Excessive Gas and Bloating: Gastrointestinal Issues

Loud and pronounced flatulence?

For the past 2-3 years, I have frequently experienced excessive and loud flatulence.
Over a year ago, a doctor at Cathay General Hospital in Xizhi prescribed medication for bloating, but after taking it for 1-2 months with no significant improvement, I did not continue follow-up.
Last week, during a chest X-ray at another hospital, the doctor pointed out that there was evidence of gas in my stomach.
Four years ago, I underwent an upper gastrointestinal endoscopy at Cathay General Hospital due to stomach pain, where the doctor noted mild erosion of the stomach wall.
I took medication for about six months and saw improvement; however, I found that eating squid always triggered stomach pain, so I avoided it and haven’t had pain since.
A few days ago, after eating one pear, my stomach felt strange again.
Is it necessary to undergo another endoscopy? Could this be related to the fact that I am missing four teeth on one side? 1.
Missing teeth, not chewing food thoroughly.
2.
Missing teeth, swallowing too much air.

Zhu Zhengshan, 60~69 year old female. Ask Date: 2013/08/12

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Zhu Zhengshan.

1.
Generally, flatulence has little clinical significance and does not require specific treatment.
Just pay attention to your diet.
Additionally, a stool examination can be performed.

2.
It is preferable to replace missing teeth, but this is not related to the ingestion of air.

3.
If discomfort persists after using gastrointestinal medications, an endoscopy may be necessary.
Changhua Hospital cares about your health.

Dr.
Chen Shidian

Reply Date: 2013/08/12

More Info

Excessive gas and bloating are common gastrointestinal complaints that can significantly affect one's quality of life. Based on your description, it seems that you have been experiencing these symptoms for an extended period, alongside a history of gastrointestinal issues, including a previous diagnosis of mild gastric mucosal injury. Let's break down your concerns and provide some insights into possible causes and management strategies.

Understanding Your Symptoms
1. Excessive Gas and Bloating: The production of gas in the gastrointestinal tract can result from various factors, including dietary choices, gut microbiota composition, and gastrointestinal motility. Foods that are high in fermentable carbohydrates (known as FODMAPs) can lead to increased gas production. Common culprits include beans, lentils, certain fruits (like pears), and some vegetables (like onions and garlic).
2. Previous Gastric Issues: Your history of gastric mucosal injury and the associated pain after consuming certain foods (like squid) suggest that your stomach may have heightened sensitivity or an underlying condition such as gastritis or peptic ulcer disease. The discomfort after eating specific foods indicates that your stomach lining may still be sensitive, and certain foods could exacerbate this sensitivity.

3. Dental Issues: The missing teeth could indeed contribute to your gastrointestinal symptoms. Chewing is the first step in digestion, and inadequate chewing can lead to larger food particles entering the stomach, which may be harder to digest. This can result in increased gas production as the food ferments in the intestines. Additionally, swallowing air while eating (aerophagia) can also occur if you're not chewing properly, leading to further bloating and discomfort.

Recommendations
1. Dietary Modifications: Consider adopting a low-FODMAP diet temporarily to identify if specific foods are exacerbating your symptoms. Keeping a food diary can help you track what you eat and correlate it with your symptoms. Gradually reintroducing foods can help pinpoint triggers.

2. Chewing and Eating Habits: Focus on chewing your food thoroughly to aid digestion. Eating slowly and avoiding talking while eating can help minimize the amount of air swallowed.

3. Medical Evaluation: Given your history of gastric issues and the recent findings of gas on your chest X-ray, it may be prudent to consult with a gastroenterologist. They might recommend a repeat endoscopy to assess the state of your gastric mucosa, especially if you continue to experience discomfort after eating.
4. Probiotics: Introducing probiotics may help balance your gut microbiota, potentially reducing gas production. Foods like yogurt, kefir, and fermented vegetables can be beneficial.

5. Hydration and Fiber: Ensure you are adequately hydrated and consuming enough fiber to promote healthy bowel movements. However, be cautious with fiber intake if you are experiencing bloating, as certain types of fiber can exacerbate gas production.

6. Stress Management: Stress can significantly impact gastrointestinal function. Techniques such as mindfulness, yoga, or other relaxation methods may help alleviate some of your symptoms.

Conclusion
In summary, excessive gas and bloating can stem from various factors, including dietary habits, previous gastrointestinal issues, and dental health. It is essential to approach this condition holistically, considering both dietary modifications and potential medical evaluations. If symptoms persist or worsen, seeking further medical advice is crucial to rule out any underlying conditions and to receive appropriate treatment.

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