in this intestinal mucosal enzyme which catalyzes the breakdown of lactose, the ingestion of milk (which contains lactose) will result in abdominal cramping, bloating, flatulence, and diarrhea. This generally results in the abnormal accumulation of certain metabolites and deficiency of others.

Promoting an Optimal Response to Therapy

Vasopressin may be given IM or SC to treat diabetes insipidus. The injection solution may also be administered intranasally on cotton pledgets, by nasal spray, or dropper. When given parenterally 5 to 10 units administered two to three times daily is usually sufficient. To prevent or relieve abdominal distension, 5 units of the drug is administered initially and may increase to 10 units every 3 or 4 hours IM. When the drug is administered before abdominal roentgenography, the nurse administers 2 injections of 10 units each. The first dose is given 2 hours before x-ray examination and the second dose V2 hour before the testing. An enema may be given before the first dose.

Chamomile and Matricaria

Roman chamomile is usually taken as an aqueous infusion (chamomile tea) to aid digestion, curb flatulence, etc, but extracts also feature in mouthwashes, shampoos, and many pharmaceutical preparations. It has mild antiseptic and anti-inflammatory properties. The flowerheads yield 0.4-1.5 of volatile oil, which contains over 75 of aliphatic esters of angelic, tiglic, isovaleric, and isobutyric acids (Figure 5.29), products of isoleucine, leucine, and valine metabolism (see pages 100, 295, 306), with small amounts of monoterpenes and sesquiterpenes. Matricaria is also used as a digestive aid, but is mainly employed for its anti-inflammatory and spasmolytic properties. Extracts or the volatile oil find use in creams and ointments to treat inflammatory skin conditions, and as an antibacterial and antifungal agent. Taken internally, matricaria may help in the control of gastric ulcers. The flowers yield 0.5-1.5 volatile oil containing the sesquiterpenes a-bisabolol (10-25 ), bisabolol...

Inborn Errors of TAG Storage and Metabolism

Several distinct abnormalities of intracellular TAG mobilization and transfer occur which manifest themselves in rare inherited metabolic disorders, such as Wol-man's disease (WD) and neutral lipid storage disease (NLSD). The former arises from an inherited deficiency of lysosomal acid lipase (LAL) and causes a massive increase in neutral lipids due to an inability of tissues to degrade exogenous lipo-protein-derived TAG and cholesterylester. However, the metabolism of endoge-nously derived TAG is unaffected 95, 96 . The disease is characterized by hepatomegaly, maladsorption, steatorrhea and abdominal distension 96 . The human enzyme amino acid sequence has been deduced from cDNA 97, 98 , and the mutation has been identified in a rat model of WD through cloning of rat lysosomal acid lipase cDNA 99 . In a sense, WD is a consequence of defective lipolytic transfer of exogenous TAG into normal storage pools.

Cyclospora cayetanensis

Cryptosporidium Parvum Carbol Fuchsin

Villus atrophy, cryptic hyperplasia, and inflammatory changes in the intestinal mucosa. Incubation about one week, self-limiting diarrhea in immunocompetent persons (lasts for about two to three weeks) with loss of appetite, flatulence, and malaise, usually nonfebrile the diarrhea may persist for months in immunodeficient patients.

Presenting Symptoms of Failed Anti Reflux Operations

Upright Abdominal Radiograph

Patients with an improperly constructed fundo-plication may not be able to easily belch and painful abdominal bloating may arise when swallowed air is trapped. This is readily diagnosed with a plain film of the abdomen showing a distended gas-filled stomach (Figure 8.1) or in the absence of an X-ray, prompt relief of pain by passage of a nasogastric tube. The gas bloat syndrome should be differentiated from the more common complaint of generalized abdominal bloating and increased flatulence as the latter tends to resolve on its own over time.

Inulin Type Fructans and Feed for Domestic Animals and pets

Population, which tends to have a less favorable intestinal microbial composition, is more prone to intestinal dysfunctions and has diminished digestive efficiency as compared to younger animals.36-38 The nature of the diet is also of vital importance the supplementation with prebiotic being more appropriate in high protein, meat-based diets that are, usually, associated with elevated production of putrefactive metabolites such as ammonia, amines, and phenols and indols 39 this causes alka-linization of the colonic content40 and may produce unpleasant fecal odors (especially in poultry, rabbits, pigs, and horses). Another pertinent consideration in the inclusion of inulin-type fructans in companion animal diets is determining the effective dose while minimizing potential negative side effects like flatulence and loose stools that may occur at very high levels (i.e., 20 of dry matter), or at more moderate levels (i.e., 10 of dry matter) in nonadapted animals. This is particularly...

Outcomes Laparoscopic Surgery

The studies were carefully analyzed and the following items extracted if given Morbidity, mortality, the proportion of conversion to a conventional approach, the duration of surgery, time to first flatus, time to resumption of a regular diet, and the length of postoperative hospital stay. All endpoints were looked at in the comparative cohort studies, summarized in an intent-to-treat analysis, and compared between laparoscopic and conventional surgery. If long-term results were available, the length of follow-up and recurrence rate were documented.

G.l A 42-years-old Obese

G.L., a 42-year-old obese Caucasian woman, entered the hospital with nausea and vomiting, flatulence and eructation, a fever of 100.5 F, and continuous right upper quadrant and subscapular pain. Examination on admission showed rebound tenderness in the RUQ with a positive Murphy sign. Her skin, nails, and conjunctivae were yellowish, and she complained of frequent clay-colored stools. Her leukocyte count was 16,000. An ERCP and ultrasound of the abdomen suggested many small stones in her gallbladder and possibly the common bile duct. Her diagnosis was cholecystitis with cholelithiasis. _ 1. Flatulence and eructation represent

Case Study for Chapter

Crease renal excretion of sodium and water) and intermittent paracentesis (insertion of a needle into the peritoneal space, evacuating fluid, which relieves the abdominal distension and discomfort). She subsequently undergoes placement of a transjugular intrahepatic portosystemic shunt (TIPS), which serves to lower portal pressure by shunting blood into systemic veins. She is also given warfarin, an anticoagulant.

Ovarian Hyperstimulation Syndrome

Mild OHSS, with high serum E2 levels, mild abdominal distension, and large ovaries of about 5 cm due to the presence of multiple fol-licular and corpus luteal cysts. 2. Moderate OHSS, characterized by more abdominal distension, mild ascites, and gastrointestinal symptoms such as nausea, vomiting, and less frequently, diarrhea, some gain in weight, and ovaries enlarged up to 12 cm. 3. Severe OHSS which can be a life-threatening situation, characterized by pronounced abdominal distension, ascites, pleural effusion, hemoconcentration, electrolyte imbalance, oliguria anuria, and sometimes disseminated intravascular coagulation and hypovolemic shock. The ovaries are enlarged to more than 12 cm in diameter.

Defecation Involves the Neural Coordination of Muscles in the Large Intestine and Pelvic Floor

Distension of the rectum by the mass movement of feces or gas results in an urge to defecate or release flatus. CNS processing of mechanosensory information from the rectum is the underlying mechanism for this sensation. Local processing of the mechanosensory information in the enteric neural circuits activates the motor program for relaxation of the internal anal sphincter. At this stage of rectal distension, voluntary contraction of the external anal sphincter and the pu-borectalis muscle prevents leakage. The decision to defecate at this stage is voluntary. When the decision is made, commands from the brain to the sacral cord shut off the excitatory input to the external sphincter and levator ani muscles. Additional skeletal motor commands contract the abdominal muscles and diaphragm to increase intra-abdominal pressure. Coordination of the skeletal muscle components of defecation results in a straightening of the anorectal angle, descent of the pelvic floor, and opening of the...

Gerontologie Alert

Acarbose and miglitol are given three times as day with the first bite of the meal because food increases absorption. Some patients begin therapy with a lower dose once daily to minimize gastrointestinal effects, such as abdominal discomfort, flatulence, and diarrhea. The dose is then gradually increased to three times daily. The nurse monitors the response to these drugs by periodic testing. Dosage adjustments are made at 4- to 16-week intervals based on 1-hour postprandial glucose levels.

Intraabdominal Pressure

The increase in IAP increases the gravitational gradient of pleural pressure especially in the dependent lung regions, inducing an increase in the volume of airway closure, and a decrease in the FRC, with possible risk of compressive atelectasis due to the upward push of the diaphragm to the lung. Mutho et al. evaluated the effect of abdominal distension on the lung and chest wall mechanics in anesthetized pigs 21 . The abdominal distension caused a rightward and downward shift of the pressure volume curve (PV curve) of the respiratory system and the chest wall by a stiffening of the diaphragm abdomen and by a reduction in lung expansion. Similarly Ranieri et al. found that surgical ARDS patients presented a rightward shift of the thoracic and abdominal PV curves compared to medical ARDS patients, related to abdominal distension 22 . When these patients underwent abdominal decompression, the PV curve of the thorax and abdomen moved upward and leftward. Abdominal distension can also...

Discussion And Conclusion

Oligofructose and inulin are thus both nondigestible and fermentable carbohydrates. Like all dietary substrates that become fermented in the intestine but mostly in the large bowel, they may produce intestinal discomfort and at very high doses (30 g d or higher) they can even become laxative (because of osmotic effect). From the studies available it can be concluded that, on average, the most frequent intestinal side effects are flatulence and bloating and that these symptoms are mild or moderate, but a small percentage (1-4 ) of the adult population may experience more severe reactions. However, it must always be kept in mind that these conclusions concern all types of nondigestible but fermentable dietary substrates and not only inulin-type fructans. As a result of the assessment of the available data, it can be concluded that for a wide proportion of the adult population (probably 95 or more), a daily dose of 10 g inulin-type fructans will cause no unusual intestinal side effects....

Verum Hook

It is often chewed in small quantities after each meal to promote digestion and to sweeten the breath (Grieve, 1998), and it has carminative properties (Simonetti, 1991) and helps to relieve flatulence (Lust, 1986). The fruit is used in Asia as a remedy for colic and rheumatism (Grieve, 1998).

Production of Gases

Even though the microflora producing them has still not be completely identified, relatively large quantities of gases are released by fermentation in the human colon (from 0.5 up to 4 l d). The composition of the gas flatus varies considerably from one individual to the other.11 33 34 Healthy subjects pass flatus gas up to 14 times a day with a total volume of between 0.35 and 1.4 l,1133 and they absorb and excrete, in-breath, a variable proportion of all gas (mainly H2 and CO2 but also CH4 in some individuals) produced in the colon. The excretion of semi-in-breath is used as a quantitative measurement of carbohydrate fermentation35 36 (see Section 5.4.1.2).

In Vivo Data

The gases (mainly CO2, CH4, and H2) are inevitable products of fermentation but also provide the major clinical disincentive to consumption of high doses of fermentable carbohydrates that might create unwanted symptoms relating to their production in the gut of flatulence, bloating, borborygmi, and cramps. But intestinal acceptability of nondigestible carbohydrates that are fermented in the large bowel is also dependent on the osmotic effect that brings more water into the colon. 1. In Stone-Dorshow and Levitt's study, 12 subjects consuming 15 g of oligofructose daily for 12 d reported mild symptoms of abdominal pain, eructation, flatulence, and bloating when compared with a group of five subjects taking an equivalent dose of additional sucrose. There was no adaptation over the test period.91 2. In Briet's study aimed at establishing a threshold for oligofructose-induced intestinal side effects, some 15 of the 14 volunteers consuming 10 g d reported excessive flatus and borborygmi,...

Large Intestines

Many microorganisms are found within the lumen or cavity of the large intestines. Certain microorganisms are responsible for the production of vitamin K. Depending on the type of food present, some species of microorganisms produce various gases (flatulence). On occasion, pathogenic organisms may be present and cause problems for the individual.

Clinical Features

Cystic fibrosis results from the complete absence of, or dramatic reduction in, the epithelial Cl conductance, as a consequence of mutations in CFTR. The most important pathological abnormalities occur in the lungs although these appear normal at birth, subsequent mucous accumulation leads to chronic infection and a progressive destruction of the alveolar tissue. Air-trapping, due to occlusion of the distal airways, and fibrosis also occur. Increasing lung damage is associated with enhanced resistance of the pulmonary vasculature, which sometimes leads to right ventricular hypertrophy (cor pulmonale). Cystic fibrosis is also associated with pancreatic insufficiency (i.e., a lack of digestive enzyme secretion) and malabsorption in the gut. In the past this was a major cause of malnutrition but today it can be ameliorated by administration of pancreatic enzymes. As with the lung, pancreatic disease is often progressive and increases with age, as accumulating obstructions in the...

Alimentary Symptoms

Disorders of the alimentary tract may present with a wide range of symptoms including painful mouth, difficulty in swallowing (dysphagia), nausea and vomiting, abdominal pain, heartburn, indigestion (dyspepsia), toss of appetite (anorexia), weight loss, abdominal distension, alLered bowel habit, rectal bleeding and jaundice (Table 5.1). Sometimes, alimentary disease is suggested only by the occurrence of a secondary feature such as anaemia. Occasionally palienls may conceal important symptoms such as rectal bleeding

Pouch Fistulae

Fistula originating from the ileoanal anastomosis or the pouch itself is a serious complication. The incidence varies between 5 and 17 and depends on the accuracy and duration of follow-up 44, 45 . It often requires further surgery and may alter ultimate functional outcome and lead to pouch excision. Fis-tulae may occur to the perineum, vagina, bladder or abdominal wall skin. Aetiologic factors include anas-tomotic dehiscence, pelvic sepsis, surgical experience, localised ischaemia, entrapment of the posterior vaginal wall in the stapling device and Crohn's disease. Pelvic sepsis is probably the major predisposing factor. Patients may be asymptomatic, some may have only minor symptoms whereas others may have disabling symptoms. Symptoms consist of purulent discharge and flatus or stool passing through the vagina, perineum or abdominal wall. Diagnosis is based on history and physical examination and may be confirmed by examination under anaesthesia. Other diagnostic modalities may be...

Methods

The studies were carefully analyzed and the following items extracted if given Morbidity, mortality, the proportion of conversion to a conventional approach, the duration of surgery, time to first flatus, time to resumption of a regular diet, and the length of postoperative hospital stay. The same endpoints were looked at in the comparative cohort studies, summarized in an intent-to-treat analysis, and compared between laparoscopic and conventional surgery. If long-term results were available, the length of follow-up and recurrence rate were documented.

Outcomes

The studies were carefully analyzed and the following items extracted if given indication for surgery, morbidity, mortality, the proportion of conversion to a conventional approach, the duration of surgery, time to first flatus, time to resumption of a regular diet, and the length of postoperative hospital stay. All endpoints were looked at in the comparative cohort studies, summarized in an intent-to-treat analysis, and compared between laparoscopic and conventional surgery. If long-term results were available, the length of follow-up and recurrence rate were documented.

Faecal Incontinence

The severity of incontinence can range from unintentional elimination of flatus to seepage of liquid faecal matter or, sometimes, to the complete evacuation of bowel contents. These events can be a cause of considerable embarrassment for patients, affecting in the long run their self-esteem and causing in turn social isolation and a poorer quality of life 6 . To maintain normal faecal continence, it is important to preserve the neuromuscular integrity of the rectum, anus and adjoining pelvic floor musculature. It follows that incontinence occurs when there is disruption of one or more mechanisms that maintain continence the disruption is to such an extent that other mechanisms are unable to compensate. Incontinence in patients affected by IBD and by FAP is caused by 5

Autonomic Seizures

Gastrointestinal symptoms are also common ictal phenomena. These include flatulence, epigastric rising sensations, borbyrigmy, nausea, and emesis (52-56). These symptoms are frequently isolated in children. Ictal emesis, in particular, has been described from the insula, the frontal operculum, and in benign occipital epilepsy. Ictus emeticus can occur without impairment of awareness and in isolation (57). Rectal pain and burning may occur in an epileptic seizure and can be triggered by a bowel movement (58).

Nausea and vomiting

Gastric outlet obstruction is associated with the projectile vomiting of large volumes of gastric content, the vomitus also being noteworthy for the absence of bile-staining. Obstruction distal to the pylorus produces bilc-stained vomiting the lower the level of intestinal obstruction, the more marked are the accompanying symptoms of abdominal distension and intestinal colic. Vomiting also occurs in other gastrointestinal disorders, e.g. acute gastroenteritis, acute cholecystitis, acute pancreatitis and hepatitis.

Toxic Megacolon

The exact explanation for toxic megacolon is not known the pathogenic mechanism driven by soluble inflammatory mediators and bacterial products, leading to downstream inhibitory effect on colonic muscle tone, could be one of the key players responsible for the and systemic inflammatory response syndrome 11, 15 . Appearance of gastrointestinal distension during the clinical course of acute ulcera-tive colitis attack should be considered an alarm signal for toxic megacolon or systemic multiorgan dysfunction leading, with high probability, to an emergent colectomy. A certain number of patients presents with toxic megacolon during the first bout of ulcerative colitis or within 2-3 months of diagnosis. Mean duration of disease, before the attack, has been reported to be 3-5 years 6,16 . Many patients present in the midst of an ongoing attack of severe colitis, with a predominating clinical picture before the onset of toxic megacolon. Patients are acutely ill, with fever, chills and...

Altered bowel habit

The irritable bowel syndrome is a common cause of altered bowel function in patients under the age of 50 years. The principal symptoms include episodic constipation and diarrhoea associated with abdominal distension, intermittent abdominal pain relieved by defecation and often accompanied by non-specific symptoms including dyspepsia, urinary frequency, backache and tiredness (Table 5.11). Abdominal distension or a feeling of abdominal bloating

Balloon Dilatation

The stenosis of the small intestine is one of the typical symptoms of CD. The standard treatment should be strictureplasty or resection of the affected part 34 . The less common clinical manifestation is large-intestine stricture, which is diagnosed when a colonoscope of a standard diameter (13-13.6 mm) cannot be inserted through the affected part of the intestine. The clinical manifestations of the stricture include flatulence, tenesmus (when the stricture is localised near the rectum), constipation, abdominal pain, ileus or subileus 34 . The exacerbation and severity of symptoms depend on the diameter of the narrowing. An intestinal diameter greater than 13 mm usually suffices for correct passage. When the diameter of the stricture falls below 9 mm, it leads to increased symptoms of obstruction 35 . This type of changes is observed usually in neoplastic tumours of the large intestine. When neoplastic etiology is excluded, the most frequent causes are the healing complications of the...

Visceroptosis

In addition to this finding, an abdominal radiograph in the upright position may reveal intestinal gas bubbles between the left dome of the diaphragm and the spleen. This sign may be helpful in suggesting the diagnosis. Splenic scans with 99mTc-sulfur colloid and CT are helpful in defining the position of the spleen more precisely.

Toxic Substances

Toxic or antinutritional substances found in some legumes include alkaloids, cyanide poisons, enzyme inhibitors, saponin, and goitrogen, the last causing an enlargement of the thyroid gland. More serious still are the lectins or haemagglutinins (blood clotting agents) that may cause vomiting, diarrhea and severe abdominal pain, and lathyrism, which can produce mild to severe neurological disorders. Unpleasant but nontoxic substances that occur in certain legumes include stachyose and raffinose carbohydrates, which cause flatulence. Most of these unwanted substances can be removed by appropriate washing and cooking methods prior to consumption.