Symptom Finder - Meteorism
METEORISM
This is the accumulation of gas in the intestines causing distention. The mnemonic VINDICATE lends itself well to facilitate the recall of most of the possible causes.
V—Vascular would prompt the recall of mesenteric thrombosis or embolism. Aortic aneurysms may precipitate bouts of meteorism by causing mesenteric vascular insufficiency.
I—Inflammatory conditions cause meteorism, most notably peritonitis and pancreatitis. However, lobar pneumonia, typhoid, fever, and dysentery should not be forgotten.
N—Neurologic conditions such as transverse myelitis, spinal cord trauma, and anterior spinal artery occlusion may cause meteorism. Conversion hysteria may present with pseudopregnancy and phantom tumors.
D—Degenerative conditions of the intestinal tract or nervous system do not usually cause distention until late in their course.
I—Intoxication should bring to mind the many parasympatholytic drugs (i.e., Pro-Banthine) that cause paralytic ileus.
C—Congenital conditions that may cause this symptom are Hirschsprung disease and malrotation.
A—Allergy would suggest food allergies such as sensitivity to chocolate, peanuts, and so forth. Autoimmune conditions such as granulomatous colitis and ulcerative colitis may produce meteorism.
T—Trauma to the spinal cord has already been mentioned, but penetrating wounds, contusions, and intraperitoneal bleeding may cause meteorism.
E—Endocrine disorders such as myxedema may cause gaseous distention
of the bowel.
Approach to the Diagnosis
A flat plate of the abdomen, chest x-ray, and routine laboratory tests including a CBC; sedimentation rate; chemistry panel; serum amylase and lipase; and stool for occult blood, ovum, and parasites may be indicated depending on the clinical picture. A general surgeon or gastroenterologist may need to be consulted in the acute cases. CT scans, ultrasonography, or contrast radiography may be necessary before the diagnosis can be certain. An exploratory laparotomy is occasionally the only way to pin down the diagnosis.
Other Useful Tests
1. Quantitative stool fat (malabsorption syndrome)
2. Thyroid panel (myxedema)
3. MRI of the thoracolumbar spine (spinal cord trauma, transverse
myelitis)
4. Peritoneal taps (intraperitoneal hemorrhage, peritonitis)
This is the accumulation of gas in the intestines causing distention. The mnemonic VINDICATE lends itself well to facilitate the recall of most of the possible causes.
V—Vascular would prompt the recall of mesenteric thrombosis or embolism. Aortic aneurysms may precipitate bouts of meteorism by causing mesenteric vascular insufficiency.
I—Inflammatory conditions cause meteorism, most notably peritonitis and pancreatitis. However, lobar pneumonia, typhoid, fever, and dysentery should not be forgotten.
N—Neurologic conditions such as transverse myelitis, spinal cord trauma, and anterior spinal artery occlusion may cause meteorism. Conversion hysteria may present with pseudopregnancy and phantom tumors.
D—Degenerative conditions of the intestinal tract or nervous system do not usually cause distention until late in their course.
I—Intoxication should bring to mind the many parasympatholytic drugs (i.e., Pro-Banthine) that cause paralytic ileus.
C—Congenital conditions that may cause this symptom are Hirschsprung disease and malrotation.
A—Allergy would suggest food allergies such as sensitivity to chocolate, peanuts, and so forth. Autoimmune conditions such as granulomatous colitis and ulcerative colitis may produce meteorism.
T—Trauma to the spinal cord has already been mentioned, but penetrating wounds, contusions, and intraperitoneal bleeding may cause meteorism.
E—Endocrine disorders such as myxedema may cause gaseous distention
of the bowel.
Approach to the Diagnosis
A flat plate of the abdomen, chest x-ray, and routine laboratory tests including a CBC; sedimentation rate; chemistry panel; serum amylase and lipase; and stool for occult blood, ovum, and parasites may be indicated depending on the clinical picture. A general surgeon or gastroenterologist may need to be consulted in the acute cases. CT scans, ultrasonography, or contrast radiography may be necessary before the diagnosis can be certain. An exploratory laparotomy is occasionally the only way to pin down the diagnosis.
Other Useful Tests
1. Quantitative stool fat (malabsorption syndrome)
2. Thyroid panel (myxedema)
3. MRI of the thoracolumbar spine (spinal cord trauma, transverse
myelitis)
4. Peritoneal taps (intraperitoneal hemorrhage, peritonitis)
