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 of embarrassment, they may indicate disordered small bowel motility.

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