Flatulence (bloating)

Flatulence - as a syndrome of excessive formation or accumulation of gaseous waste from the process of digesting food - can occur when in the small and large intestine over a day more than 600-700 cu. Cm of gas.

According to the latest version of the International Classification of Diseases, the flatulence of ICD 10 is attributed to the XVIII class of symptoms and abnormalities that are observed during clinical examinations. In this class, bloating or flatulence takes place in R14, which combines the signs of abnormalities in the organs of the digestive system.

There are three main complaints related to "gassing": excessive belching, bloating (flatulence) and excessive leakage of gases through the anus.

In the intestine, there is usually a gas that enters it as a result of ingestion of air (aerophagia), direct formation in the intestine, or diffusion from the blood into the lumen of the intestine. The gas diffuses between the lumen of the gut and the blood in direct proportion to the difference in partial pressure. Thus, nitrogen (N) enters the intestinal lumen from the bloodstream, and hydrogen (H) enters the bloodstream from the intestinal lumen.

[1], [2], [3], [4], [5]

Causes of flatulence

First of all, the causes of flatulence can be covered in elementary overeating, when the amount of food consumed simply does not have time to be qualitatively processed by the body. Often, a strong flatulence after eating arises from the products that people eat. To products that increase gassing in the intestine, include complex carbohydrates, and animal fats, and milk, and various vegetable crops.

The causes of flatulence can be rooted in the congenital or acquired deficiency of digestive enzymes (dyspepsia), which leads to incomplete digestion of food. With this etiology, constant flatulence is accompanied by a feeling of heaviness and a feeling of increased intra-abdominal pressure (in the upper part of the cavity), and sometimes cramping pains. With enzyme deficiency, diarrhea and flatulence are very common. One example of a lack of enzymes is hypolactasia, an intolerance to milk sugar due to a deficiency in the enzyme beta-galactosidase.

However, in the majority of cases, the causes of flatulence are functional disorders of the gastrointestinal tract and pathology of the organs of the middle part of the digestive system: the stomach, duodenum, pancreas, gallbladder, and small and large intestine.

[6], [7], [8], [9]

At what diseases is flatulence one of their symptoms?

Flatulence in gastritis, that is, inflammation of the mucous membrane of the stomach, is manifested by rumbling in the abdomen, mainly with exacerbation of the chronic form of the disease, proceeding against the background of a decreased acidity of the gastric juice. Most patients with this diagnosis complain of heaviness in the stomach and flatulence.

Nausea, eructation, flatulence in the evenings and night pain in the hypochondrium is a classic symptom of duodenal ulcer. While for the syndrome of the diffuse intestine, as well as for dyskinesia of the intestine, flatulence is characteristic in the morning.

Flatulence in pancreatitis, caused by disruption of the pancreas, provokes swelling of the abdominal wall and rumbling, frequent loose stools with undigested food and fat particles. With this pathology, fetid flatulence is noted, which is due to the prevalence of hydrogen sulfide in the intestinal gases (the smell of which is compared to the smell of rotten eggs), indole (has the smell of naphthalene), skatole and thiol. The 3-methylindole (skatole) released during the decomposition of amino acids has a pronounced fecal odor, and the sulfur-containing thiol (mercaptan) smells just disgustingly and is not in vain a part of the protective secretion of skunks.

By the way, flatulence without smell, in the sense of increased flutulence, as well as belching of air is most often with aerophagia (physiological pneumatosis of the stomach) - increased ingestion of air during eating and drinking, poor grinding of food in the mouth, with the abuse of carbonated drinks, violation of nasal breathing. According to research, air entering the gulls of the intestine as a result of aerophagy is at least a third or even half of the intestinal gases. The chemical composition of flatus in flatulence without odor consists of nitrogen, carbon dioxide, hydrogen and methane.

Meteorism with cholecystitis - inflammation of the gallbladder - develops in parallel with nausea and bitter eructations. Heartburn with flatulence constantly occurs in those who have increased acidity of gastric juice or stones in the gallbladder. A flatulence and a temperature above + 37.5-38 ° C are fixed with exacerbation of gallbladder inflammation and the appearance of cholangitis - an infectious inflammatory process in the bile ducts.

Flatulence after surgery accompanies virtually all clinical cases of intracavitary surgery, but especially surgery on the stomach, duodenum and gallbladder. Flatulence after removal of the gallbladder (cholecystectomy) is a common and almost inevitable phenomenon, as well as other symptoms of this clinical condition. Thus, patients after such an operation still suffer for at least half a year flatulence and back pain (shingles), pain in the right hypochondrium, nausea, diarrhea, duodenal reflux, etc.

Flatulence and rumbling in the abdomen, as well as diarrhea and flatulence, are on the list of symptoms of inflammation of the small intestine - enteritis, in which digestion in the small intestine, as well as chronic enterocolitis and gastric ulcers with decreased acidity, worsens.

Flatulence in colitis (inflammation of the large intestine), especially chronic, has the closest relationship with the pathology of digestion. Gastroenterologists emphasize that with this disease there is a constant eructation, bitterness in the mouth, often there is nausea, flatulence and fever (up to fever), constipation and flatulence, diarrhea and flatulence with tenesmus - false urge to defecate.

Dull aching abdominal pains with flatulence in patients with chronic colitis are felt in the lower abdomen and on the sides of the abdominal cavity, they become more intense after eating, walking, and before defecation. Flatulence and mucus in the stool are also characteristic for exacerbation of chronic colitis, especially for the mucus-membranous variety of the disease.

Many women have flatulence before menstruation, which is explained by the specifics of hormonal changes in the premenstrual period. Flatulence on nervous soil - the so-called psychogenic meteorism - experts associate with increased stress loads, in which the synthesis of adrenaline increases and, as a result, disruptions in the work of the intestine occur, in particular, its normal motor skills are disrupted.

[10], [11], [12], [13]

Dysbacteriosis and flatulence

Separate consideration of the issue of dysbiosis and flatulence deserves because the imbalance of the obligate microbiological environment of the large intestine is one of the key causes of pathological gassing.

The formation of intestinal gases refers to natural, biochemically conditioned processes, participation in which colonies of microorganisms inhabiting the intestines performing enzymatic functions take part. These are gram-positive bifidobacteria (Bifidobacterium), lactobacillus (Lactobacillus), gram-negative bacteria - Escherichia coli (E. Coli), Eubacteria, Fusobacteria, and various bacteroids (Acidifaciens, Biacutis, Distasonis, Gracilis, Fragilis, Ovatus, Putredinis, etc.). ).

In addition, the normal microbiological climate of the intestine helps to maintain conditionally pathogenic Gram-positive bacteria of the genus Peptostreptococcus anaerobius - Clostridia peptostreptococcus, enterobacteria Enterobacter aerogenes, Klebsiella, anaerobes of the Propionibacterium family (propionobacteria), etc.

Dysbacteriosis is expressed, on the one hand, in the disappearance or a significant reduction in the number of bifido- and lactobacilli and Escherichia coli. On the other hand, the share of conditionally pathogenic bacteria increases. If there are dysbiosis and flatulence, it means that:

• because of the lack of bifidobacteria, the intensity of enzymatic parietal digestion in the small intestine decreases, the volume of unsplit carbohydrates and amino acids and unsweetened nutrients increases;
• deficiency of lactobacilli leads to alkalization of the intestinal environment, and, hence, the activity of rotting processes accompanied by the release of hydrogen and methane increases;
• The degradation of lactose in the intestine, which is facilitated by E. Coli, worsens.

It should be borne in mind that if all gases formed during the digestion of food left the intestine through the rectum, then it would not be 600-700 cu. Cm, and an average of at least 25,000-40,000 cubic meters. Cm per day ...

But, fortunately, in the intestinal microflora there are not only bacteria that release carbon dioxide, nitrogen, hydrogen and methane, but also microorganisms that absorb these gases. And when the biological balance of their symbiotic connections is broken, it comes about the appearance of meteorism.

[14], [15], [16], [17], [18]

Pathogenesis of bloating

It has been suggested that recurrent periods of screaming in infants of 2-4 months of age are due to pain called "colic," the appearance of which was associated with recurrent bowel spasms or gas formation. However, studies of babies with colic showed no increase in H production or passage time from the oral cavity to the caecum. Consequently, the cause of infant colic remains unclear.

Excessive burp

Eruption (eruption) occurs due to swallowed air or from a gas of carbonated beverages. Aerophagy is usually observed in small amounts during eating and drinking, but some people subconsciously constantly swallow air during eating, smoking and in other cases, especially when agitated. Excessive salivation increases aerophagia and may be associated with various gastroesophageal reflux disorders (gastroesophageal reflux disease), improper dentures, certain medications, chewing gum, or nausea of any etiology.

The most common cause of eructation is swallowed air. Only a small amount of it enters the small intestine; the amount of air probably depends on the position of the body. In the vertical position, a person has a free belching of air; in the supine position on the back, the air is located above the level of the liquid in the stomach, which promotes its movement into the duodenum. Excessive belching can also be involuntary; patients who have a belch after taking antacids, can improve the condition with a belch, and not with antacids, and therefore can deliberately cause eructations with the hope of reducing the symptoms of the disease.

The appearance of flatulence can be a consequence of various diseases of the digestive tract (eg, aerophagia, nonulcer dyspepsia, gastrostasis, irritable bowel syndrome), as well as disorders not associated with the gastrointestinal tract (eg, myocardial ischemia). However, excessive intestinal gas formation is not directly related to these complaints. In most healthy individuals, 1 l / h of gas can be injected into the gut with minimal symptoms. Probably many of the symptoms are mistakenly attributed to "too much gas accumulation."

On the other hand, some patients with relapsing gastrointestinal symptoms are often intolerant even to small gas accumulations: retrograde enlargement of the colon with air injection or stretching of a balloon inserted into the bowel or insufflation of the air during colonoscopy often causes severe discomfort in some patients (eg, patients with irritable bowel syndrome), but minimal - in others. Similarly, patients with eating disorders (eg, anorexia, bulimia) are often sensitive and particularly stressed when symptoms such as bloating occur. Thus, the main violations in patients with complaints associated with "gas formation", can be caused by too high sensitivity of the intestine. A change in motility can be effective in symptomatic treatment.

Excessive flatus (excessive secretion of gases from the intestine)

There is a large variability in the volume and frequency of the release of gases from the rectum. As with the increase in stools, some people complain of frequent gas emissions, having a misconception about what is the norm. The average number of flatus is approximately 13-21 per day. Objective patient fixation of flatus (patient's use of the diary) is the first step in assessing violations.

Flutus is a by-product of the metabolism of intestinal bacteria; none of the flatuses originate from swallowed air or reverse diffusion of gases (primarily N) from the bloodstream. The metabolism of bacteria leads to the formation of significant volumes of H, methane (CH) and is formed in large quantities after eating certain fruits and vegetables containing hard-to-digest carbohydrates (eg baked beans) and in patients with malabsorption syndromes. In patients with a deficiency of disaccharidase (usually lactase deficiency), large amounts of disaccharides enter the large intestine and are fermented to form N. Gluten disease, sprue, pancreatic insufficiency and other causes of malabsorption of carbohydrates should also be considered as cases of excessive gas formation in the large intestine.

CH is formed by the metabolism of exogenous bacteria (dietary fiber) and endogenous (intestinal mucus) substances in the large intestine; the amount of gas produced depends on the nature of the food. Some people constantly allocate large amounts of CH. The tendency to produce large amounts of gas is hereditary, appearing in infancy and remaining all life.

Also formed in the metabolism of bacteria in the reaction HCO ^_ and H. The source of H can be HCI gastric juice or fatty acids; H is released when digesting fats, and sometimes several hundred meq

Acidic residues formed during bacterial fermentation of unabsorbed carbohydrates in the large intestine can also react with HCO ^_ to form CO ₂. Sometimes, swelling of the intestine may occur, however, rapid absorption of CO ₂ into the bloodstream prevents flatulence.

Food plays a major role in the characteristics of gassing in different people, but some factors that may not be fully understood (eg differences in motility and bacterial flora of the colon) may also be important.

Despite the flammable nature of H and CH ₄, when the gases are released to outside, a nearby open fire is not dangerous. However, there are reports of a gas explosion, even with a fatal result, when performing operations on the small and large intestine, as well as using diathermy in a colonoscopy; while the procedures were performed in patients with insufficient preparation of the intestine.

[19], [20], [21], [22]

Symptoms of flatulence

Symptoms of flatulence - in terms of severity and concomitant factors - depend on the disease that causes this phenomenon.

With problems with the gastrointestinal tract, symptoms of flatulence are manifested, such as:

• feelings of overflow and increased intra-abdominal pressure;
• a feeling of discomfort in the epigastrium;
• abdominal or intestinal swelling;
• Borborigma (rumbling in the abdomen);
• increased flutulence (increase in the frequency and volume of gases released through the rectum);
• eructation;
• nausea;
• diarrhea or constipation;
• stomach ache.

It is worth a little more detail on pain in the abdomen with flatulence. With the accumulation of gases, squeezing and uneven stretching of the intestines occurs, which causes irritation of the parasympathetic pain receptors. They are the ones that transmit signals to the axons of the peripheral nervous system of the spinal cord, and they, in turn, deliver this signal to the brain.

It happens that pain with increased gas formation is felt in the abdomen, and in the chest on the left - as if the heart is aching with angina pectoris. In clinical medicine, such pains are clearly discernible in meteorism associated with the accumulation of gas in the left-sided (spleen) flexure of the colon under the diaphragm itself. By the way, such an anatomical anomaly may appear in those who wear too tight clothes or have problems with posture.

A flatulence and pain in the lower back on the right, in the back and right upper quadrant can occur if there is such a bend of the colon, but already between the diaphragm and the liver.

Diagnosis of flatulence

In patients with complaints of eructations, it is necessary in history to identify the immediate cause of aerophagia, especially associated with nutrition. Complaints of patients on gas formation and bloating require clarification in the history of somatic (organic) causes (especially cardiac causes in patients with risk factors). An eructation with a prolonged anamnesis in young patients without signs of weight loss is unlikely to be caused by a serious physical illness, although it is necessary to presume a possible eating disorder in young women. Older patients, especially when new symptoms appear, deserve a full examination before initiating treatment for increased real or imagined gas formation.

[23], [24], [25], [26], [27], [28], [29]

Physical examination

The examination is rarely informative in patients with eructations or flatus. Patients with complaints of bloating, gas formation and pain in the left side require a more detailed objective assessment of symptoms caused by diseases of the gastrointestinal tract or other pathology.

Study

In the absence of suspicion of a specific somatic etiology, the study is limited. A rare cause can be an extremely rapid bacterial multiplication in the small intestine, diagnosed with the H-respiratory test (hydrogen respiratory test).

Flatulence, which can be the cause of great psychosocial stress, is unofficially described according to its characteristic features: "slider" (type of "crowded elevator"), which is released slowly and silently, sometimes with a detrimental effect; an open sphincter or "fu" type, in which the higher the temperature, the more flatus has a stronger odor; type of staccato or drumbeat, pleasantly passes in solitude; and the type of "barking" (described in a personal message), characterized by a sharp noisy eruption, which can quickly be interrupted (and often ends) when talking. The nature of the smell is not a noticeable feature. Le Petoman - a French meteorist and entertainer - was known for his phenomenal control of the abdominal muscles, which allowed him to control the emission of intestinal gases. He played gas melodies from the rectum on the Moulin Rouge stage.

What kind of doctor should I turn to in flatulence? Clarification of the etiology of this symptom complex, the diagnosis of meteorism, as well as recommendations for treatment are within the competence of gastroenterologists.

First of all, the doctor will thoroughly study the patient's anamnesis, and also find out how and what he eats.

To determine the cause of flatulence, a survey should be conducted, which includes:

• general blood analysis:
• Analysis of urine;
• analysis of feces for helminths;
• physico-chemical and bacteriological study of feces (coprogram);
• analysis of the level of acidity of gastric juice;
• gastroscopy or colonoscopy;
• radiography of abdominal cavity organs;
• Ultrasound of the abdominal cavity and small pelvis.

Treatment of bloating

Belching and flatulence are difficult to reduce, as they are usually caused by unconscious aerophagy or hypersensitivity to the usual accumulation of gas in the intestine. To reduce aerophagia, the patient should avoid habits such as chewing gum or smoking. It is possible to assume diseases of the upper gastrointestinal tract (eg, peptic ulcer), which can cause reflex increased salivation. Carbonated drinks or antacids should be excluded if they are associated with belching. Foods containing non-digestible carbohydrates should be avoided. Dairy products should be excluded from the diet in case of lactose intolerance.

The mechanism of frequent eructation must be explained and proven. If aerophagia is unpleasant for the patient, biofeedback and relaxation therapy can help them learn more efficient swallowing and chewing and change the pathological cycle of aerophagia-discomfort-belching-relief.

Medications are not very effective. The simethicone drug destroys small gas bubbles, and various anticholinergic drugs have not been effective enough. Some patients with dyspepsia and a feeling of postprandial overflow in the upper abdomen often find the effect of using antacids.

Treatment for complaints of increased flatus is aimed at excluding triggering factors. It can be added to the diet of coarse food (eg, bran, flax seed) in order to speed up the passage through the large intestine; However, in some patients, on the contrary, there may be an increase in symptoms. Activated charcoal helps to reduce gas generation and odor, but the property of dirty clothes and mouth mucosa make it undesirable to use. Chlorophyll tablets reduce odor and are better perceived by patients.

Thus, functional bloating, flatulence and flatus indicate an intermittent, chronic course that is only partially treatable. It is important to convince the patient that these manifestations are not harmful to health.

Intoxication

Intoxication is extremely rare. Consumption of zinc within 100-150 mg / day disturbs the metabolism of copper and leads to a decrease in the level of copper in the blood, microcytosis, neutropenia, weakening of immunity. Absorption of large amounts of zinc (200-800 mg / day), usually with the use of foods and drinks stored in galvanized containers, causes vomiting and diarrhea. Fever from metal vapors, also called fever casters or zinc chills, is caused by the inhalation of industrial vapors of zinc oxide; this leads to neurological disorders. Symptoms go 12-24 hours later in a medium without zinc.

How to treat flatulence?

On the question - how to get rid of flatulence and where to begin treatment - any physician will answer: it is necessary to eat right, cure diseases of the gastrointestinal tract, to establish the normal functioning of the digestive system, including the intestine. This requires combined etiotropic and pathogenetic therapy.

But flatulence is most often treated with symptomatic medications, trying to reduce the excessive formation of gases and, if possible, prevent it.

How to treat flatulence? Restricting some products and taking drugs: sorbents, suppress gassing defoamers and accelerating the evacuation of gases from the intestine carminative means.

Reduce the intensity of gas formation and bloating can be, taking the most popular adsorbent - activated-charcoal tablets. But it has the property of absorbing not only harmful substances, but vitamins, minerals and useful intestinal microbes necessary for the body.

Smecta - dioctahedral smectite (double silicate of magnesium and aluminum) - is used as a symptomatic agent for chronic diarrhea, has absorbing properties. Dose for an adult - 2-3 packets of powder (for the preparation of a suspension) per day, and the recommended duration of treatment is no more than 7 days. Among the side effects of Smecta there are constipation, vomiting and ... Flatulence.

The adsorbent also includes the preparation Polyphepan (tablets 375 mg containing hydrolytic lignin), which is recommended for use in diseases of the digestive tract, the symptoms of which are diarrhea and flatulence. Tablets are taken orally (1-1.5 hours before meals); for adults, the daily dose is 12-16 tablets; with chronic pathologies, the procedure is performed for 10-15 days with interruptions of 7-10 days. As a rule, Polyphepan is well tolerated and does not lead to dysbacteriosis. However, it is contraindicated to take patients with an anatomic gastritis, intestinal atony and in case of an exacerbation of stomach and duodenum ulcers.

The drug Almagel (other trade names - Alumag, Maalox, Gestid, Gastal, Palmagel) contains aluminum and magnesium hydroxides, which neutralize the hydrochloric acid of gastric juice. This drug is used in the treatment of gastrointestinal diseases associated with high acidity of gastric juice. In addition, due to the content of benzocaine, it acts as a local anesthetic for gastric pain; has an adsorbent, laxative and choleretic effect. Almagel is prescribed to adults for 1-2 teaspoons 4 times a day (half an hour before meals and at bedtime). The course of treatment is 10-12 days.

Among the antimicrobial medications antiseptic medicines are given (and most often recommended) by Simethicone (trade names - Espumizan, Simecon, Espuzin, Alverin, Pepfiz, Sab simplex, Disfatil, Colicides, Meteospazmil, Bobotik) - in the form of emulsion, suspension and capsules. The therapeutic action of this agent is based on the silicone polymer polydimethylsiloxane, which is a surfactant (surfactant). It breaks the bubbles of accumulated gases in the intestine, and they are freely absorbed through the mucous membranes of the intestines or are eliminated from the body during defecation. Dosage of the drug for adults: 1-2 capsules, or 1-2 teaspoons of emulsion, or 25-50 drops of the suspension for one dose (after eating, squeezed with water); Take should be 3 to 5 times during the day.

Severe flatulence after eating, many doctors offer to treat with Motilium, which refers to drugs that stimulate intestinal motility and stop vomiting, as well as reducing eructations and bloating in the abdomen. A rapidly dissolving tablet of the drug should be put on the tongue and, without washing down, swallow. The active substance Motilium - domperidone - acts as an antipsychotic agent (neuroleptic), and its side effect is expressed in the enhancement of pituitary hormone prolactin production, so that unwanted neuroendocrine effects are possible: galactorrhea, gynecomastia, amenorrhea. In the presence of problems with the liver, kidneys, cardiovascular system, as well as during pregnancy, this drug is contraindicated.

Finally, flatulence and rumbling in the abdomen are successfully treated with carminative medicinal plants: infusions and broths of chamomile, dill, fennel or caraway. In the famous medieval medical treatise "Salerno Health Code" you can read the following: "Gases accumulate outwards from the fennel seed." And today, fruits and essential oil of fennel (a relative of dill) are widely used in flatulence - in the form of dill water and infusions. To prepare medicinal infusion it is necessary to take 2 tablespoons of seeds, brew a glass of steep boiling water, cover the container with a lid and insist for at least 60 minutes. During the day, drink infusion several times 50 ml.

Exercises with flatulence

Those who like to lie down after a dense dinner, doctors warn: you can "lie down" a lot of problems with the intestines, including flatulence. And those who want to improve their well-being, are advised to perform the following exercises daily with flatulence.

• Lie on your back, legs bend at the knees, raise them above the floor and "twist the pedals" of an imaginary bicycle - for 20 seconds three times with interruptions in a few seconds.
• Stay in the supine position on the back, legs bend at the knees and put them on the width of the shoulders, straight arms extend along the body. Leaning against the feet and shoulder blades, raise the pelvis from the floor, remain in this position at the expense of 1-2-3-4, and then slowly fall into the starting position. The number of repetitions is 10.
• Lie on your stomach; Straight legs in the knees and feet are pressed together; The arms bent at the elbows are located along the chest. Raise the body from the floor, leaning on the palms of straightened hands, bend your back, throwing your head back. Remain in this position for 5 seconds, then smoothly return to its original position. The number of repetitions is 10.
• Stand upright, put your feet at the width of your shoulders, your bent hands, locked together "in the lock" to raise your head. The inspiration is carried forward (not bending the legs in the knees), on exhalation - straightening with the deflection back. The number of repetitions is 8-12.
• The starting position, as in the previous exercise, but hands on the waist. At the expense of 1 - raise your hands up, at the expense of 2-3 to perform a spring-tilt forward with the touch of the floor with your fingers. On account 4 - return to the original position. The number of repetitions is 8-10.

[30], [31], [32], [33]

Products with flatulence: what can and can not be eaten?

Part of what you can not eat with flatulence, has already been named above (see Causes of Flatulence), but we will once again list products that enhance gas formation.

This is bread made from rye flour and fresh white bread (as well as all baked pastries); all legumes (beans, beans, peas, lentils); Millet, oats, pearl barley and semolina; fatty meat, all sweets (except for natural honey); whole milk (including dry milk): pasta; all fizzy drinks.

Vegetables with flatulence, causing gassing: cabbage (white, colored, Brussels, broccoli), potatoes, corn, raw onions, radish, radish, cucumbers, pepper, spinach, asparagus, artichokes.

Fruits with flatulence, contributing to increased flutulenium: pears, apples, apricots, peaches, grapes, cherries, gooseberries, figs, dates, prunes.

In addition, nutritionists say that some products with flatulence simply can not be combined with each other, so as not to increase gas formation in the intestine. For example, it is not necessary to mix dairy products with anything, at the same time there are grain products and sour fruits and berries, any raw vegetables need not be mixed with any fruits, and potatoes should be used as a garnish for meat.

The logical question arises: what can you eat with flatulence? Everything, except that which is impossible. That is, you can sour milk products, cheese, cottage cheese, crumbly cereal side dishes (buckwheat, rice), chicken eggs, boiled or stewed vegetables and lean meat, fruit and berry juices, vegetable and butter, wheat bread is better stale or dried.

Prophylaxis of flatulence

Prophylaxis of flatulence includes several items, namely:

1. It is necessary to eat properly (see Products under meteorism).
2. Do not allow intestinal dysbacteriosis (systematically eat foods with probiotics Lactobacillus and Bifidobacterium).
3. Treat existing pathologies of the gastrointestinal tract.
4. Maintain physical activity in any form - walking, cycling, swimming, jogging and, of course, daily exercise (see Exercises for flatulence).

And in conclusion, take note of the conspiracy of flatulence, which should be done at dawn or at sunset.

In a large vessel you need to pour holy water and throw a pinch of salt into it; cook clean cutlery - a spoon, a fork and knife, a church candle, a sheet of white paper and an empty glass jar. The patient should sit next to him.

Next, you should light a candle, from it, set fire to the paper and while it burns, read the prayer "Our Father". After that, the burning paper should be put in an empty jar and, turning it over, put in a container of water.

The following actions: a vessel with a jar is taken to the left hand and is held over the belly of the person who is being talked, reads the words of the plot from the flatulence and simultaneously crosses the water - with a knife, fork and spoon - in turn. After the consummation of the conspiracy, it is necessary for the patient to breathe several times over the reservoir.

The words of the conspiracy should be pronounced only once: "The lone-night-owl is brewed, bitten from the bones, from the relics, from the veins, from the half-dead, from the white body, from the red blood, from the zealous heart, from the violent head. Do not be in a white body, in red blood, in a violent head, do not get sick, do not stab, do not swell. I do not pronounce it, but I summon the twelve apostles and all the saints. Save, O Lord, save, O Lord, hide, protect from all tribulations and diseases, from the midnight snot. Amen".