Document Detail

Evaluation of an extremely flatulent patient: case report and proposed diagnostic and therapeutic approach.
MedLine Citation:
PMID:  9820415     Owner:  NLM     Status:  MEDLINE    
We recently encountered a patient with severe flatulence who previously had been subjected to innumerable diagnostic tests and ineffective therapies based on the belief that his rectal gas was produced in the colon. Analysis of three flatus samples demonstrated that nitrogen (N2) was the predominant flatus gas whereas the three gases produced in the gut (CO2, H2 [hydrogen], and CH4 [methane]) comprised <16% of rectal gas. This result plus a series of other diagnostic tests clearly indicated that the patient's flatus was derived almost entirely from swallowed air. Based on this case, the present report summarizes available data on excessive flatulence and suggests a rational approach to the patient complaining of this problem. Particular emphasis is placed upon a sequential strategy consisting of: 1) a count of flatus passages to determine if the subject truly is abnormal (normal: <20 passages/day); 2) an analysis of flatus to determine if the flatus originates from swallowed air (predominantly nitrogen) or intraluminal production (predominantly CO2, H2, and CH4); and 3) treatment based upon the origin of the rectal gas.
M D Levitt; J Furne; M R Aeolus; F L Suarez
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  93     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-09     Completed Date:  1998-12-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2276-81     Citation Subset:  IM    
The Minneapolis Veterans Affairs Medical Center, Minnesota 55417, USA.
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MeSH Terms
Carbon Dioxide / analysis
Flatulence / diagnosis*,  therapy*
Hydrogen / analysis
Methane / analysis
Nitrogen / analysis
Grant Support
Reg. No./Substance:
124-38-9/Carbon Dioxide; 1333-74-0/Hydrogen; 74-82-8/Methane; 7727-37-9/Nitrogen

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