You Can Reduce Fat By Practicing Yoga

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Some exercises that are highly beneficial for reduction of baby fat from stomach are described below. Remember, you should not attempt any of these on your own unless you have been shown and guided by a certified yoga master or guru.

Pavan Muktasan (Release or Regulation of Air): ..Click & see
Lie down on your back and take a deep breath. Bend your left leg at the knee and catching the toes, bring it to touch your stomach while at the same time you lift your head to touch the bent knee. Keep the right leg straight and your breath in. Count 10 and return to the original position. Leave your breath. Repeat with the other leg.

Dhanurasan (The bow posture) –click to see

Lie down on your stomach. Catch your ankles by bending your knees and then push outwards (up) to make your body look like a bow. Pull your head back as much as it goes. Keep for 10 seconds and release posture.

Bhujangasana to see
lie on your stomach and keep your hands right under your shoulders. Push your upper body backwards using only the back muscles not your hands. In case you find it difficult to ignore the hands, try keeping them over the hips.

All the above yoga exercises are extremely beneficial in reducing stomach fat. These need to be initially done in the presence and under the guidance of a yoga guru. There are many, many more other yoga exercises or postures that are helpful in reducing midriff fat and stomach flab. However, as with all other exercises, yoga too needs to be practiced on a daily basis regularly, preferably outdoors, at the crack of the dawn.

Click to see:->What is Yoga  Jan.19.2010

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Diagnonistic Test

Barium Swallow (Upper Gastrointestinal Series or “Upper GI Series”)

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Definition:A barium swallow, or upper GI series, is an x-ray test used to examine the upper digestive tract (the esophagus, stomach, and small intestine). Because these organs are normally not visible on x-rays, you need to swallow barium, a liquid that does show up on x-rays. The barium temporarily coats the lining of the esophagus, stomach, and intestine, making the outline of these organs visible on the xray pictures. This test is useful for diagnosing cancers, ulcers, problems that cause narrowing of the esophagus, some causes of inflammation in the intestine, and some swallowing problems.


An upper gastrointestinal (UGI) series looks at the upper and middle sections of the gastrointestinal tract. The test uses barium contrast material, fluoroscopy, and X-ray. Before the test, you drink a mix of barium (barium contrast material) and water. The barium is often combined with gas-making crystals. Your doctor watches the movement of the barium through your esophagus, stomach, and the first part of the small intestine (duodenum) on a video screen. Several X-ray pictures are taken at different times and from different views.

A small bowel follow-through may be done immediately after a UGI to look at the rest of the small intestine. If just the throat and esophagus are looked at, it is called an esophagram (or barium swallow).

Upper endoscopy is done instead of a UGI in certain cases. Endoscopy uses a thin, flexible tube (endoscope) to look at the lining of the esophagus, stomach, and upper small intestine (duodenum).

Why It Is Done:-
An upper gastrointestinal (UGI) series is done to:

1.Find the cause of gastrointestinal symptoms, such as difficulty swallowing, vomiting, burping up food, belly pain (including a burning or gnawing pain in the center of the stomach), or indigestion. These may be caused by conditions such as hiatal hernia.

*Find narrow spots (strictures) in the upper intestinal tract, ulcers, tumors, polyps, or pyloric stenosis.

*Find inflamed areas of the intestine, malabsorption syndrome, or problems with the squeezing motion that moves food through the intestines (motility disorders).

*Find swallowed objects.

Generally, a UGI series is not used if you do not have symptoms of a gastrointestinal problem. A UGI series is done most often for people who have:

1.A hard time swallowing.
2.A history of Crohn’s disease.
3.A possible blocked intestine (obstruction).
4.Belly pain that is relieved or gets worse while eating.
5.Severe heartburn or heartburn that occurs often.

How To Prepare for the Test:-
Tell your doctor and the x-ray technicians if you :

1.Are taking any medicine.

2.Are allergic to any medicines, barium, or any other X-ray contrast material.

3.Are or might be pregnant. This test is not done during pregnancy because of the risk of radiation to the developing baby (fetus).

4.You may be asked to eat a low-fiber diet for 2 or 3 days before the test. You may also be asked to stop eating for 12 hours before the test. Your doctor will tell you if you need to stop taking certain medicines before the test.

The evening before the test, you may be asked to take a laxative to help clean out your intestines. If your stomach cannot empty well on its own, you may have a special tube put through your nose and down into your stomach just before the test begins. A gentle suction on the tube will drain the stomach contents.

If you are having the small bowel follow-through after the UGI series, you will need to wait between X-rays. The entire small bowel follow-through exam takes up to 6 hours, so bring along a book to read or some other quiet activity.

You may be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?) .
How It Is Done
A UGI series is usually done in your doctor’s office, clinic, or X-ray department of a hospital. You do not need to stay overnight in the hospital. The test is done by a radiologist and a radiology technologist.

You will need to take off your clothes and put on a hospital gown. You will need to take out any dentures and take off any jewelry. You may not smoke or chew gum during the test, since the stomach will respond by making more gastric juices and this will slow the movement of the barium through the intestines.

You might also be asked to swallow some tablets that “fizz,” causing air-bubbles to be released in your stomach. This might make you feel like burping, but try not to. You will get better pictures if you can keep yourself from burping.

The x-ray technician may ask you to stand or lie in different positions over the next few minutes, to help spread around the liquid you have swallowed. Most often, the x-ray pictures are taken while you lie on your back on a table. The x-ray machine or the table is moved a few times so it can take pictures of all of the internal structures. You are asked to hold your breath for each picture so that your breathing movement does not blur the image.

You will lie on your back on an X-ray table. The table is tilted to bring you to an upright position with the X-ray machine in front of you. Straps may be used to keep you safely on the table. The technologist will make sure you are comfortable during changes in table position.

You will have one X-ray taken before you drink the barium mix. Then you will take small swallows repeatedly during the series of X-rays that follow. The radiologist will tell you when and how much to drink. By the end of the test, you may have swallowed 1cup to 2.5cups of the barium mixture. See a picture of a barium swallow test.

The radiologist watches the barium pass through your gastrointestinal tract using fluoroscopy and X-ray pictures. The table is tilted at different positions and you may change positions to help spread the barium. Some gentle pressure is put on your belly with a belt or by the technologist’s gloved hand. You may be asked to cough so that the radiologist can see how that changes the barium flow. See an image of a barium swallow.

If you are having an air-contrast study, you will sip the barium liquid through a straw with a hole in it or take pills that make gas in your stomach. The air or gas that you take in helps show the lining of the stomach and intestines in greater detail.

If you are also having a small bowel study, the radiologist watches as the barium passes through your small intestine into your large intestine. X-ray pictures are taken every 30 minutes.

The UGI series 30 to 40 minutes. The UGI series with a small bowel study takes 2 to 6 hours. In some cases, you may be asked to return after 24 hours to have more X-ray pictures taken.

When the UGI series is done, you may eat and drink whatever you like, unless your doctor tells you not to.

You may be given a laxative or enema to flush the barium out of your intestines after the test to prevent constipation. Drink a lot of fluids for a few days to flush out the barium.

How It Feels
The barium liquid is thick and chalky, and some people find it hard to swallow. A sweet flavor, like chocolate or strawberry, is used to make it easier to drink. Some people do not like it when the X-ray table tilts. You may find that pressure on your belly is uncomfortable. After the test, many people feel bloated and a little nauseated.

For 1 to 3 days after the test, your stool (feces) will look white from the barium. Call your doctor if you are not able to have a bowel movement in 2 to 3 days after the test. If the barium stays in your intestine, it can harden and cause a blockage. If you become constipated, you may need to use a laxative to pass a stool.

Risk Factors:
There are no significant risks.

Barium does not move into the blood, so allergic reactions are very rare.

Some people gag while drinking the barium fluid. In rare cases, a person may choke and inhale (aspirate) some of the liquid into the lungs.

There is a small chance that the barium will block the intestine or leak into the belly through a perforated ulcer. A special type of contrast material (Gastrografin) can be used if you have a blockage or an ulcer.

There is always a small chance of damage to cells or tissue from being exposed to any radiation, even the low level of radioactive tracer used for this test.

How long is it before the result of the test is known?

It takes the x-ray department 30 minutes to an hour to develop the pictures from your barium swallow, and it will take additional time for a doctor to examine the x-rays and to decide how they look. Typically you can get the results within a day or two.

Must you do anything special after the test is over
After the test, you can eat normally and do your normal activities. You should drink more water than usual to help clear out the barium and to prevent constipation, which might be a side effect of the test. Your stool may appear light in color for a couple of days.

An upper gastrointestinal (UGI) series looks at the upper and middle sections of the gastrointestinal tract. Results are usually ready in 1 to 3 days.

Upper gastrointestinal (UGI) series  Normal: The esophagus, stomach, and small intestine all look normal.

Abnormal: A narrowing (stricture), inflammation, a mass, a hiatal hernia, or enlarged veins (varices) may be seen. Spasms of the esophagus or a backward flow (reflux) of barium from the stomach may occur.

The UGI series may show a stomach (gastric) or intestinal (duodenal) ulcer, a tumor, or something pushing on the intestines from outside the gastrointestinal tract. Narrowing of the opening between the stomach and the small intestine (pyloric stenosis) may be seen.

The small bowel follow-through may show inflammation or changes in the lining that may explain poor absorption of food. This may be caused by Crohn’s disease or celiac disease.

What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:

*Eating before or during the test.
*Too much air in the small intestine.

*A gastrointestinal (GI) motility study may be done if the squeezing motions of the small intestine are not normal during the UGI series and small bowel follow-through. The movement of the barium through the lower intestinal tract is recorded every few hours for up to 24 hours. A barium enema or colonoscopy may be needed to confirm the diagnosis.

*Upper endoscopy is done instead of a UGI test in certain cases. Endoscopy uses a thin, flexible tube (endoscope) to look at the lining of the esophagus, stomach, and upper small intestine (duodenum). For more information, see the medical test Upper Gastrointestinal Endoscopy.

*The UGI series test:

*Cannot show irritation of the stomach lining (gastritis) or esophagus (esophagitis) or ulcers that are smaller than about 0.25in. in diameter.

*Cannot show an infection with the bacteria Helicobacter pylori, which may be a cause of stomach ulcers.

*A biopsy cannot be done during the UGI if a problem is found.


Ailmemts & Remedies

Peptic Ulcer

Peptic ulcers are open sores that develop on the inside lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is pain.Not long ago, the common belief was that peptic ulcers were a result of lifestyle. Doctors now know that a bacterial infection or some medications — not stress or diet — cause most ulcers of the stomach and upper part of the small intestine (duodenum). Esophageal ulcers also may occur and are typically associated with the reflux of stomach acid.

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A peptic ulcer, also known as PUD or peptic ulcer disease, is an ulcer (defined as mucosal erosions equal to or greater than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. As much as 80% of ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach, however only 20% of those cases go to a doctor. Ulcers can also be caused or worsened by drugs such as Aspirin and other NSAIDs. Contrary to general belief, more peptic ulcers arise in the duodenum (first part of the small intestine, just after the stomach) than in the stomach. About 4% of stomach ulcers are caused by a malignant tumor, so multiple biopsies are needed to make sure. Duodenal ulcers are generally benign.


A peptic ulcer may arise at various locations:

* Stomach (called gastric ulcer)
* Duodenum (called duodenal ulcer)
* Esophagus (called esophageal ulcer)
* Meckel’s Diverticulum (called Meckel’s Diverticulum ulcer)

Signs and symptoms:

Burning pain is the most common peptic ulcer symptom. The pain is caused by the ulcer and is aggravated by stomach acid coming in contact with the ulcerated area. The pain typically may:

* Be felt anywhere from your navel to your breastbone
* Last from a few minutes to many hours
* Be worse when your stomach is empty
* Flare at night
* Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication
* Come and go for a few days or weeks

Less often, ulcers may cause severe signs or symptoms such as:

* The vomiting of blood — which may appear red or black
* Dark blood in stools or stools that are black or tarry
* Nausea or vomiting
* Unexplained weight loss
* Chest pain

A history of heartburn, gastroesophageal reflux disease (GERD) and use of certain forms of medication can raise the suspicion for peptic ulcer. Medicines associated with peptic ulcer include NSAID (non-steroid anti-inflammatory drugs) that inhibit cyclooxygenase, and most glucocorticoids (e.g. dexamethasone and prednisolone).

In patients over 45 with more than 2 weeks of the above symptoms, the odds for peptic ulceration are high enough to warrant rapid investigation by EGD (see below).

The timing of the symptoms in relation to the meal may differentiate between gastric and duodenal ulcers: A gastric ulcer would give epigastric pain during the meal, as gastric acid is secreted, or after the meal, as the alkaline duodenal contents reflux into the stomach. Symptoms of duodenal ulcers would manifest mostly before the meal — when acid (production stimulated by hunger) is passed into the duodenum. However, this is not a reliable sign in clinical practice.
Depending on their location, peptic ulcers have different names:

* Gastric ulcer. This is a peptic ulcer that occurs in your stomach.
* Duodenal ulcer. This type of peptic ulcer develops in the first part of the small intestine (duodenum).
* Esophageal ulcer. An esophageal ulcer is usually located in the lower section of your esophagus. It’s often associated with chronic gastroesophageal reflux disease (GERD).

The culprit in most cases
Although stress and spicy foods were once thought to be the main causes of peptic ulcers, doctors now know that the cause of most ulcers is the corkscrew-shaped bacterium Helicobacter pylori (H. pylori).

H. pylori lives and multiplies within the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, H. pylori causes no problems. But sometimes it can disrupt the mucous layer and inflame the lining of the stomach or duodenum, producing an ulcer. One reason may be that people who develop peptic ulcers already have damage to the lining of the stomach or small intestine, making it easier for bacteria to invade and inflame tissues.

H. pylori is a common gastrointestinal infection around the world. In the United States, one in five people younger than 30 and half the people older than 60 are infected. Although it’s not clear exactly how H. pylori spreads, it may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water.

H. pylori is the most common, but not the only, cause of peptic ulcers. Besides H. pylori, other causes of peptic ulcers, or factors that may aggravate them, include:

*Regular use of pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate or inflame the lining of your stomach and small intestine. The medications are available both by prescription and over-the-counter. Nonprescription NSAIDs include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) and ketoprofen (Orudis KT). To help avoid digestive upset, take NSAIDs with meals.

NSAIDs inhibit production of an enzyme (cyclooxygenase) that produces prostaglandins. These hormone-like substances help protect your stomach lining from chemical and physical injury. Without this protection, stomach acid can erode the lining, causing bleeding and ulcers.
* Smoking. Nicotine in tobacco increases the volume and concentration of stomach acid, increasing your risk of an ulcer. Smoking may also slow healing during ulcer treatment.
* Excessive alcohol consumption. Alcohol can irritate and erode the mucous lining of your stomach and increases the amount of stomach acid that’s produced. It’s uncertain, however, whether this alone can progress into an ulcer or whether other contributing factors must be present, such as H. pylori bacteria or ulcer-causing medications, such as NSAIDs.
* Stress. Although stress per se isn’t a cause of peptic ulcers, it’s a contributing factor. Stress may aggravate symptoms of peptic ulcers and, in some cases, delay healing. You may undergo stress for a number of reasons — an emotionally disturbing circumstance or event, surgery, or a physical trauma, such as a burn or other severe injury.


* Gastrointestinal bleeding is the most common complication. Sudden large bleeding can be life threatening[2]. It occurs when the ulcer erodes one of the blood vessels.
* Perforation (a hole in the wall) often leads to catastrophic consequences. Erosion of the gastro-intestinal wall by the ulcer leads to spillage of stomach or intestinal content into abdominal cavity. Perforation at the anterior surface of stomach leads to acute peritonitis, initially chemical and later bacterial peritonitis. Often first sign is sudden intense abdominal pain. Posterior wall perforation leads to pancreatitis; pain in this situation often radiates to back.
* Penetration is when the ulcer continues into adjacent organs such as liver and pancreas[3].
* Scarring and swelling due to ulcers causes narrowing in the duodenum and gastric outlet obstruction. Patient often presents with severe vomiting.
* Pyloric Stenosis

n order to detect an ulcer, your doctor may have you undergo the following diagnostic tests:

* Upper gastrointestinal (upper GI) X-ray. Your doctor may begin with this test, which outlines your esophagus, stomach and duodenum. During the X-ray, you swallow a white, metallic liquid (containing barium) that coats your digestive tract and makes an ulcer more visible. An upper GI X-ray can detect some ulcers, but not all.
* Endoscopy. This procedure may follow an upper GI X-ray if the X-ray suggests a possible ulcer, or your doctor may perform endoscopy first. In this more sensitive procedure, a long, narrow tube with an attached camera is threaded down your throat and esophagus into your stomach and duodenum. With this instrument, your doctor can view your upper digestive tract and identify an ulcer.

If your doctor detects an ulcer, he or she may remove small tissue samples (biopsy) near the ulcer. These samples are examined under a microscope to rule out cancer. A biopsy can also identify the presence of H. pylori in your stomach lining. Depending on where the ulcer is found, your doctor may recommend a repeat endoscopy after two to three months to confirm that the ulcer is healing.

Additional tests
In addition to a biopsy, these other tests can determine if the cause of your ulcer is H. pylori infection:

* Blood test. This test checks for the presence of H. pylori antibodies. A disadvantage of this test is that it sometimes can’t differentiate between past exposure and current infection. After H. pylori bacteria have been eradicated, you may still have a positive result for many months.
* Breath test. This procedure uses a radioactive carbon atom to detect H. pylori. First, you blow into a small plastic bag, which is then sealed. Then, you drink a small glass of clear, tasteless liquid. The liquid contains radioactive carbon as part of a substance (urea) that will be broken down by H. pylori. Thirty minutes later, you blow into a second bag, which also is sealed. If you’re infected with H. pylori, your second breath sample will contain the radioactive carbon in the form of carbon dioxide.

The advantage of the breath test is that it can monitor the effectiveness of treatment used to eradicate H. pylori, detecting when the bacteria have been killed or eradicated. With the blood test, H. pylori antibodies may sometimes still be present a year or more after the infection is gone.
* Stool antigen test. This test checks for H. pylori in stool samples. It’s useful both in helping to diagnose H. pylori infection and in monitoring the success of treatment.

Younger patients with ulcer-like symptoms are often treated with antacids or H2 antagonists before EGD is undertaken. Bismuth compounds may actually reduce or even clear organisms.

Patients who are taking nonsteroidal anti-inflammatories (NSAIDs) may also be prescribed a prostaglandin analogue (Misoprostol) in order to help prevent peptic ulcers, which may be a side-effect of the NSAIDs.

When H. pylori infection is present, the most effective treatments are combinations of 2 antibiotics (e.g. Clarithromycin, Amoxicillin, Tetracycline, Metronidazole) and 1 proton pump inhibitor (PPI), sometimes together with a bismuth compound. In complicated, treatment-resistant cases, 3 antibiotics (e.g. amoxicillin + clarithromycin + metronidazole) may be used together with a PPI and sometimes with bismuth compound. An effective first-line therapy for uncomplicated cases would be Amoxicillin + Metronidazole + Rabeprazole (a PPI). In the absence of H. pylori, long-term higher dose PPIs are often used.

Treatment of H. pylori usually leads to clearing of infection, relief of symptoms and eventual healing of ulcers. Recurrence of infection can occur and retreatment may be required, if necessary with other antibiotics. Since the widespread use of PPI’s in the 1990s, surgical procedures (like “highly selective vagotomy”) for uncomplicated peptic ulcers became obsolete.

Perforated peptic ulcer is a surgical emergency and requires surgical repair of the perforation. Most bleeding ulcers require endoscopy urgently to stop bleeding with cautery or injection.

Click to see:->Homeopathic Treatment for Peptic Ulcer

>Ayurvedic-Integrated Medical Treatment

> Natural way to cure peptic ulcer

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose


Ailmemts & Remedies


Definition:Belching is the act of bringing up air from the stomach with a typical sound.A normal process to relieve distention from the air that accumulates in the stomach. The upper abdominal discomfort associated with excessive swallowed air may extend into the lower chest, producing symptoms suggesting heart or lung disease.

Burps or belches are simply the sound of gas leaving your body. When you scarf down food or even nibble on it, you also swallow air. You’d be amazed at how much air you’re really sucking down your throat. If you’re drinking pop with your meal, you’re also swallowing another gas – carbon dioxide which is full of bubbles. Those bubbles in your body don’t just float around. They need to go somewhere.

Extra gas escapes from the stomach, travels up the esophagus and comes out the mouth. It doesn’t usually leave slowly. Gas can quickly escape which is why we can’t always cover our mouth in time. Burps have little to do with farts. Farts are the sounds and smells of gas that get out through the anus. Farts may only take 30 to 45 minutes to travel through your body, but burps travel even faster. During the day you probably burp or fart at least 10 to 15 times. Stinky!


Alternative Names :Burping; Eructation; Gas – belching


The ability to belch is almost universal. Belching, also known as burping, is the act of expelling gas from the stomach out through the mouth.

The usual cause of belching is a distended (inflated) stomach caused by swallowed air. The distention of the stomach causes abdominal discomfort, and the belching expels the air and relieves the discomfort.

The common reasons for swallowing large amounts of air (aerophagia) are gulping food or drink too rapidly, anxiety, and carbonated beverages. People are often unaware that they are swallowing air.

“Burping” infants during bottle or breast feeding is important in order to expel air in the stomach that has been swallowed with the formula or milk.

Excessive air in the stomach is not the only cause of belching. For some people, belching becomes a habit and does not reflect the amount of air in their stomachs. For others, belching is a response to any type of abdominal discomfort and not just to discomfort due to increased gas.

Everyone knows that when they have mild abdominal discomfort, belching often relieves the problem. This is because excessive air in the stomach is often the cause of mild abdominal discomfort. As a result, people belch whenever mild abdominal discomfort is felt-whatever the cause.

Belching is not the simple act that many people think it is. Belching requires the coordination of several activities. The larynx must be closed-off so that any liquid or food that might return with the air from the stomach won’t get into the lungs.

This is accomplished by voluntarily raising the larynx as is done when swallowing. Raising the larynx also relaxes the upper esophageal sphincter so that air can pass more easily from the esophagus into the throat. The lower esophageal sphincter must open so that air can pass from the stomach into the esophagus.

While all this is occurring, the diaphragm descends just as it does when a breath is taken. This increases abdominal pressure and decreases pressure in the chest. The changes in pressure promote the flow of air from the stomach in the abdomen to the esophagus in the chest.

One unusual type of belching has been described in aerophagic individuals who swallow air. It has been demonstrated that during some of their belches room air enters the esophagus and is immediately expelled, giving rise to a belch. This in and out flow of air also is likely to be the explanation for the ability of many people to belch at will, even when there is little or no air in the stomach.

If the problem causing the discomfort is not excessive air in the stomach, then belching does not provide relief. When belching does not ease the discomfort, the belching should be taken as a sign that something may be wrong within the abdomen and the cause of the discomfort should be sought.

Belching by itself, however, does not help the physician determine what may be wrong because belching can occur in virtually any abdominal disease or condition that causes discomfort.

In discussing bloating, it is important to distinguish between bloating and distention.

Bloating is the subjective sensation (feeling) that the abdomen is larger than normal. Thus, bloating is a symptom akin to the symptom of discomfort.

In contrast, distention is the objective determination (physical finding) that the abdomen is actually larger than normal. Distention can be determined by such observations as the inability to fit into clothes or looking down at the stomach and noting that it is clearly larger than normal.

In some instances, bloating may represent a mild form of distention since the abdomen does not become physically (visibly or measurably) enlarged until its volume increases by one quart.

Nevertheless, bloating should never be assumed to be the same as distention.

There are three ways in which abdominal distention can arise. The causes are an increase in air, fluid, or tissue within the abdomen.

The diseases or conditions that cause an increase of any of these three factors are very different from one anther. Therefore, it is important to determine which of them is distending the abdomen.

There are two types of distention; continuous and intermittent.

*Continuous distention may be caused by the enlargement of an intra-abdominal (within the abdomen) organ, an intra-abdominal tumor, a collection of fluid around the intra-abdominal organs (ascites), or just plain obesity.
*Intermittent distention is usually due to the occasional accumulation of gas and/or fluid within the stomach, small intestine, or colon.

Causes flatulence:

Flatulence, also known as farting, is the act of passing intestinal gas from the anus.

Gas in the gastrointestinal tract has only two sources. It is either swallowed air or it is produced by bacteria that normally inhabit the intestines, primarily the colon.

Swallowed air is rarely the cause of excessive flatulence. The usual source is the production of excessive gas by intestinal bacteria. The bacteria produce the gas (hydrogen and/or methane) when they digest foods, primarily sugars and polysaccharides (e.g., starch, cellulose), that have not been digested during passage through the small intestine.

Sugars that are commonly poorly digested (maldigested) and malabsorbed are lactose, sorbitol, and fructose.

Lactose is the sugar in milk. The absence of the enzyme lactase in the lining of the intestines, which is a genetic trait, causes the maldigestion. Lactase is important because it breaks apart the lactose so that it can be absorbed.

Sorbitol is a commonly used sweetener in low calorie foods. Fructose is a commonly used sweetener in all types of candies and drinks.

Starches are another common source of intestinal gas. Starches are polysaccharides that are produced by plants and are composed of long chains of sugars.

Common sources of different types of starch include wheat, oats, potatoes, corn, and rice.

Rice is the most easily digested starch and little undigested rice starch reaches the colon and the colonic bacteria. Accordingly, the consumption of rice produces little gas.

In contrast, the starches in wheat, oats, potatoes, and, to a lesser extent, corn, all reach the colon and the bacteria in substantial amounts. These starches, therefore, result in the production of appreciable amounts of gas.

The starch in whole grains produces more gas than the starch in refined (purified) grains. Thus, more gas is formed after eating foods made with whole wheat flour than with refined wheat flour.

This difference in gas production probably occurs because the fiber present in the whole grain flour slows the digestion of starch as it travels through the small intestine. Much of this fiber is removed during the processing of whole grains into refined flour.

Finally, certain fruits and vegetables, for example, cabbage, also contain poorly digested starches that reach the colon and result in the formation of gas.

Most vegetables and fruits contain cellulose, another type of polysaccharide that is not digested at all as it passes through the small intestine.

However, unlike sugars and other starches, cellulose is used only very slowly by colonic bacteria. Therefore, the production of gas after the consumption of fruits and vegetables usually is not great unless the fruits and vegetables also contain sugars or polysaccharides other than cellulose.

Small amounts of air are continuously being swallowed and bacteria are constantly producing gas.

Contractions of the intestinal muscles normally propel the gas through the intestines and cause the gas to be expelled. Flatulence (passing intestinal gas) prevents gas from accumulating in the intestines.

However, there are two other ways in which gas can escape the intestine.

First, it can be absorbed across the lining of the intestine into the blood. The gas then travels in the blood and ultimately is excreted in the breath.

Second, gas can be removed and used by certain types of bacteria within the intestine. In fact, most of the gas that is formed by bacteria in the intestines is removed by other bacteria in the intestines.

Causes of intermittent abdominal bloating/distention :
Excessive production of gas:

Excessive production of gas by bacteria is a common cause of intermittent abdominal bloating/distention. Bacteria can produce too much gas in three ways.

* First, the amount of gas that bacteria produce varies from individual to individual. In other words, some individuals may have bacteria that produce more gas, either because there are more of the bacteria or because their particular bacteria are better at producing gas.
*Second, there may be poor digestion and absorption of foods in the small intestine, allowing more undigested food to reach the bacteria in the colon. The more undigested food the bacteria have, the more gas they produce. Examples of diseases of that involve poor digestion and absorption include lactose intolerance, pancreatic insufficiency, and celiac disease.
* Third, bacterial overgrowth can occur in the small intestine. Under normal conditions, the bacteria that produce gas are limited to the colon. In some medical conditions, these bacteria spread into the small intestine. When this bacterial spread occurs, food reaches the bacteria before it can be fully digested and absorbed by the small intestine. Therefore, the bacteria in the small intestine have a lot of undigested food from which to form gas. This condition in which the gas-producing bacteria move into the small intestine is called bacterial overgrowth of the small intestine (bowel).

Excessive production of gas by bacteria is usually accompanied by more flatulence. Increased flatulence may not always occur, however, since gas potentially can be eliminated in other ways-absorption into the body, utilization by other bacteria, or possibly, by elimination at night without the knowledge of the gas-passer.

Physical obstruction:

An obstruction (blockage) can occur virtually anywhere from the stomach to the rectum. When the blockage is temporary or partial, it can cause intermittent abdominal bloating/distention.

For example, scarring of the pylorus (pyloric stenosis) can obstruct the opening from the stomach into the intestines, thereby blocking the complete emptying of the stomach.

After meals, the stomach is normally filled with food and swallowed air. Then, during the next hour or two, the stomach secretes acid and fluid, which mix with the food and assist in digestion.

As a result, the stomach distends further. When the obstruction is incomplete, the food, air, and fluid eventually pass into the intestines and the bloating/distention resolves.

An obstruction in the small bowel, which is most commonly due to adhesions from a previous surgery, is another cause of intermittent abdominal distention.

To make matters worse, the distention that is caused by the physical obstruction stimulates both the stomach and intestines to secrete fluid, which adds to the distention.

Finally, severe constipation or fecal impaction (hardened stool in the rectum) can also obstruct the flow of the intestinal contents and result in distention.

In this case, however, the bloating/distention is usually constant and progressive and is relieved by bowel movements or removal of the impacted stool.

Functional obstruction:

A functional obstruction is not caused by an actual physical blockage, but rather by the poor functioning of the muscles of the stomach or intestines that propel the intestinal contents.

When these muscles are not working normally, the intestinal contents will accumulate and distend the abdomen.

Examples of functional obstruction include:

*gastroparesis (paralysis of the stomach) of diabetes;
*chronic intestinal pseudo-obstruction, an unusual condition in which the muscles of the small intestine do not work normally; and
*Hirschprung’s disease, in which a small stretch of colonic muscle does not contract normally due to missing nerves.

There is accumulating scientific evidence that some patients with abdominal bloating and distention due to gas may have a functional abnormality of the intestinal muscles that prevents gas from being normally transported through the intestine and expelled.

Instead, their gas accumulates in the intestine. Among patients with irritable bowel syndrome(IBS) with bloating as an important symptom, the gas accumulates in the small intestine and not the colon. The gas accumulates during the day and is greatest in the evening.

Fats in food have an effect on the intestine that mimics a functional obstruction. Dietary fat reaching the small intestine causes transport of digesting food, gas, and liquid within the intestines to slow. This can promote the accumulation of food, gas, and liquid and lead to bloating and/or distention.

Intestinal hypersensitivity:

Some people appear to be very sensitive (hypersensitive) to distention of their intestines, and they may feel bloated even with normal amounts of digesting food, gas, and fluid in the intestine after a meal. The bloating may be aggravated or even progress to distention if the meal contains substantial amounts of fat.

How are belching, bloating/distention, and flatulence evaluated?

A patient’s medical history is important because it directs the evaluation. If the bloating/distention is continuous rather than intermittent, then enlargement of abdominal organs, abdominal fluid, tumors, or obesity are probable causes.

If the bloating/distention is associated with increased flatulence, then bacteria and excessive gas production are likely factors. If a diet history reveals the consumption of large amounts of milk or dairy products (lactose), sorbitol or fructose, then the maldigestion and malabsorption of these sugars may be the cause of the distention.

When individuals complain of flatulence, it may be useful for them to count the number of times they pass gas for several days. This count can confirm the presence of excessive flatulence since the number of times gas is passed correlates well with the total amount (volume) of passed gas.

As you might imagine, it is not easy to measure the amount of passed gas. It is normal to pass gas up to 20 times a day. (The average volume of gas passed daily is estimated to be about ¾ of a quart.)

If an individual complains of excessive gas but passes gas fewer than 20 times per day, the problem is likely to be something other than too much gas.

For example, the problem may be the foul odor of the gas (usually due to sulfur-containing foods), the lack of ability to control (hold back) the passing of gas, or the soiling of underwear with small amounts of stool when passing gas.

All of these problems, like excessive gas, are socially embarrassing and may prompt individuals to consult a physician. These problems, however, are not due to excessive gas production, and their treatment is different.

Simple abdominal X-rays: Simple X-rays of the abdomen, particularly if they are taken during an episode of bloating or distention, can often confirm air as the cause of the distention since large amounts of air can be seen easily within the stomach and intestine.

Moreover, the cause of the problem may be suggested by noting where the gas has accumulated. For example, if the air is in the stomach, emptying of the stomach is likely to be the problem.

Small intestinal X-rays: X-rays of the small intestine, in which barium is used to fill and outline the small intestine, are particularly useful for determining if there is an obstruction of the small intestine.

Gastric emptying studies: These studies measure the ability of the stomach to empty its contents.

For gastric emptying studies, a test meal that is labeled with a radioactive substance is eaten and a Geiger counter-like device is placed over the abdomen to measure how rapidly the test meal empties from the stomach. A delay in emptying of the radioactivity from the stomach can be caused by any condition that reduces emptying of the stomach (e.g., pyloric stenosis, gastroparesis).

Ultrasound, CT scan, and MRI: Imaging studies, including ultrasound examination, computerized tomography (CT), and magnetic resonance imaging (MRI), are particularly useful in defining the cause of distention that is due to enlargement of the abdominal organs, abdominal fluid, and tumor.

Maldigestion and malabsorption tests: Two types of tests are used to diagnose maldigestion and malabsorption; general tests and specific tests. The best general test is a 72 hour collection of stool that measures fat in the stool. If maldigestion and/or malabsorption exist because of pancreatic insufficiency or diseases of the lining of the small intestine (e.g., celiac disease), the amount of fat in the stool will increase.

Specific tests can be done for maldigestion of individual sugars that are commonly maldigested, including lactose (the sugar in milk) and sorbitol (a sweetener in low calorie foods).

The specific tests require ingestion of the sugars followed by hydrogen/methane breath testing.

The sugar fructose, a commonly used sweetener, like lactose and sorbitol, also may cause abdominal bloating/distention and flatulence.

However, the problem that can occur with fructose is different from that with lactose or sorbitol. Thus, as already discussed, lactose and sorbitol may be poorly digested by the pancreas and small intestine.

On the other hand, fructose may be digested normally but may pass so rapidly through the small intestine that there is not enough time for digestion and absorption to take place.

Hydrogen/methane breath tests: The most convenient way to test for bacterial overgrowth of the small intestine is hydrogen/methane breath testing. Normally, the gas produced by the bacteria of the colon is composed of hydrogen and/or methane.

For hydrogen/methane breath testing, a non-digestible sugar, lactulose, is consumed. At regular intervals following ingestion, samples of breath are taken for analysis.

When the lactulose reaches the colon, the bacteria form hydrogen and/or methane. Some of the hydrogen or methane is absorbed into the blood and eliminated in the breath where it can be measured in the samples of breath.

In normal individuals, there is one peak of hydrogen or methane when the lactulose enters the colon.

In individuals who have bacterial overgrowth, there are two peaks of hydrogen or methane. The first occurs when the lactulose passes and is exposed to the bacteria in the small intestine. The second occurs when the lactulose enters the colon and is exposed to the colonic bacteria.

Hydrogen breath testing for overgrowth also may be done utilizing glucose as the test sugar.

The treatment of excessive intestinal gas depends on the cause. If there is maldigestion of specific sugars-lactose, sorbitol, or fructose–the offending sugars can be eliminated from the diet. In the case of lactose in milk, an alternative treatment is available. Enzymes that are similar to intestinal lactase can be added to the milk in order to break down the lactose prior to its ingestion so that it can be absorbed normally

Some people find that yogurt, in which the lactose has been broken down partially by bacteria, produces less gas than milk.

There also are certain types of vegetables and fruits that contain types of starches that are poorly digested by people but well digested by bacteria.

These include beans, lentils, cabbage, brussel sprouts, onions, carrots, bananas, apricots, and prunes.

Reducing the intake of these vegetables and fruits, as well as foods made from whole grains, should reduce gas and flatulence. However, the list of gas-producing foods is rather long, and it may be difficult to eliminate them all without severely restricting the diet.

When maldigestion is due to pancreatic insufficiency, then supplemental pancreatic enzymes can be ingested with meals to replace the missing enzymes.

If maldigestion and/or malabsorption is caused by disease of the intestinal lining, the specific disease must be identified, most commonly through a small bowel biopsy. Then, treatment can be targeted for that condition.

For example, if celiac disease is found on the biopsy, a gluten-free diet can be started.

An interesting form of treatment for excessive gas is alpha-D-galactosidase, an enzyme that is produced by a mold. This enzyme, commercially available as Beano, is consumed as either a liquid or tablet with meals.

This enzyme is able to break down some of the difficult-to-digest polysaccharides in vegetables so that they may be absorbed. This prevents them from reaching the colonic bacteria and causing unnecessary production of gas. Beano has been shown to be effective in decreasing the incidence of intestinal gas.

Two other types of treatment have been promoted for the treatment of gas;

*simethicone and
*activated charcoal.

It is unclear if simethicone has an effect on gas in the stomach. However, it has no effect on the formation of gas in the colon.

Moreover, in the stomach, simethicone would be expected only to affect swallowed air, which, as previously mentioned, is an uncommon cause of excessive intestinal gas.

Nevertheless, some individuals are convinced that simethicone helps them. Activated charcoal has been shown to reduce the formation of gas in the colon, though the way in which it does so is unknown.

If there is a physical obstruction to the emptying of the stomach or passage of food, liquid, and gas through the small intestine, then surgical correction of the obstruction is required.

If the obstruction is functional, medications that promote activity of the muscles of the stomach and small intestine are given. Examples of these medicines are erythromycin or metoclopramide (Reglan).

Bacterial overgrowth of the small bowel is usually treated with antibiotics. However, this treatment is frequently only temporarily effective or not effective at all.

When antibiotics provide only a temporary benefit, it may be necessary to treat patients intermittently or even continuously with antibiotics. If antibiotics are not effective, probiotics (e.g., lactobacillus) can be tried although their use in bacterial overgrowth has not been studied. This condition may be difficult to treat.

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.Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose


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The Digestive System and How It Works

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The digestive system is a series of hollow organs joined in a long, twisting tube from the mouth to the anus(see the figure below) . Inside this tube is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food… & see

Two solid organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes. In addition, parts of other organ systems (for instance, nerves and blood) play a major role in the digestive system.

Why is digestion important?

When we eat such things as bread, meat, and vegetables, they are not in a form that the body can use as nourishment. Our food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body. Digestion is the process by which food and drink are broken down into their smallest parts so that the body can use them to build and nourish cells and to provide energy.

How is food digested?

Digestion involves the mixing of food, its movement through the digestive tract, and the chemical breakdown of the large molecules of food into smaller molecules. Digestion begins in the mouth, when we chew and swallow, and is completed in the small intestine. The chemical process varies somewhat for different kinds of food.

Movement of Food Through the System

The large, hollow organs of the digestive system contain muscle that enables their walls to move. The movement of organ walls can propel food and liquid and also can mix the contents within each organ. Typical movement of the esophagus, stomach, and intestine is called peristalsis. The action of peristalsis looks like an ocean wave moving through the muscle. The muscle of the organ produces a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ.

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The first major muscle movement occurs when food or liquid is swallowed. Although we are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves.

The esophagus is the organ into which the swallowed food is pushed. It connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a ringlike valve closing the passage between the two organs. However, as the food approaches the closed ring, the surrounding muscles relax and allow the food to pass.

The food then enters the stomach, which has three mechanical tasks to do. First, the stomach must store the swallowed food and liquid. This requires the muscle of the upper part of the stomach to relax and accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.

Several factors affect emptying of the stomach, including the nature of the food (mainly its fat and protein content) and the degree of muscle action of the emptying stomach and the next organ to receive the contents (the small intestine). As the food is digested in the small intestine and dissolved into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion.

Finally, all of the digested nutrients are absorbed through the intestinal walls. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are propelled into the colon, where they remain, usually for a day or two, until the feces are expelled by a bowel movement.

Production of Digestive Juices

The glands that act first are in the mouth—the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules.

The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. One of the unsolved puzzles of the digestive system is why the acid juice of the stomach does not dissolve the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.

After the stomach empties the food and juice mixture into the small intestine, the juices of two other digestive organs mix with the food to continue the process of digestion. One of these organs is the pancreas. It produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine or even a part of that wall.

The liver produces yet another digestive juice—bile. The bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder into the bile ducts to reach the intestine and mix with the fat in our food. The bile acids dissolve the fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After the fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.

Absorption and Transport of Nutrients

Digested molecules of food, as well as water and minerals from the diet, are absorbed from the cavity of the upper small intestine. Most absorbed materials cross the mucosa into the blood and are carried off in the bloodstream to other parts of the body for storage or further chemical change. As already noted, this part of the process varies with different types of nutrients.

Carbohydrates. It is recommended that about 55 to 60 percent of total daily calories be from carbohydrates. Some of our most common foods contain mostly carbohydrates. Examples are bread, potatoes, legumes, rice, spaghetti, fruits, and vegetables. Many of these foods contain both starch and fiber.

The digestible carbohydrates are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is digested in two steps: First, an enzyme in the saliva and pancreatic juice breaks the starch into molecules called maltose; then an enzyme in the lining of the small intestine (maltase) splits the maltose into glucose molecules that can be absorbed into the blood. Glucose is carried through the bloodstream to the liver, where it is stored or used to provide energy for the work of the body.

Table sugar is another carbohydrate that must be digested to be useful. An enzyme in the lining of the small intestine digests table sugar into glucose and fructose, each of which can be absorbed from the intestinal cavity into the blood. Milk contains yet another type of sugar, lactose, which is changed into absorbable molecules by an enzyme called lactase, also found in the intestinal lining.

Protein. Foods such as meat, eggs, and beans consist of giant molecules of protein that must be digested by enzymes before they can be used to build and repair body tissues. An enzyme in the juice of the stomach starts the digestion of swallowed protein. Further digestion of the protein is completed in the small intestine. Here, several enzymes from the pancreatic juice and the lining of the intestine carry out the breakdown of huge protein molecules into small molecules called amino acids. These small molecules can be absorbed from the hollow of the small intestine into the blood and then be carried to all parts of the body to build the walls and other parts of cells.

Fats. Fat molecules are a rich source of energy for the body. The first step in digestion of a fat such as butter is to dissolve it into the watery content of the intestinal cavity. The bile acids produced by the liver act as natural detergents to dissolve fat in water and allow the enzymes to break the large fat molecules into smaller molecules, some of which are fatty acids and cholesterol. The bile acids combine with the fatty acids and cholesterol and help these molecules to move into the cells of the mucosa. In these cells the small molecules are formed back into large molecules, most of which pass into vessels (called lymphatics) near the intestine. These small vessels carry the reformed fat to the veins of the chest, and the blood carries the fat to storage depots in different parts of the body.

Vitamins. Another vital part of our food that is absorbed from the small intestine is the class of chemicals we call vitamins. The two different types of vitamins are classified by the fluid in which they can be dissolved: water-soluble vitamins (all the B vitamins and vitamin C) and fat-soluble vitamins (vitamins A, D, and K).

Water and salt. Most of the material absorbed from the cavity of the small intestine is water in which salt is dissolved. The salt and water come from the food and liquid we swallow and the juices secreted by the many digestive glands.

How is the digestive process controlled?

Hormone Regulators

A fascinating feature of the digestive system is that it contains its own regulators. The major hormones that control the functions of the digestive system are produced and released by cells in the mucosa of the stomach and small intestine. These hormones are released into the blood of the digestive tract, travel back to the heart and through the arteries, and return to the digestive system, where they stimulate digestive juices and cause organ movement.

The hormones that control digestion are gastrin, secretin, and cholecystokinin (CCK):

  • Gastrin causes the stomach to produce an acid for dissolving and digesting some foods. It is also necessary for the normal growth of the lining of the stomach, small intestine, and colon.
  • Secretin causes the pancreas to send out a digestive juice that is rich in bicarbonate. It stimulates the stomach to produce pepsin, an enzyme that digests protein, and it also stimulates the liver to produce bile.
  • CCK causes the pancreas to grow and to produce the enzymes of pancreatic juice, and it causes the gallbladder to empty.

Additional hormones in the digestive system regulate appetite:

  • Ghrelin is produced in the stomach and upper intestine in the absence of food in the digestive system and stimulates appetite.
  • Peptide YY is produced in the GI tract in response to a meal in the system and inhibits appetite.

Both of these hormones work on the brain to help regulate the intake of food for energy.

Nerve Regulators

Two types of nerves help to control the action of the digestive system. Extrinsic (outside) nerves come to the digestive organs from the unconscious part of the brain or from the spinal cord. They release a chemical called acetylcholine and another called adrenaline. Acetylcholine causes the muscle of the digestive organs to squeeze with more force and increase the “push” of food and juice through the digestive tract. Acetylcholine also causes the stomach and pancreas to produce more digestive juice. Adrenaline relaxes the muscle of the stomach and intestine and decreases the flow of blood to these organs.

Even more important, though, are the intrinsic (inside) nerves, which make up a very dense network embedded in the walls of the esophagus, stomach, small intestine, and colon. The intrinsic nerves are triggered to act when the walls of the hollow organs are stretched by food. They release many different substances that speed up or delay the movement of food and the production of juices by the digestive organs.

National Digestive Diseases Information Clearinghouse

2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
Fax: 703–738–4929