Bloating, Belching –Bowel Sounds Podcast with Dr. Jose Garza

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A recent episode of Bowel Sounds Podcast with my colleague Dr. Jose Garza was terrific. I scribbled a few notes afterwards but I usually listen while on a ride to an outreach clinic. So, there may be errors in omission, and in transcription.

Here’s the link: buzzsprout.com/581062/15556601

Key points:

  • Toddlers frequently have aerophagia and asymptomatic bloating
  • Nitrogen gas needs to be expelled from GI tract
  • Bloating symptoms can occur with and without distention
  • Bloating without other symptoms usually does not require an extensive workup.  Bloating with diarrhea could indicate malabsorption
  • Bloating symptoms can worsen due to constipation
  • Chronic symptoms are usually reassuring; acute changes are more concerning
  • Intermittent distention is less concerning than persistent distention
  • Abdomino-phrenic dyssynergia occurs when the diaphragm pushes down on the abdomen and results in distention (see reference below)
  • Bloating symptoms frequently occur in those with only a small amount of excess air (less than 1 oz).  There is often a degree of hypersensitivity. 
  • Treatments for bloating could include diaphragmatic breathing, peppermint products, neuromodulators and sometimes diet.  Diets can result in adverse effects including eating disorders, nutrient deficiencies, and cost
  • SIBO is over diagnosed in those without risk factors
  • pH-Impedance study, read manually, is a good test for belching: differentiates aerophagia, supragastric belching, and gastric belching
  • The podcast reviewed the inability to burp due to rRetrograde cricopharyngeus dysfunction (see prior post: Jose Garza: What’s New in Motility (Part 2))

Dr. Garza also previously did a Bowel Sounds Podcast on Why Kids Poop Their Pants

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