RESUMO
OBJECTIVE: To describe an adolescent with pathologic aerophagia, a rare condition caused by excessive and inappropriate swallowing of air and to review its treatment and differential diagnoses. CASE DESCRIPTION: An 11 year-old mentally impaired blind girl presenting serious behavior problems and severe developmental delay with abdominal distension from the last 8 months. Her past history included a Nissen fundoplication. Abdominal CT and abdominal radiographs showed diffuse gas distension of the small bowel and colon. Hirschsprung's disease was excluded. The distention was minimal at the moment the child awoke and maximal at evening, and persisted after control of constipation. Audible repetitive and frequent movements of air swallowing were observed. The diagnosis of pathologic aerophagia associated to obsessive compulsive disorder and developmental delay was made, but pharmacological treatment was unsuccessful. The patient was submitted to an endoscopic gastrostomy, permanently opened and elevated relative to the stomach. The distention was resolved, while maintaining oral nutrition COMMENTS: Pathologic aerophagia is a rare self-limiting condition in normal children exposed to high levels of stress and may be a persisting problem in children with psychiatric or neurologic disease. In this last group, the disease may cause serious complications. Pharmacological and behavioral treatments are ill-defined. Severe cases may demand surgical strategies, mainly decompressive gastrostomy.
Assuntos
Abdome/patologia , Aerofagia/complicações , Criança , Doença Crônica , Dilatação Patológica/etiologia , Feminino , HumanosRESUMO
In the present paper, the author reminds investigations performed, since forty-four years ago, to clarify the etiopathogenesis and to improve the diagnosis and treatment of the flatulence syndrome.
Assuntos
Flatulência/etiologia , Aerofagia/complicações , Sintomas Afetivos/complicações , Bismuto/uso terapêutico , Fermentação , Flatulência/diagnóstico , Flatulência/tratamento farmacológico , Flatulência/psicologia , Humanos , Mucosa Intestinal/metabolismo , Intestinos/microbiologia , Metronidazol/uso terapêutico , Compostos Organometálicos/uso terapêutico , Salicilatos/uso terapêuticoRESUMO
Now we expose important data on definition and cardinal symptoms of the flatulence syndrome and, besides, on accumulated knowledge in relation to digestive tract gases.
Assuntos
Flatulência , Aerofagia/complicações , Eructação/etiologia , Eructação/fisiopatologia , Fermentação , Flatulência/etiologia , Flatulência/microbiologia , Flatulência/fisiopatologia , Gases , Humanos , Intestinos/microbiologia , SíndromeRESUMO
At present physicians focus their medicine studies in well defined illnesses as peptic ulcer, gastric cancer, ulcerative colitis and so on. However, patients reveal their discomfort to us, that is their symptoms or group of symptoms (syndromes). For this reason, our concern for many years has been the study of symptoms and syndromes. In this review we will be looking at the concepts and information gathered with respect to intestinal gases, clinically known as flatulence.