Gas

While looking for a handout for a patient I came across a fantastic summary about gas in the digestive tract. Gas can be a huge source of distress since there are only two points of exit for gas (upper and lower).

Points to Remember

•    Gas is air in the digestive tract.

•    Everyone has gas. However, many people think they pass gas too often and that they have too much gas. Having too much gas is rare.

•    Gas in the digestive tract is usually caused by swallowing air and by the breakdown of certain foods in the large intestine by bacteria.

•    Most foods that contain carbohydrates can cause gas. In contrast, fats and proteins cause little gas.

•    Foods that produce gas in one person may not cause gas for someone else.

•    The most common symptoms of gas are burping, passing gas, bloating, and abdominal pain or discomfort.

Gas can be treated by reducing swallowed air, making dietary changes, or taking over-the-counter or prescription medications.

Burping, or belching, once in a while, especially during and after meals, is normal. However, people who burp frequently may be swallowing too much air and releasing it before the air enters the stomach. Passing gas around 13 to 21 times a day is normal.

People’s eating habits and diet affect the amount of gas they have. For example, eating and drinking too fast may increase the amount of air swallowed, and foods that contain carbohydrates may cause some people to have more gas. Tracking eating habits and symptoms can help identify the foods that cause more gas. Avoiding or eating less of these foods may help reduce gas symptoms.

Breakfast Like A King

“Eat breakfast like a king, lunch like prince and dinner like a pauper” is an old nutrition tip that we should remember. You are better off consuming calories early in the day, when you need them. Weight control appears to be related to when you eat – the same number of calories per day eaten late at night can pack on the pounds. A lot of people don’t feel hungry for breakfast because they are eating too much at night. Eating at night can also disturb sleep patterns – and disordered sleep is also associated with obesity.

 Most people eat very little protein at breakfast, have some with lunch and eat the majority of their protein at dinner. Eating protein with every meal will help maintain energy levels during the day and help with muscle protein synthesis. A protein rich breakfast will provide essential fuel to the brain and muscles in the morning.

Adding a fruit or vegetable to every meal is an easy way to improve nutrient intake. Stay away from juices since the fiber in the fruits and vegetables will aid digestion.

 Small changes can make a big difference.

Magnesium

The blood magnesium concentration is not usually measured as part of routine blood tests and is ordered when there is a clinical suspicion that the level might be too high or too low. Common reasons to check for a low magnesium level would be chronic diarrhea, alcoholism, diuretic use or chronic protein pump inhibitor for reflux/heartburn/peptic ulcer disease. Less common manifestations of low magnesium would be unexplained low blood potassium, low blood calcium or cardiac arrhythmias.

Patients with severely low magnesium levels should receive intravenous therapy with cardiac monitoring. Oral replacement is appropriate for an asymptomatic patient.

Magnesium is excreted by the kidneys and can rise to toxic levels in renal failure. The body’s reserve of magnesium is stored in the bones but the high levels of magnesium in renal failure is due to dietary magnesium, usually from medications such as antacids or laxatives in usual doses. Patients with renal impairment should not take over the counter medications that contain magnesium.

Medical Trivia: Extremely high blood magnesium in conjunction with very high blood calcium is seen as a unique feature of Dead Sea water poisoning since the Dead Sea contains very high concentrations of both magnesium and calcium.