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Pediatrics - Gas and Bloating 

Introduction

Gas symptoms occur daily as part of your child’s normal digestive process.  Belching, burping, and passing gas (flatulence) eliminates gas from your child’s digestive tract.  Excess gas can cause discomfort, pain, and bloating.

Gas symptoms are produced by swallowed air and the breakdown of certain foods by bacteria in the digestive system.  In some cases, gas and bloating can be symptoms of gastrointestinal (GI) disorders.  Treatment depends on the cause of the gas symptoms.  Treatments may include dietary changes, changing how your child eats, and medications.  Underlying medical conditions may require more specific treatments.

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Anatomy
Whenever your child eats and drinks, food travels through his or her digestive system for processing.  Your child’s body absorbs nutrients and removes waste products via his or her digestive system.  When your child eats, your child’s tongue moves chewed food to the back of the throat.  When your child swallows, the food moves into the opening of the esophagus.  The esophagus is a tube that moves food from the throat to the stomach.
 
Your child’s stomach produces acids to break down food for digestion.  Your child’s stomach processes food into a liquid form.  The processed liquid travels from your child’s stomach to his or her small intestine.  The liquid solidifies as it moves through the large intestine, forming a stool.  The stool is eliminated from your child’s body when he or she has a bowel movement.

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Causes
Gas and bloating is very common.  It typically results from two sources, swallowed air and the breakdown of foods by bacteria in the digestive system.  Gas and bloating may also be symptoms of certain gastrointestinal (GI) conditions.
 
Air swallowing causes stomach gas.  Your child naturally swallows some air when he or she eats and drinks.  However, smoking, chewing gum, and eating or drinking too quickly may cause your child to swallow too much air.  Most of the extra air leaves the stomach when your child burps or belches.  A small portion of the extra air travels through the digestive system and is released as gas.
 
Gas and bloating may result if your child’s body does not digest and absorb certain food components in his or her small intestine.  Some people lack or have a shortage of enzymes that are necessary to digest carbohydrates.  Carbohydrates include sugar, starch, and fiber found in many foods.  The undigested carbohydrates travel to the large intestine where they are broken down by harmless bacteria.  This process can result in gas and bloating.
 
The carbohydrates that produce gas and bloating in one person may not cause symptoms in another person.  Sugars with the greatest potential to cause gas include raffinose, lactose, fructose, and sorbitol.  Some foods contain more than one of these types of sugars.  Beans contain a large amount of raffinose.  Other foods with raffinose include cabbage, brussels sprouts, broccoli, other vegetables, and whole grains.  Lactose is contained in milk and milk products, such as ice cream and cheese.  It is also a component of processed foods including cereal and salad dressings.  Tree fruits, berries, honey, onions, some vegetables, and wheat contain fructose.  Fructose is used as a sweetener in soda pop and fruit drinks.  Sorbitol is found in tree fruits.  It is used as a sweetener in diet foods and sugar-free candies. 
 
Some starchy foods produce gas when they are broken down in the stomach.  Such foods include potatoes, corn, noodles, and wheat products.  Additionally, foods containing soluble fiber do not break down until they reach the large intestine.  Soluble fiber is found in oat bran, beans, peas, and most fruits. 
 
Eating high-fat food products can cause bloating and discomfort, with lesser amounts of gas.  Fatty foods can slow or delay stomach emptying.  This can lead to the accumulation of gas, upper abdominal pressure, nausea or vomiting.
 
Chronic belching can be a symptom of certain medical conditions.  Some upper GI disorders can cause an overproduction of stomach gas, which results in belching and burping.  Peptic ulcer disease, gastroesophageal reflux disease (GERD), hiatal hernia, and gastroparesis (slow stomach emptying) are some upper GI disorders that can cause belching. 
 
Gas and bloating can be the symptom of certain lower GI disorders.  Some lower GI disorders can cause inflammation or increased sensitivity in the colon, making gas especially uncomfortable.  Irritable bowel syndrome (IBS), Inflammatory Bowel Disease, colon cancer, chronic constipation, and celiac sprue are some lower GI conditions that can result in gas and bloating.

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Symptoms
Gas symptoms occur daily as part of your child’s normal digestive process.  However, excessive gas symptoms may also be caused by certain medical conditions.  Belching, burping, and passing gas eliminates gas from your digestive tract.  Excess gas can cause discomfort, pain, and bloating.  Sometimes gas may have a bad odor.

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Diagnosis
Your doctor can diagnose the cause of your child’s gas symptoms and determine appropriate treatment.  To diagnose the cause of your child’s gas symptoms, your doctor will review your child’s medical history and conduct a physical examination.  Tell your doctor about your child’s dietary habits, symptoms, and any changes in your child’s bowel habits.  Your doctor may ask you to keep a journal of the food that your child eats and the symptoms your child experiences.  Depending on your child’s symptoms and risk factors, your doctor may order blood, stool, or imaging tests to identify or rule out gastrointestinal conditions that may cause your child’s symptoms.

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Treatment
Treatment for gas, belching, and bloating depends on what is causing the excess gas.  Changes in how your child eats and what your child eats may help. Your child can reduce the amount of air that he or she swallows by not smoking, not chewing gum, and eating and drinking slower.  It may help to limit or avoid the foods that cause gas.  Over-the-counter digestive enzymes may help digest carbohydrates and allow your child to eat certain foods that normally cause gas.  Additionally, over-the-counter antacid medications can help remove gas from your child’s digestive tract.
 
The treatment for upper and lower GI conditions depends on the condition type, extent of the condition, and magnitude of your child’s symptoms.  Upper and lower GI conditions can be treated in a variety of ways including lifestyle changes, dietary changes, medications, and surgery.  Your doctor will discuss appropriate treatment options with you if your child is diagnosed with a GI disorder.

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Prevention
Your child can avoid gas by avoiding or limiting foods that cause gas symptoms.  Food triggers are different for everyone.  Your child may also use over-the-counter digestive enzymes to allow him or her to eat foods that normally cause you gas.  It is also helpful to eat and drink slowly to avoid swallowing air.  Further, it is helpful to avoid smoking, chewing gum, and eating hard candies.

You should contact your doctor if your child experiences excessive gas or pain.  You should contact your doctor if your child has changes in his or her bowel habits, bloody stools, black tarry stools, or vomits blood.  These can be signs of digestive system disorders and need your doctor’s prompt attention.

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Am I at Risk

Is My Child at Risk?

Anyone can experience gas, bloating, and belching.  It commonly occurs to everyone, everyday.  However, for some people gas, bloating, and belching may happen quite frequently and be bothersome or uncomfortable. 

Factors associated with gas, bloating, and belching:

_____ Swallowing air can cause stomach pain, burping, and belching.  Smoking, chewing gum, and eating or drinking too quickly may cause your child to swallow too much air.
_____ If your child lacks digestive enzymes in his or her small intestine, your child may be unable to digest certain types of carbohydrates.  Food intolerance can cause gas and bloating.
_____ Some starchy foods, high-fiber foods, and high-fat foods can cause gas in certain people.
_____ Belching and burping can be symptoms of some upper GI disorders.
_____ Bloating and gas can be symptoms of some lower GI disorders.

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Complications
Gas, belching, and bloating are a normal part of the digestive process and are not life-threatening symptoms.  In some cases, excess gas production can be the symptom of a serious GI condition.  You should tell your doctor about your child’s symptoms and discuss your concerns. 

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.