Can Passage of air per- rectum/ Flatulence be due to any disease?

Gas causing flatulence is an uncomfortable and really an embarrassing experience, especially when it makes a bad smell or a sound.  The term flatulence is used to describe belching, abdominal distension, gurgling and the passage of flatus per rectum. But this article mainly focuses on passage of gas per rectum as it is very embarrassing.

The rectal flatus consists of,

• Nitrogen
• carbon dioxide
• hydrogen
• methane.

Almost all of us pass gas through rectum every day.  Passing gas 20 times a day is normal and not due to any pathological condition.

How Gas is Produced

Gas we pass is from two different sources.

1. People swallow air involuntarily during eating. Usually this swallowed air is absorbed in to the body through the intestinal wall, but sometimes some of this air may still remain and travel all the way to the rectum to be passed per-rectally.
2. Part from above, the bacteria who reside in the intestines can also produce a small amount of gas by degradation of food particles.  These are also passed through the rectum. 

 

What are the disease conditions associated with flatulence?

Small intestinal growth of bacteria – Normal small intestine does not have any bacteria. The small intestine contains a lot of undigested food. As I mentioned above, gas can be produced by bacterial break down of food. If the bacteria get a chance to multiply in the small intestine, they get a chance to act on those foods before they are digested and absorbed. Therefore, a lot of gas is produced.

Lactose intolerance – This is a condition in which the intestine lacks the enzymes required for the digestion of lactose. Lactose is present in diary products and once the person eats those foods the lactose remains undigested. This gives a chance for the bacteria to act on it and produce gas.

References: Kumar and Clark’s Clinical Medicine

 Natural Relief from Constipation

Normal Glucose Metabolism in the Body

The body in a way is like a machine. As all machine need fuel in order to function, our body also needs fuel. So, what is the fuel to the body? There are several energy sources to the body. They are,

• Glucose
• Fat
• Proteins

Among these energy sources, glucose plays a major role, since it is the only energy source for red blood cells, and an essential energy source for the brain. In diabetes glucose metabolism is affected mainly.

We gain these fuels from our food. Once absorbed from the gut, first these molecules are transported to the liver, which is one of the major metabolic organs in our body. In the liver some are metabolized and some are converted to other storage forms.

As we are mainly considering about glucose, we’ll see what happens to glucose. Once absorbed from the gut, glucose is taken to the liver. In the liver, most of these molecules are metabolized. It means that it is burned mainly through glycolysis. This is one place where insulin comes in to action.

Some are converted to the storage form, glycogen. The rest is released again in to the circulation, by which glucose is transported though out the body. The glucose concentration in the blood should be kept with in an optimal range, unless it will lead to many problems.

 Then glucose is taken up into almost all of the cells in the body. Skeleton muscle cells and adipose tissue cells (fat cells) are two of such important cells, which play major roles in regulating the blood glucose levels. The uptake of glucose into these cells is also tightly regulated by insulin.

In this way, glucose concentration in the body is tightly regulated by insulin. Any derangement in insulin production or its action gives rise to diabetes.

If you have any query, just leave it on comments, I am always looking forward to answer them all.

You may also find more information on following. If there is anything that you don't understand in them, Always fell free to ask me.

Role of Insulin

Insulin secretion or its action is affected in Diabetes Mellitus. It is the hormone that is responsible in regulating the blood glucose level. The blood glucose level rises when glucose is absorbed from the gut after a meal.

The pancreas detects the rise in glucose level. Pancreas is the organ involved in secreting insulin. There are special groups of cells in pancreas called islets of Langerhan. These islets have two kinds of cells, alpha and beta, secreting glucagon and insulin respectively. Both hormones are involved in regulating the blood glucose level.

When the pancreas detects the rise in blood glucose, beta cells start secreting insulin. Insulin goes and acts on several organs and stimulates activities that reduce blood glucose level and inhibit activities that increase blood glucose level.

It acts by binding with insulin receptors that are situated in cell surface. Then cascades of events that are involved in intracellular signal transduction take place.

Liver is one of the major organs, on which insulin acts on. Insulin stimulates rapid removal of glucose from the circulation, by stimulating intracellular breakdown of glucose and inhibits gluconeogenesis (production of glucose from other molecules). Insulin also acts on skeletal muscle and adipose tissue to increase glucose uptake from the circulation. It stimulates lipogenesis in adipose tissues.

All the above reactions lead to rapid removal of glucose from the circulation and thereby reducing the blood glucose level. Therefore, any defect in insulin secretion or its action leads to increased blood glucose levels.

If you have any query, just leave it on comments, I am always looking forward to answer them all.

What will Happen after Surgery? What are the Complictions that can occur?

Surgery is a scary thing for most of people who undergo surgery. From the day you were told that you have to undergo surgery, thousands of questions will come in to your mind.

• What will they do to me during the surgery?
• What will happen to me during and after surgery?
• Will the surgery be successful?
• Will I be as normal as before?
• Will I be OK?
• Will I gain consciousness back again?

For many people get positive answers to above questions as most of the surgeries is a success thanks to the advancement of medical knowledge as well as the skills of the surgeons. 

There are many complications associated with surgery, but don’t be afraid, because the doctors are clever enough to manage them very well. The aim of this article is not to scare people. It is to give people a clear idea about what will happen to them after surgery. 

I will more stress on complications, but stressing the fact that most of these complications are rare and even they did arise, most are managed well. The complications also may vary according the type of surgery, the health status of the patient, the facilities available and the skills of the surgeon.

What will Happen Immediately after Surgery?

After the surgery is over you will be transferred to a place called recovery room. At this time you still might be unconscious or might be starting to gain consciousness. There you will be managed by anaesthetics, who will monitor you and help you to regain consciousness. There they will be keep a close eye on you to make sure that you will not develop any complications. They will monitor your blood pressure, heart rate, respiratory rate, etc. 

Problems that could occur can be in any of the following systems.

• Respiratory System
• Cardiovascular System
• Central Nervous System
• Gastrointestinal System
• Liver Problems
• Renal Problems

 

 Respiratory problems that can arise immediately after surgery

Respiratory problems are very common immediately following surgery. This is mainly due to two reasons.

• Due to anaesthesia – Anaesthesia is used to make the person unconscious during surgery or to make a certain part of the body insensitive to external stimuli, so person will not feel pain or any discomfort. Most of these anaesthesia are respiratory depressants. That means that they reduce the rate and depth of the respiration. They also diminish protective airway reflexes like cough and sneeze reflex putting the airway into danger.

Anaestheic procedure in general anaesthesia where the patient is kept totally unconscious also includes inserting various instruments (endotracheal tube) into the airway. These procedures can also harm the respirator tract.   

• The site of surgery also play role in producing the respiratory problems.

The problems that can occur are listed below.

Airway obstruction –

The obstruction could be either inn upper airway or lower airway.

Causes for upper airway obstruction–

1.      Tongue falling back – This is because the upper airway muscle tone is diminished in an unconscious person. As the airway is obstructed, the air cannot reach the lungs. If this happens you will be put in a semiprone position with the head tilted and the chin lifted. They may also put an artificial airway. These techniques are well enough to solve the problem. Therefore you won’t even notice that there was a problem.

2.      Laryngeal spasm – As I mentioned earlier the anaesthetic procedure involves instrumentation of the airway. These instruments can damage the airway. This can lead to bleeding. These factors irritate which cause spasms. This causes reflex closure of the vocal codes. The obstruction could be complete or partial. If it is the later, there will be noisy breathing. This is managed by clearing the secretions by suction and mask ventilation by 100% oxygen.

3.      Laryngeal oedema

4.      Vocal cord paralysis

5.      Heamatoma formation

6.      Tracheomalacia

Cause for lower airway obstruction –

1.      Bronchospasms

2.      Pulmonary aspiration

Other respiratory problems -

1.      Pneumothorax

2.      Pulmonary oedema

3.      Pulmonary embolism

4.      Hypoventilation

5.      Post operative hypoxaemia

What are the cardiovascular complications that could occur after surgery?

1.      Hypotension

2.      Hypertension

3.      Cardiac arrhythmias

What are the neurological complications that could occur after surgery?

1.      Prolonged unconsciousness

2.      Restlessness

3.      Confusion

What are the gastrointestinal complications that could occur after surgery?

1.      Nausea

2.      Vomiting

What are the liver complications that could occur after surgery?

1.      Jaundice

2.      Viral hepatitis

3.      Sepsis

4.      Fulminant hepatic failure

What are the renal complications that could occur after surgery?

1.      Oliguria

Apart from above complications, the patient might have temperature abnormalities, and anaphylaxis

1.