Flatulence - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

FLATULENCE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

ii

ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Flatulence: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84424-0 1. Flatulence-Popular works.I. Title.

iii

Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

iv

Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on flatulence. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

v

About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

vi

About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

vii

Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON FLATULENCE ............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Flatulence.................................................................................... 14 The National Library of Medicine: PubMed ................................................................................ 15 CHAPTER 2. NUTRITION AND FLATULENCE ................................................................................... 25 Overview...................................................................................................................................... 25 Finding Nutrition Studies on Flatulence..................................................................................... 25 Federal Resources on Nutrition ................................................................................................... 26 Additional Web Resources ........................................................................................................... 27 CHAPTER 3. ALTERNATIVE MEDICINE AND FLATULENCE ............................................................. 29 Overview...................................................................................................................................... 29 National Center for Complementary and Alternative Medicine.................................................. 29 Additional Web Resources ........................................................................................................... 34 General References ....................................................................................................................... 38 CHAPTER 4. PATENTS ON FLATULENCE ......................................................................................... 39 Overview...................................................................................................................................... 39 Patents on Flatulence................................................................................................................... 39 Patent Applications on Flatulence ............................................................................................... 53 Keeping Current .......................................................................................................................... 55 CHAPTER 5. BOOKS ON FLATULENCE ............................................................................................. 57 Overview...................................................................................................................................... 57 Book Summaries: Federal Agencies.............................................................................................. 57 Book Summaries: Online Booksellers........................................................................................... 58 The National Library of Medicine Book Index ............................................................................. 58 Chapters on Flatulence................................................................................................................. 58 CHAPTER 6. MULTIMEDIA ON FLATULENCE .................................................................................. 61 Overview...................................................................................................................................... 61 Video Recordings ......................................................................................................................... 61 CHAPTER 7. PERIODICALS AND NEWS ON FLATULENCE ............................................................... 65 Overview...................................................................................................................................... 65 News Services and Press Releases................................................................................................ 65 Newsletter Articles ...................................................................................................................... 67 Academic Periodicals covering Flatulence ................................................................................... 67 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 71 Overview...................................................................................................................................... 71 NIH Guidelines............................................................................................................................ 71 NIH Databases............................................................................................................................. 73 Other Commercial Databases....................................................................................................... 75 APPENDIX B. PATIENT RESOURCES ................................................................................................. 77 Overview...................................................................................................................................... 77 Patient Guideline Sources............................................................................................................ 77 Finding Associations.................................................................................................................... 79 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 81 Overview...................................................................................................................................... 81 Preparation................................................................................................................................... 81 Finding a Local Medical Library.................................................................................................. 81 Medical Libraries in the U.S. and Canada ................................................................................... 81 ONLINE GLOSSARIES.................................................................................................................. 87

viii Contents

Online Dictionary Directories ..................................................................................................... 87 FLATULENCE DICTIONARY ...................................................................................................... 89 INDEX .............................................................................................................................................. 125

1

FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with flatulence is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about flatulence, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to flatulence, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on flatulence. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to flatulence, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on flatulence. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

3

CHAPTER 1. STUDIES ON FLATULENCE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on flatulence.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and flatulence, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “flatulence” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Gastrointestinal Safety and Tolerance of Ibuprofen at Maximum Over-the-Counter Dose Source: Alimentary Pharmacology and Therapeutics. 13(7): 897-906. July 1999. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Determining nonsteroidal antiinflammatory drug (NSAID) gastrointestinal toxicity has largely depended on retrospective epidemiologic studies that demonstrate that lower doses of NSAIDs pose a lower risk of gastrointestinal toxicity. Ibuprofen, a proprionic acid NSAID has, in most such studies, exhibited a favorable profile in terms of gastrointestinal bleeding. This article reports on a study that prospectively evaluated

4

Flatulence

the gastrointestinal tolerability, as compared to placebo, of the maximum nonprescription dose and duration of ibuprofen use in healthy subjects representative of a nonprescription analgesic user population. Gastrointestinal adverse experiences were similar in the placebo and ibuprofen groups (67 out of 413 patients, 16 percent with placebo versus 161 out of 833 patients, 19 percent with ibuprofen). There was no difference between the two groups in the proportion discontinuing due to a gastrointestinal event. Gastrointestinal adverse experiences reported by more than 1 percent of subjects were dyspepsia (heartburn), abdominal pain, nausea, diarrhea, flatulence (gas), and constipation. Seventeen (1.4 percent) subjects had positive occult blood tests; their frequency was comparable between treatments. The authors conclude that, when used as directed to treat episodic pain, nonprescription ibuprofen at the maximum dose (1200 mg per day for 10 days) is well tolerated. 4 tables. 22 references. •

Gastrointestinal Symptoms During Long-Distance Walking Source: Medicine and Science in Sports and Exercise. 31(6): 767-773. June 1999. Contact: Available from American College of Sports Medicine. Customer Service, Subscriptions, Lippincott Williams and Wilkins. P.O. Box 350, Hagerstown, MD 217400350. (800) 638-3030. Fax (301) 824-7390. Summary: Gastrointestinal (GI) symptoms are common during prolonged intense exercise. This article reports on a study to examine whether GI symptoms are also common during prolonged exercise of lower intensity. The researchers obtained data on incidence, duration, and severity of GI symptoms during a race consisting of four consecutive days walking with a total distance of 203 km for men and 164 km for women. The research population consisted of 79 men and 76 women, aged 30 to 49 years, who responded to a questionnaire and a diary concerning anthropometric data, activity pattern, dietary intake, and GI symptoms. The results show that 24 percent of the subjects experienced one or more symptoms. Nausea, headache, and flatulence were the most frequent symptoms. Nine subjects dropped out during the race, two of whom indicated that they stopped as a result of one or more GI symptoms. Logistic regression analysis revealed that the occurrence of GI symptoms was a significant factor in limiting exercise. Incidence and duration of GI symptoms were significantly related to the subjects' experience (number of prior participation to the event), body weight loss during walking, and several components of the diet before and during the event. A significant relationship between GI symptoms and age, gender, training status, and walking speed could not be found. The authors conclude that GI symptoms during long distance walking can impair exercise performance, although these symptoms occur less frequently and are less severe in comparison with prolonged intense exercise. 6 tables. 26 references.

•

Lactose Intolerance: Problems in Diagnosis and Treatment Source: Journal of Clinical Gastroenterology. 28(3): 208-216. April 1999. Contact: Available from Lippincott-Raven Publishers. P.O. Box 1550, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Summary: Lactose (milk sugar) malabsorption and lactase deficiency are chronic organic pathologic conditions characterized by abdominal pain and distention, flatulence (gas), and the passage of loose, watery stools. This article reviews problems in the diagnosis and treatment of lactose intolerance. Though malabsorption of sugar lactose can be determined by breath hydrogen test or jejunal biopsy, intolerance can be confirmed only by challenge with food containing lactose, and the response to it may not be immediate.

Studies

5

The difficulty of making a positive diagnosis of these conditions has led to a proportion of lactose intolerant patients being misdiagnosed with irritable bowel syndrome (IBS), which has a remarkably similar symptom complex and for which there is no current pathophysiologic marker. The incidence of the two disorders is approximately equal, but the actual proportion of patients with IBS incorrectly diagnosed in this way varies as a function of the methodology used. Once the correct diagnosis is established, introduction of a lactose free dietary regime relieves symptoms in most patients. Symptom similarity and the resultant incorrect diagnosis of IBS may explain the refractory nature of some patients who are thought to have IBS and remain largely unaware of the relationship between food intake and symptoms. 4 tables. 80 references. (AA). •

Commonsense Approach to Lactose Intolerance Source: Patient Care. 31(7): 185-190, 195. April 15, 1997. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Many adults avoid milk and milk products because they believe that even small quantities of lactose will cause diarrhea, bloating, and flatulence resulting from lactose intolerance. However, the author of this article stresses that nearly everyone can tolerate moderate amounts of lactose. A sizable fraction of people self-diagnosed as having lactose intolerance actually absorb lactose completely, and virtually all lactose malabsorbers tolerate moderate amounts of lactose without exhibiting discernible symptoms. The author describes the importance of milk in the adult diet, notably to counter the bone loss usually observed in middle and late adulthood. An additional section describes lactose digestion and lactase activity. One sidebar explores the physiology of lactose digestion in detail. Lactose digestive aids are available in several formulations at varying cost; these include lactase-containing drops and tablets that resist acid-peptic denaturation in the stomach. The author concludes by describing how the symptomatic and breath-hydrogen response of people with lactase nonpersistence appears to decrease when they regularly consume large amounts of lactose. This improved tolerance apparently reflects an adaptation by the colonic flora, resulting in increased metabolism of lactose via non-gas-forming reactions. 1 figure. 2 tables. 5 references.

•

Sorting out the most Common GI Complaints Source: Patient Care. 36(3): 21-22, 25-26, 28, 31. February 15, 2002. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Millions of patients have gastrointestinal (GI) symptoms including belching (burping), intestinal gas (flatulence), abdominal distension, and indigestion, among others. Most of these do not signal the presence of a serious illness, but the practitioner's advice on preventing and treating nuisance symptoms can be enormously valuable to patients. This article helps primary care providers sort out the most common GI complaints. The authors stress that even trivial GI complaints deserve careful attention in the history and physical. Ominous symptoms include anemia, dysphagia (swallowing difficulties), bleeding, and weight loss. Once a potentially serious GI disorder has been ruled out, prevention and treatment efforts against the patient's most troublesome complaints can be initiated. Alpha-D-galactosidase may reduce gas associated with bean consumption; patients should be encouraged to incorporate these valuable foods in their

6

Flatulence

diets. Sorbitol containing products may cause excessive gas production, even diarrhea. Patients should not increase their fiber consumption without increasing their fluid intake. Heartburn is usually well managed with H2 receptor antagonists and proton pump inhibitors. The authors caution that testing for gallstones is not indicated, unless the patient has the characteristic severe pain associated with this condition. And eradicating Helicobacter pylori in a patient with nonulcer dyspepsia usually does not reduce the symptoms. 1 figure. 1 table. 6 references. •

Fear of Offending: Odor and Its Management Source: Metro Wash By-Pass. 98(68): 6-7. September 1991. Contact: Available from United Ostomy Association. Metropolitan Washington Chapter, Washington Hospital Center, East Building, Room 3102, 110 Irving Street, N.W., Washington, DC 20010. (202) 877-6019. Summary: Offensive odors is among the concerns of many people with ostomies. This article describes a number of effective methods and precautions that can be taken for preventing odor. Topics covered include general cleanliness and personal hygiene, odorproof appliances, external deodorizers, pouch deodorants, dietary adjustment, excessive flatulence, and systemic deodorizers. The author concludes with a brief discussion of odor prevetion related to urostomies.

•

Prebiotic Digestion and Fermentation Source: American Journal of Clinical Nutrition. 73(2 Supplement): 415S-420S. 2001. Contact: Available from American Journal of Clinical Nutrition. Production Office, 9650 Rockville Pike, Bethesda, MD 20814. (301) 530-7038. Fax (301) 571-8303. Website: www.ajcn.org. Summary: Prebiotics are food ingredients that stimulate selectively the growth and activity of specific species of bacteria in the gut, usually bifidobacteria and lactobacilli, with benefits to health. Prebiotics, as currently conceived of, are all carbohydrates of relatively short chain length. To be effective, they must reach the cecum (the first part of the large intestine). This article reviews prebiotic digestion and fermentation. Present evidence concerning the 2 most studied prebiotics, fructooligosaccharides and inulin, is consistent with their resisting digestion by gastric acid and pancreatic enzymes in vivo. However, the wide variety of new candidate prebiotics becoming available for human use requires that a manageable set of in vitro tests be agreed on so that their nondigestability and fermentability can be established without recourse to human studies in every case. In the large intestine, prebiotics, in addition to their selective effects on the bacteria noted above, influence many aspects of bowel function through fermentation. Short chain fatty acids are a major product of prebiotic breakdown, but as yet, no characteristic pattern of fermentation acids has been identified. Through stimulation of bacterial growth and fermentation, prebiotics affect bowel habit and are mildly laxative. Perhaps more important, some are a potent source of hydrogen in the gut. Mild flatulence (gasiness) is frequently observed by subjects being fed prebiotics; in a significant number of subjects it is severe enough to be unacceptable and to discourage consumption. Prebiotics are like other carbohydrates that reach the cecum, such as nonstarch polysaccharides, sugar alcohols, and resistant starch, in being substrates for fermentation. They are, however, distinctive in their selective effect on the microflora and their propensity to produce flatulence. 2 figures. 2 tables. 37 references.

Studies

•

7

Long-term Safety of Tegaserod in Patients with Constipation-Predominant Irritable Bowel Syndrome Source: Alimentary Pharmacology and Therapeutics. 16(10): 1701-1708. October 2002. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: The oral administration of the drug tegaserod causes gastrointestinal (GI) effects resulting in increased gastrointestinal motility (movement of contents through the GI tract) and attenuation of visceral sensation. This article reports on a study undertaken to determine the long term safety and tolerability of tegaserod in patients with irritable bowel syndrome (IBS) with constipation as the predominant symptom of altered bowel habits. The multicenter, open label study included 579 patients. Of these, 304 (53 percent) completed the trial. The most common adverse events, classified as related to tegaserod for any dose, were mild and transient diarrhea (10.1 percent), headache (8.3 percent), abdominal pain (7.4 percent), and flatulence (5.5 percent). Forty serious adverse events were reported in 25 patients (4.4 percent of patients) leading to discontinuation in 6 patients. There was one serious adverse event, acute abdominal pain, classified as possibly related to tegaserod. There were no consistent differences in adverse events between patients previously exposed to tegaserod and those treated for the first time in this study. The authors conclude that tegaserod appears to be well tolerated in the treatment of patients with constipation-predominant IBS. The adverse event profile, clinical laboratory evaluations, vital signs, and electrocardiogram recordings revealed no evidence of any unexpected adverse events, and suggest that treatment is safe over a 12 month period. 1 figure. 4 tables. 23 references.

•

Acute Diverticulitis Source: New England Journal of Medicine. 338(21): 1521-1526. May 21, 1998. Summary: This article brings readers up to date on the current approach to acute diverticulitis. The authors first review the classification system to categorize the varieties of inflammatory conditions encountered in patients with diverticular disease. Stage I encompasses patients with small, confined pericolonic abscesses, whereas patients with stage II disease have larger collections. Stage III includes patients with generalized suppurative peritonitis, and stage IV is categorized as fecal peritonitis. The article then discusses the pathogenesis, diagnosis (clinical findings, and imaging studies), and treatment of acute diverticulitis. The cause of colonic diverticula is primarily related to two factors: increased intraluminal pressure (pressure in the colon) and weakening of the bowel. Diminished stool bulk, from insufficient dietary fiber, leads to alterations in gastrointestinal transit time and elevated colonic pressure. Supplementing dietary fiber has been shown to increase stool weight, alter transit time, decrease intraluminal pressures, and provide relief from pain, nausea, vomiting, and flatulence in patients with diverticulitis. Diverticula are easily demonstrated by contrast enema, but their presence alone does not confirm diverticulitis. CT scan is the safest, most cost effective diagnostic method, with additional potential for use in treating abscesses. In patients whose diagnosis can be made with confidence by clinical examination, it is reasonable to begin empirical treatment immediately. Treatment can be initiated on an outpatient basis, with a liquid diet and 7 to 10 days of broad spectrum oral antibiotics. Once the acute attack has resolved, the patient should be instructed to maintain a diet high in fiber, and colonoscopy is advised to exclude cancer. If the patient is unable to tolerate oral hydration, if pain is severe enough to require narcotic analgesia, or if the symptoms

8

Flatulence

fail to improve despite adequate outpatient therapy, admission to the hospital is appropriate. The indications for emergency colonic resection include generalized peritonitis, uncontrolled sepsis, visceral perforation, and acute clinical deterioration. The authors note that 27 percent of patients who undergo surgical treatment will continue to have some symptoms, with or without fiber supplementation. However, increased dietary fiber intake is still recommended in both patients who have undergone sigmoid resection and those who have recovered from acute attacks treated nonsurgically. 3 figures. 51 references. •

Randomized Double-Blind Trial of Acarbose in Type 2 Diabetes Shows Improved Glycemic Control Over 3 Years (U.K. Prospective Diabetes Study 44) Source: Diabetes Care. 22(6): 960-964. June 1999. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article describes a 3-year, randomized, double-blind trial that investigated the degree to which acarbose might improve or help maintain glycemic control in patients on established therapy for type 2 diabetes. Of 3,309 patients attending the United Kingdom Prospective Diabetes Study (UKPDS) clinics between May and September 1993, 1,946 agreed to take part in the 3-year trial of acarbose. The patients were randomized to acarbose, titrating to a maximum dose of 110 milligrams three times per day, or to matching placebo. Fourteen percent of patients were treated with diet alone, 52 percent with monotherapy, and 34 percent with combined therapy. Patients were monitored in UKPDS clinics every 4 months for 3 years. The main outcome measures were glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body weight, compliance with study medication, incidence of side effects, and frequency of major clinical events. The study found that, at 3 years, a lower proportion of patients were taking acarbose compared with placebo. The main reasons for noncompliance were flatulence and diarrhea. Analysis by intention to treat shows that patients randomized to acarbose, compared with placebo, had 0.2 percent significantly lower median HbA1c at 3 years. In patients remaining on their allocated therapy, the HbA1c difference at 3 years was 0.5 percent lower median HbA1c. Acarbose appeared to be equally effective when given in addition to diet alone; in addition to monotherapy with a sulfonylurea, metformin, or insulin; or in combination with more complex treatment regimens. No significant differences were seen in FPG, body weight, incidence of hypoglycemia, or frequency of major clinical events. The article concludes that acarbose significantly improved glycemic control over 3 years in patients who had established type 2 diabetes, regardless of concomitant therapy for diabetes. Careful titration of acarbose is needed in view of the increased noncompliance rate seen secondary to the known side effects. 2 figures. 3 tables. 12 references. (AA-M).

•

Chronic Treatment of African-American Type 2 Diabetic Patients with AlphaGlucosidase Inhibition Source: Diabetes Care. 21(3): 416-422. March 1998. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article describes a study that evaluated the long-term efficacy, safety, and tolerability of the alpha-glucosidase inhibitor miglitol in treating African Americans with type 2 diabetes. A total of 345 African Americans with type 2 diabetes who were treated with either diet alone or sulfonylurea were randomized to 1 year of double-blind

Studies

9

treatment with either placebo or miglitol at doses of 50 or 100 mg three times a day, titrated on the basis of tolerability. The primary efficacy criterion was change from baseline in glycosylated hemoglobin (HbA1c) at the 6-month visit. Secondary efficacy parameters included changes from baseline in plasma glucose and serum insulin, fasting lipid, and urinary albumin-to-creatinine ratio. Safety and tolerability evaluations were primarily based on reporting of adverse events and symptoms and on periodic laboratory analyses. At 6 months, miglitol treatment was associated with a mean placebo-subtracted reduction in HbA1c of 1.19 percent from baseline. Fasting and 120minute postprandial plasma glucose levels were reduced in parallel to HbA1c, in association with miglitol treatment. Significant reductions compared with placebo in 120-minute postprandial insulin levels, in low density lipoprotein cholesterol, and in fasting triglycerides were also seen in the miglitol group at individual study time points. Softer, more frequent stools and flatulence were significantly more common in the miglitol group. Urinary tract infections, hematuria, and herpes simplex infections were significantly more common in the placebo group. The article concludes that miglitol appears to be at least as efficacious in the African American type 2 population as in the U.S. type 2 population at large, with comparable tolerability. Alpha-glucosidase treatment may be an important therapeutic option in these patients, in view of their greater risk of microvascular complications and the accumulating body of evidence that better glucose control reduces the risk of these complications. 5 tables. 20 references. (AA-M). •

Alpha-Glucosidase Inhibitors as Agents in the Treatment of Diabetes Source: Diabetes Reviews. 6(2): 132-145. 1998. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article discusses the use of alpha-glucosidase inhibitors in treating diabetes and focuses on their structure, mechanism of action, metabolism, pharmacology, clinical efficacy, and adverse effects. Alpha-glucosidase inhibitors are drugs that delay the digestion of complex carbohydrates by acting as competitive inhibitors of the intestinal alpha-glucosidase enzymes that hydrolyze oligosaccharides into monosaccharides. This reduces the rise in postprandial plasma glucose. As a consequence of their pharmacological action, alpha glucosidase inhibitors also cause a concomitant decrease in postprandial plasma insulin and gastric inhibitory polypeptide and a rise in late postprandial plasma glucagon-like peptide 1 levels. In those who have normal or impaired glucose tolerance with hyperinsulinemia, alpha glucosidase inhibitors decrease hyperinsulinemia and improve sensitivity. In people with type 2 diabetes, when alpha-glucosidase inhibitors are added to a high carbohydrate diet, they lower fasting plasma glucose by a mean of 23 milligrams (mg) per deciliter (dL), postprandial plasma glucose by a mean of 54 mg per dL, and glycosylated hemoglobin (HbA1c) by a mean of 0.90 percent. When added to the treatment of people who have type 2 diabetes and who are on insulin, metformin, or sulfonylureas, there is an additional decrease in HbA1c of 0.54, 0.73, and 0.85 percent, respectively. In people with type 1 diabetes, alpha-glucosidase inhibitors can be used to reduce postprandial glycemic excursions and decrease postprandial hypoglycemia. Additional benefits of alpha-glucosidase inhibitors in patients with type 2 diabetes are the absence of hypoglycemia with monotherapy, an excellent safety profile, and a modest decrease in postprandial plasma triglyceride levels. The major adverse events associated with alpha glucosidase inhibitor treatment are flatulence, abdominal discomfort, and bloating. Appropriate dosing will significantly reduce these gastrointestinal side effects. Acarbose

10

Flatulence

and miglitol are the alpha glucosidase inhibitors available in the United States. 6 figures. 6 tables. 89 references. (AA-M). •

Over-the-Counter Drugs: What's Safe to Take? Source: Diabetes Self-Management. 17(6): 46, 48-50, 52. November-December 2000. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-self-mgmt.com. Summary: This article examines some of the most commonly used nonprescription drugs and their effects and side effects and lists many brand name products and their active ingredients. The article also includes some general guidelines for using nonprescription medications. Nonprescription pain relievers include acetaminophen, aspirin, ibuprofen, ketoprofen, and naproxen, as well as combinations of these products. Products containing capsaicin may be the most effective nonprescription topical agents for relieving neuropathy. Typical nonprescription remedies for upper respiratory symptoms include antihistamines, decongestants, cough relievers, expectorants, and pain relievers, or a combination of these ingredients. Another option for relief of upper respiratory symptoms caused by the cold or flu is a topical ointment containing camphor, menthol, and eucalyptus oil. Antihistamines are the primary nonprescription medications used to prevent and control motion sickness. Antihistamines are also the active ingredient in nonprescription sleep aids. Caffeine is the only nonprescription stimulant product approved by the Food and Drug Administration. An occasional cold sore or canker sore can be effectively treated with a nonprescription ointment such as benzocaine, camphor and phenol, dyclonine and allantoin, tannic acid, and tetracaine hydrochloride. Nonprescription medications available to treat vaginal yeast infections include antifungal products such as butoconazole, clotrimazole, and miconazole. Premenstrual discomfort may be relieved with nonprescription products such as ibuprofen; pamabrom; pamabrom and acetaminophen; and pamabrom, acetaminophen, and pyrilamine. Many gastrointestinal symptoms can be eased by nonprescription products. Relief from heartburn, indigestion, or reflux can be attained with antacids or acid blockers. Constipation may be treated with bulk forming laxatives, stool softeners, emollients, and lubricants. Diarrhea can be relieved with various antidiarrheal products. Relief from flatulence can be obtained with the use of alpha galactosidase enzyme, lactase enzyme, and simethicone. Skin care products that ease dry skin include those with the active ingredients of glycerin, mineral oil, and petrolatum. People who have diabetes can self treat mild burns and sunburns, acne, and other skin irritations with various nonprescription drugs. People who have diabetes should avoid nonprescription callus, corn, and wart removers, but self treatment of athlete's foot is generally safe. Although weight loss is an important part of diabetes management, many nonprescription weight control products contain a decongestant that can elevate blood glucose and blood pressure. Nonprescription nicotine patches or nicotine gum can help smokers quit. 1 figure.

•

Getting a Grip on Gas Source: Digestive Health and Nutrition. p. 16-19. March-April 2000. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This article familiarizes readers with the physiology underlying a common occurrence: flatulence (passing gas). The author stresses that everyone must pass gas,

Studies

11

either from the anus or through the mouth as a burp. It is part of eating a healthful diet, particularly one high in fiber, and it is also part of having a healthy digestive system. The author explains why some of the gas is odorous, discusses the interaction of diet and flatulence, and describes both over the counter (OTC) and prescription medications for reducing gas, pain, and bloating. The author notes that irritable bowel syndrome (IBS) should be considered first for the person who has pain and bloating, but many other conditions of the stomach and small intestine may cause these symptoms. The author concludes with a brief discussion of belching, that includes suggestions for reducing problematic belching. Readers are encouraged to discuss this topic with their physicians because, while sometimes it is embarrassing or uncomfortable, treatment options do exist. The article includes the website of the American Gastroenterological Association (www.gastro.org/gas.html) for patients wanting additional information. 1 figure. •

Improved Lactose Digestion and Intolerance Among African-American Adolescent Girls Fed a Dairy-Rich Diet Source: Journal of the American Dietetic Association. 100(5): 524-528. May 2000. Summary: This article reports on a study undertaken to determine whether African American girls who were fed a dairy rich diet for 21 days could adapt to lactose, experiencing an overall improvement in lactose tolerance as well as a decrease in hydrogen gas production. Seventeen of 21 girls (aged 11 to 15 years) enrolled in a calcium metabolism study chose to participate in the lactose tolerance study. Subjects consumed a dairy based diet averaging 1,200 mg calcium and 33 g lactose per day for 21 days. Lactose digestion was assessed by an 8 hour breath hydrogen test on days 1 and 21, and symptoms of intolerance (abdominal pain, bloating, flatulence, and diarrhea) were evaluated hourly on a ranked scale during the breath hydrogen tests and once each evening during the 21 day feeding period. Results showed that 14 of the 17 subjects had lactose maldigestion. Breath hydrogen excretion decreased significantly from the beginning to the end of the 21 day period. Gastrointestinal symptoms were negligible during both the breath hydrogen tests as were symptoms during the 21 day period. The authors conclude that the diet was well tolerated by the subjects. Furthermore, the decrease in breath hydrogen suggests colonic adaptation to the high lactose diet. The results indicate that lactose maldigestion should not be a restricting factor in developing adequate calcium diets for this population. 1 figure. 1 table. 27 references.

•

Surprising Side Effects Source: Diabetes Forecast. 51(7): 52-56. July 1998. Contact: American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article reports on the side effects of various diabetes medications, including sulfonylureas, metformin, acarbose, troglitazone, repaglinide, and insulin. Sulfonylureas are commonly prescribed for the treatment of type 2 diabetes. They stimulate the pancreas to produce and release more insulin. Common side effects of drugs in this class include gastrointestinal disturbances, alcohol intolerance, skin reactions, and weight gain. Metformin is also used to treat type 2 diabetes. Its side effects can include gastrointestinal disturbances and, rarely, lactic acidosis. Acarbose blocks the enzymes in the stomach that break down starches in foods into simple sugars. The most common side effects of this drug are gastrointestinal difficulties, including abdominal bloating, diarrhea, and flatulence. Troglitazone is an insulin sensitizer that

12

Flatulence

improves the action of insulin, particularly in the muscle cells. Although early studies showed that it was very well tolerated and had minimal side effects, it appears to adversely affect the liver in some people; these problems seem to be reversible when caught early. Repaglinide, the newest approved drug for treating type 2 diabetes, appears to be well tolerated and to have few side effects; because it is new, adverse effects are not completely known. Insulin has several side effects, including allergic reactions, lipohypertrophy, and weight gain. •

Physiology of the Lower Urinary Tract Source: Urologic Clinics of North America. 23(2): 171-175. May 1996. Contact: Available from W.B. Saunders Company. Periodicals Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 654-2452. Summary: This article reviews data obtained from physiologic studies of the lower urinary tract. Through a series of figures, the author presents the concepts behind the pressures observed in the various parts of the body, occurring normally and abnormally in various conditions. Included are normal pressure relationships; normal at rest, at strain, and at holding urine pressures; voiding, including pure detrusor contraction, pure strain, straining and detrusor contraction simultaneously, and urethral pressure drop; incontinence; and flatulence and defecation. Normally, the patient resists the rise in bladder pressure (as it fills) by involuntarily increasing the squeeze on the urethra and the rectum to prevent incontinence. At strain, it is observed that the curve of urethral pressures at rest has been elevated as a whole. Urethral pressure exceeds bladder pressure throughout its length, and rectal pressure exceeds colon pressure. Voiding occurs when urethral pressure throughout its entire length falls below bladder pressure. 4 figures. 2 tables. (AA-M).

•

Diverticulitis: Current Management Strategies Source: Patient Care. 31(12): 170-172, 175-177, 181-182, 185-186. July 15, 1997. Contact: Available from Medical Economics. Five Paragon Drive, Montvale, NJ 076451742. (800) 432-4570 or (201) 358-7200. Summary: This article reviews present recommendations for the management of patients with diverticulitis. The author notes that the incidence of colonic diverticulosis (diverticula or herniations of the mucosa and submucosa through the colonic wall) is increasing as the population ages. When diverticula become inflamed, diverticulitis ensues. Patients with diverticulitis most often have abrupt onset of pain and tenderness in the left lower quadrant. Other symptoms of diverticular disease include abdominal distention, diarrhea or constipation, flatulence, heartburn, nausea and vomiting, a palpable mass, and urinary symptoms. The author reviews the differential diagnosis, discriminating between diverticulitis and acute appendicitis, gynecologic conditions, peptic ulcer disease, Crohn's disease, carcinoma, irritable bowel syndrome (IBS), and ischemic colitis. Diagnostic tests are also discussed: roentgenography, contrast enema, CT scan, ultrasonography, and endoscopy. The author then discusses dietary therapy, noting that during an acute episode of diverticulitis, patients need to be on a clear liquid diet until the inflammation subsides. Subsequently, a high fiber, low fat diet should be initiated. Other topics covered include the role of antibiotic therapy, analgesics, surgery, and rare manifestations and complications. A detailed patient care algorithm is provided. 2 figures. 1 table. 9 references. (AA-M).

Studies

•

13

What You Need to Know About Gas in Children Source: Digestive Health and Nutrition. p. 20. March-April 2000. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This brief article familiarizes readers with the physiology underlying a common occurrence: gas in children. The author stresses that burping and passing gas is usually part of the child's healthy digestive system. However, when the child has stomach pain that is relieved by making stool, has a change in stool habit, stool hardness, or bloating of the stomach, then he or she may suffer from irritable bowel syndrome (IBS). There are some situations that do lead to too much gas in a child. Some of these are nursing with an empty bottle, using a stiff nipple or a nipple with too small an opening, and failure to bring a baby into an upright position to burp after feeding. In older children, using a straw, chewing gum, sucking on candies, drinking too many carbonated drinks, overusing antacids, swallowing large amounts of air, or suddenly increasing dietary fiber can cause gas. The author concludes by reiterating that there is no link between colic and gas. The article is printed in the same issue with a lengthy article on gas problems (flatulence and burping) in adults.

•

Dietary Adequacy in Patients with Diabetic Gastroparesis Source: Journal of the American Dietetic Association. 97(4): 420-422. April 1997. Summary: This brief research report describes a study undertaken to investigate dietary intake and adequacy in patients with diabetic gastroparesis (delayed gastric emptying due to diabetes mellitus). Approximately 50 percent of patients with diabetes have some delay in gastric emptying as one component of autonomic neuropathy. Diabetic gastroparesis is most commonly found in patients with insulin-dependent diabetes mellitus (IDDM) who have a long-standing history of poorly controlled diabetes. In this cross-sectional study, 10 patients were studied throughout a 5 week period. Study measures included gastroparesis (by gastric emptying study), height and weight of subjects, body mass index (BMI), glycated hemoglobin (HbA1c) levels, home blood glucose measurements, physical activity (self-recorded), and gastrointestinal symptoms (measured with a daily questionnaire). Symptoms of appetite, abdominal pain after meals, difficulty swallowing, acid regurgitation, bloating, belching, nausea, vomiting, halitosis (bad breath), heartburn, flatulence (gas), constipation, and diarrhea were recorded. Outcome variables of primary interest were dietary intakes of energy (calories) and macronutrients. The authors had hypothesized that postprandial (after meal) difficulties may influence a patient to reduce the quantity and frequency of food intake. Also, blood glucose control may be difficult to achieve because of slow and unpredictable gastric emptying. Their results did not observe any significant associations between symptom severity and dietary variables, or between dietary adequacy and age, BMI, HbA1c level, and medication use. However, patients who are not physically active (versus active patients) may be at greater risk of consuming inadequate diets. The small sample size is noted as a limitation of the study. The authors conclude that relationships between dietary intake, food choices, and gastrointestinal symptoms might be evident with a larger group. 2 tables. 16 references. (AA-M).

•

Diarrhea and Tube Feeding Source: Nutrition in Clinical Practice. 14(2): 83-84. April 1999.

14

Flatulence

Contact: Available from American Society for Parenteral and Enteral Nutrition. 8630 Fenton Street, Suite 412, Silver Spring, MD 20910-3805. (301) 587-6315. Summary: Tube feeding (enteral nutrition) and diarrhea are often present together. The incidence of diarrhea in tube fed patients is 2 percent to 70 percent, with a higher occurrence in critically ill patients. This brief article offers a systematic method for the treatment of diarrhea in patients who are tube fed. The author notes that effective treatment of diarrhea must be initiated to minimize its metabolic, physical, and emotional complications. The primary goal is to reduce fluid, electrolyte, and nutrient losses through the stool. Intragastric feeds are associated with an increased incidence of diarrhea. Large caloric loads infused into the stomach promote colonic secretion of water, sodium, and chloride and, hence, reduce the absorptive capacity of the colon. If patients receiving gastric tube feeding develop diarrhea, they can be changed to a duodenal infusion. Fiber can be provided to safely promote fluid absorption in the colon during the diagnostic workup. Fiber should be added incrementally to reduce flatulence, abdominal distention (bloating), and constipation. The first step in identifying the etiology of diarrhea is to rule out enteric pathogens, such as Clostridium difficile. In addition, disease states such as diabetes, vitamin and mineral deficiencies, pancreatic enzyme deficiency, and malabsorption of fat and bile acids can contribute to diarrhea. Medications can be the reason for diarrhea in up to 61 percent of cases. Antibiotics, H2 receptor antagonists, antineoplastics, laxatives, antacids, and potassium and phosphate supplements are a few of the medications contributing to diarrhea. Sorbitol, an inactive ingredient in medications, is an active contributor to increased GI motility. If diarrhea continues despite treatment of enteric pathogens or disease related causes, antidiarrheal therapy, and medication adjustments, the enteral nutrition formula must be critically evaluated. One figure offers a patient care algorithm for treating diarrhea in tube fed patients. 1 figure. 4 references.

Federally Funded Research on Flatulence The U.S. Government supports a variety of research studies relating to flatulence. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to flatulence. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore flatulence.

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

15

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with flatulence, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “flatulence” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for flatulence (hyperlinks lead to article summaries): •

Acute abdomen in mentally retarded patients: role of aerophagia. Report of nine cases. Author(s): van der Kolk MB, Bender MH, Goris RJ. Source: The European Journal of Surgery = Acta Chirurgica. 1999 May; 165(5): 507-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10391173&dopt=Abstract

•

Aerophagia and depression: case report. Author(s): D'Mello D. Source: The Journal of Clinical Psychiatry. 1983 October; 44(10): 387-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6643401&dopt=Abstract

•

Aerophagia and irritable bowel syndrome. Author(s): Calloway SP, Fonagy P. Source: Lancet. 1985 December 14; 2(8468): 1368. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2866420&dopt=Abstract

•

Aerophagia as a cause of ineffective phrenic nerve pacing in high tetraplegia: a case report. Author(s): Colachis SC, Kadyan V. Source: Archives of Physical Medicine and Rehabilitation. 2003 May; 84(5): 768-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12736895&dopt=Abstract

•

Aerophagia as cause of gaseous abdominal distention in a toddler. Author(s): Loening-Baucke V. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 August; 31(2): 204-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10941981&dopt=Abstract

3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

16

Flatulence

•

Aerophagia in children. Author(s): Stone RT, Morgan MC. Source: American Family Physician. 1971 May; 3(5): 94-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5575886&dopt=Abstract

•

Aerophagia induced by the nasal obstruction on experimental animals. Author(s): Nakajima K, Ohi G. Source: Jikken Dobutsu. 1977 April; 26(2): 149-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=560312&dopt=Abstract

•

Aerophagia resulting in acute airway obstruction. Author(s): Haben CM, Al Abdulhadi K, Sadeghi N. Source: Otolaryngology and Head and Neck Surgery. 2000 November; 123(5): 650-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11077362&dopt=Abstract

•

Aerophagia, a mechanism for spontaneous rupture of the stomach in the newborn. Author(s): Shaker IJ, Schaefer JA, James AE Jr, White JJ. Source: The American Surgeon. 1973 November; 39(11): 619-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4746597&dopt=Abstract

•

Aerophagia. An unrecognized complication of tracheotomy. Author(s): Rosnagle RS, Yanagisawa E. Source: Arch Otolaryngol. 1969 March; 89(3): 537-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5764105&dopt=Abstract

•

Aerophagia: an uncommon form of self-injury. Author(s): Holburn CS. Source: Am J Ment Defic. 1986 September; 91(2): 201-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3766621&dopt=Abstract

•

Aerophagia: the case of the inveterate belcher. Author(s): Hanson ML. Source: Int J Orofacial Myology. 1988 July; 14(2): 11. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3251860&dopt=Abstract

•

Aerophagy and flatulence. Author(s): Hunt T. Source: The Practitioner. 1970 December; 205(230): 787-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5493715&dopt=Abstract

Studies

17

•

Air-flow studies in excessive flatulence. Author(s): Essop AR, Segal I. Source: The Practitioner. 1983 April; 227(1378): 647. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6856555&dopt=Abstract

•

An unusual etiology of abdominal meteorism: aerophagia. Author(s): Selvais PL, Lacrosse M. Source: Acta Clin Belg. 1991; 46(4): 249-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1659092&dopt=Abstract

•

Behavioral treatment of chronic aerophagia. Author(s): Barrett RP, McGonigle JJ, Ackles PK, Burkhart JE. Source: Am J Ment Defic. 1987 May; 91(6): 620-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3591848&dopt=Abstract

•

Behavioural techniques in the management of aerophagia in patients with hiatus hernia. Author(s): Calloway SP, Fonagy P, Pounder RE, Morgan MJ. Source: Journal of Psychosomatic Research. 1983; 27(6): 499-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6363680&dopt=Abstract

•

Belching, bloating, and flatulence. How to help patients who have troublesome abdominal gas. Author(s): Rao SS. Source: Postgraduate Medicine. 1997 April; 101(4): 263-9, 275-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9126217&dopt=Abstract

•

By the way, doctor. The more I eat a health diet--one that's rich in whole grains, fruits, and vegetables--the more trouble I have with flatulence. Is this unusual? Any suggestions? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2003 March; 10(7): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654596&dopt=Abstract

•

Comorbidity of aerophagia in GERD patients: outcome of laparoscopic antireflux surgery. Author(s): Kamolz T, Bammer T, Granderath FA, Pointner R. Source: Scandinavian Journal of Gastroenterology. 2002 February; 37(2): 138-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11843047&dopt=Abstract

18

Flatulence

•

Comparative flatulence activity of beans and bean fractions for man and the rat. Author(s): Wagner JR, Carson JF, Becker R, Gumbmann MR, Danhof IE. Source: The Journal of Nutrition. 1977 April; 107(4): 680-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=845703&dopt=Abstract

•

Constipation among operating room nurses: flatulence as evidence. Author(s): Go K. Source: Semin Perioper Nurs. 1999 April; 8(2): 85-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10455822&dopt=Abstract

•

Consultation: understanding aerophagia. Author(s): Hall S. Source: Nursing. 1979 November; 9(11): 100-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=259191&dopt=Abstract

•

Development of a technique for the in vivo assessment of flatulence in dogs. Author(s): Collins SB, Perez-Camargo G, Gettinby G, Butterwick RF, Batt RM, Giffard CJ. Source: Am J Vet Res. 2001 July; 62(7): 1014-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11453473&dopt=Abstract

•

Effect of processing on flatus producing oligosaccharides in cowpea (Vigna unguiculata) and the tropical African yam bean (Sphenostylis stenocarpa). Author(s): Nwinuka NM, Abbey BW, Ayalogu EO. Source: Plant Foods for Human Nutrition (Dordrecht, Netherlands). 1997; 51(3): 209-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9629861&dopt=Abstract

•

Effects of bean diets on concentration of carbon dioxide in flatus. Author(s): Steggerda FR, Dimmick JF. Source: The American Journal of Clinical Nutrition. 1966 August; 19(2): 120-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5916034&dopt=Abstract

•

Effects of response satiation procedures in the treatment of aerophagia. Author(s): Holburn CS, Dougher MJ. Source: Am J Ment Defic. 1986 July; 91(1): 72-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3740118&dopt=Abstract

•

Effects of various soybean products on flatulence in the adult man. Author(s): Steggerda FR, Richards EA, Rackis JJ. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1966 April; 121(4): 1235-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5949277&dopt=Abstract

Studies

19

•

Evaluation of the pathogenesis of flatulence and abdominal cramps in patients with lactose malabsorption. Author(s): Hammer HF, Petritsch W, Pristautz H, Krejs GJ. Source: Wiener Klinische Wochenschrift. 1996; 108(6): 175-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8650927&dopt=Abstract

•

Excretion of breath and flatus gases by humans consuming high-fiber diets. Author(s): Marthinsen D, Fleming SE. Source: The Journal of Nutrition. 1982 June; 112(6): 1133-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6283045&dopt=Abstract

•

Factors influencing frequency of flatus emission by healthy subjects. Author(s): Furne JK, Levitt MD. Source: Digestive Diseases and Sciences. 1996 August; 41(8): 1631-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8769291&dopt=Abstract

•

Fat, foreboding, and flatulence. Author(s): Spiro HM. Source: Annals of Internal Medicine. 1999 February 16; 130(4 Pt 1): 320-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10068391&dopt=Abstract

•

Fibre, fermentation, flora, and flatus. Author(s): Grimble G. Source: Gut. 1989 January; 30(1): 6-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2646179&dopt=Abstract

•

Flatulence and other discomforts associated with consumption of cowpea (Vigna unguiculata). Author(s): Ndubuaku VO, Uwaegbute AC, Nnanyelugo DO. Source: Appetite. 1989 December; 13(3): 171-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2596840&dopt=Abstract

•

Flatulence. Author(s): Hawkins C. Source: British Medical Journal. 1971 October 2; 4(778): 52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5096900&dopt=Abstract

•

Flatulence. Author(s): Eastwood NB. Source: British Medical Journal. 1971 September 25; 3(777): 769. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5097982&dopt=Abstract

20

Flatulence

•

Flatulence. Author(s): Bouchier IA. Source: The Practitioner. 1980 April; 224(1342): 373-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7433379&dopt=Abstract

•

Flatulence. Author(s): Levitt MD, Bond JH. Source: Annual Review of Medicine. 1980; 31: 127-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6772089&dopt=Abstract

•

Flatulence: pathophysiology and treatment. Author(s): Van Ness MM, Cattau EL Jr. Source: American Family Physician. 1985 April; 31(4): 198-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3984823&dopt=Abstract

•

Flatulence--causes, relation to diet and remedies. Author(s): Price KR, Lewis J, Wyatt GM, Fenwick GR. Source: Die Nahrung. 1988; 32(6): 609-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3068547&dopt=Abstract

•

Flatus and faecal incontinence: prevalence and risk factors at 16 weeks of gestation. Author(s): Hojberg KE, Salvig JD, Winslow NA, Bek KM, Laurberg S, Secher NJ. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 September; 107(9): 1097-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11002952&dopt=Abstract

•

Flatus emission patterns and fibre intake. Author(s): Bolin TD, Stanton RA. Source: Eur J Surg Suppl. 1998; (582): 115-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10029376&dopt=Abstract

•

Flatus inducing effect of processed legumes in pre-school children. Author(s): Geervani P, Theophilus F. Source: The Indian Journal of Medical Research. 1979 November; 70: 750-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=535974&dopt=Abstract

•

Flatus retention is the major factor in diverticular disease. Author(s): Wynne-Jones G. Source: Lancet. 1975 August 2; 2(7927): 211-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=51965&dopt=Abstract

Studies

21

•

Flatus-related colorectal and anal motor events. Author(s): Bassotti G, Germani U, Morelli A. Source: Digestive Diseases and Sciences. 1996 February; 41(2): 335-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8601379&dopt=Abstract

•

Flavor and flatulence factors in soybean protein products. Author(s): Rackis JJ, Honig DH, Sessa DJ, Steggerda FR. Source: Journal of Agricultural and Food Chemistry. 1970 November-December; 18(6): 977-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5529935&dopt=Abstract

•

Floating stools--flatus versus fat. Author(s): Levitt MD, Duane WC. Source: The New England Journal of Medicine. 1972 May 4; 286(18): 973-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5015442&dopt=Abstract

•

Fluoxetine for obsessive fear of loss of control of malodorous flatulence. Author(s): Fishbain DA, Goldberg M. Source: Psychosomatics. 1991 Winter; 32(1): 105-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2003129&dopt=Abstract

•

Fractionation of dry bean extracts which increase carbon dioxide egestion in human flatus. Author(s): Murphy EL, Horsley H, Burr HK. Source: Journal of Agricultural and Food Chemistry. 1972 July-August; 20(4): 813-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5054389&dopt=Abstract

•

Gastric dilation on cardiac exercise studies. Probably aerophagia. Author(s): Baldwin RD, Spencer RP. Source: Clinical Nuclear Medicine. 1992 January; 17(1): 52-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1544263&dopt=Abstract

•

Glyceryl trinitrate, flatus and defaecation. Author(s): Herxheimer A. Source: British Journal of Clinical Pharmacology. 1993 November; 36(5): 481. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959301&dopt=Abstract

•

Hyperventilation and aerophagia: a negative report. Author(s): Folgering H, Sistermans H. Source: Eur J Respir Dis. 1986 March; 68(3): 173-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3699119&dopt=Abstract

22

Flatulence

•

Identification of gases responsible for the odour of human flatus and evaluation of a device purported to reduce this odour. Author(s): Suarez FL, Springfield J, Levitt MD. Source: Gut. 1998 July; 43(1): 100-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9771412&dopt=Abstract

•

Indigestion and flatulence. Author(s): Hecker R. Source: Aust Fam Physician. 1981 June; 10(6): 447-51. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7283850&dopt=Abstract

•

Influence of diet on flatus volume in human subjects. Author(s): Davies PJ. Source: Gut. 1971 September; 12(9): 713-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5098326&dopt=Abstract

•

Insights into human colonic physiology obtained from the study of flatus composition. Author(s): Suarez F, Furne J, Springfield J, Levitt M. Source: The American Journal of Physiology. 1997 May; 272(5 Pt 1): G1028-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9176210&dopt=Abstract

•

Investigation of normal flatus production in healthy volunteers. Author(s): Tomlin J, Lowis C, Read NW. Source: Gut. 1991 June; 32(6): 665-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1648028&dopt=Abstract

•

Managing bloating, flatus and flatulence. Author(s): Bell AJ, Ciclitira PJ. Source: The Practitioner. 2000 April; 244(1609): 301-4, 306, 308-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10892051&dopt=Abstract

•

Mastication and aerophagia. Author(s): Balogh K. Source: Dent Dig. 1971 October; 77(10): 590-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5286123&dopt=Abstract

•

Mechanisms of flatulence and diarrhoea. Author(s): Read NW. Source: The British Journal of Surgery. 1985 September; 72 Suppl: S5-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3899262&dopt=Abstract

Studies

23

•

Methane excretion in man--a study of breath, flatus, and faeces. Author(s): McKay LF, Eastwood MA, Brydon WG. Source: Gut. 1985 January; 26(1): 69-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3965369&dopt=Abstract

•

Multiple vaginal deliveries increase the risk of permanent incontinence of flatus urine in normal premenopausal women. Author(s): Ryhammer AM, Bek KM, Laurberg S. Source: Diseases of the Colon and Rectum. 1995 November; 38(11): 1206-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7587765&dopt=Abstract

•

Myasthenia gravis presenting as uncontrollable flatus and urinary/fecal incontinence. Author(s): Berger AR, Swerdlow M, Herskovitz S. Source: Muscle & Nerve. 1996 January; 19(1): 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8538663&dopt=Abstract

•

Paradoxical intention in the treatment of obsessional flatulence ruminations. Author(s): Milan MA, Kolko DJ. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1982 June; 13(2): 16772. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7130415&dopt=Abstract

•

Pathologic childhood aerophagia: a recognizable clinical entity. Author(s): Gauderer MW, Halpin TC Jr, Izant RJ Jr. Source: Journal of Pediatric Surgery. 1981 June; 16(3): 301-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7252731&dopt=Abstract

•

Plain word for “passed flatus”. Author(s): Hershkovitz M. Source: The New England Journal of Medicine. 1977 January 20; 296(3): 178. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=831087&dopt=Abstract

•

Postoperative flatulence: causes and remedies. Author(s): Vaughn JB, Nemcek MA. Source: Todays or Nurse. 1986 October; 8(10): 19-23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3641492&dopt=Abstract

•

Recovery of bowel motility after surgery. Detection of time of first flatus from carbon dioxide concentration and patient estimate after nalbuphine and placebo. Author(s): Yukioka H, Bogod DG, Rosen M. Source: British Journal of Anaesthesia. 1987 May; 59(5): 581-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3107601&dopt=Abstract

24

Flatulence

•

Repetitive belching, aerophagia, and torticollis in Huntington's disease: a case report. Author(s): Hu MT, Chaudhuri KR. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1998 March; 13(2): 363-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9539359&dopt=Abstract

•

Stoma care. One. The cuff-link flatus filter. Author(s): Wilkins L, Reeves K. Source: Nurs Times. 1984 May 30-June 5; 80(22): 24-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6564534&dopt=Abstract

•

Tetracycline sensitivity as a cause of excessive flatus. Author(s): Anthony HM. Source: British Medical Journal. 1977 December 24-31; 2(6103): 1632. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=589390&dopt=Abstract

•

Transverse colon volvulus in a child with pathologic aerophagia. Author(s): Trillis F Jr, Gauderer MW, Ponsky JL, Morrison SC. Source: Journal of Pediatric Surgery. 1986 November; 21(11): 966-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3794954&dopt=Abstract

•

Treating aerophagia with contingent physical guidance. Author(s): Garcia D, Starin S, Churchill RM. Source: J Appl Behav Anal. 2001 Spring; 34(1): 89-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11317995&dopt=Abstract

•

You're the flight surgeon. Flatus. Author(s): Leonard F. Source: Aviation, Space, and Environmental Medicine. 1993 July; 64(7): 668. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8357327&dopt=Abstract

25

CHAPTER 2. NUTRITION AND FLATULENCE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and flatulence.

Finding Nutrition Studies on Flatulence The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “flatulence” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

26

Flatulence

The following information is typical of that found when using the “Full IBIDS Database” to search for “flatulence” (or a synonym): •

Belching, bloating, and flatulence. How to help patients who have troublesome abdominal gas. Author(s): Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242-1081, USA. Source: Rao, S S Postgrad-Med. 1997 April; 101(4): 263-9, 275-8 0032-5481

•

Call it flatulence or gas, tips on how to quiet the rumble. Source: Kline, C. Environmental-nutrition (USA). (January 1993). volume 16(1) page 2. foods digestive disorders 0893-4452

•

Effect of domestic processing on flatus producing factors in ricebean (Vigna umbellata). Author(s): Punjab Agricultural University, Department of Foods and Nutrition, INDLudhiana-141004, India. Source: Kaur, M Kawatra, B L Nahrung. 2000 December; 44(6): 447-50 0027-769X

•

Flatulence--causes, relation to diet and remedies. Author(s): Institute of Food Research, Norwich Laboratory, UK. Source: Price, K R Lewis, J Wyatt, G M Fenwick, G R Nahrung. 1988; 32(6): 609-26 0027769X

•

Flatus emission patterns and fibre intake. Author(s): Gastrointestinal Unit, Prince of Wales Hospital, Randwick, NSW, Australia. Source: Bolin, T D Stanton, R A Eur-J-Surg-Suppl. 1998; (582): 115-8

•

Flavor and flatulence factors in soybean protein products. Source: Rackis, J.J. Honig, D.H. Sessa, D.J. Steggerda, F.R. J-Agric-Food-Chem. Washington, D.C. : American Chemical Society. Nov/December 1970. volume 18 (6) page 977-982. 0021-8561

•

Wind and flatulence--a problem aired. Source: Richardson, D.P. BNF-nutr-bull. London : The Foundation,. Sept 1992. volume 17 page 233-235. 0141-9684

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

Nutrition

27

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMD®Health: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to flatulence; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Food and Diet Artichoke Alternative names: Cynara scolymus Source: Healthnotes, Inc.; www.healthnotes.com Garlic Alternative names: Allium sativum Source: Healthnotes, Inc.; www.healthnotes.com Garlic Source: Prima Communications, Inc.www.personalhealthzone.com Gluten-Free Diet Source: Healthnotes, Inc.; www.healthnotes.com

28

Flatulence

High-Fiber Diet Source: Healthnotes, Inc.; www.healthnotes.com Jerusalem Artichokes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,39,00.html

29

CHAPTER 3. ALTERNATIVE MEDICINE AND FLATULENCE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to flatulence. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to flatulence and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “flatulence” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to flatulence: •

A comparative study of the effects on colon function caused by feeding ispaghula husk and polydextrose. Author(s): Tomlin J, Read NW. Source: Alimentary Pharmacology & Therapeutics. 1988 December; 2(6): 513-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2979274&dopt=Abstract

•

A novel treatment for constipation-predominant irritable bowel syndrome using Padma Lax, a Tibetan herbal formula. Author(s): Sallon S, Ben-Arye E, Davidson R, Shapiro H, Ginsberg G, Ligumsky M. Source: Digestion. 2002; 65(3): 161-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12138321&dopt=Abstract

•

A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome. Author(s): Keefer L, Blanchard EB.

30

Flatulence

Source: Behaviour Research and Therapy. 2002 May; 40(5): 541-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12038646&dopt=Abstract •

A review of the role of the gut microflora in irritable bowel syndrome and the effects of probiotics. Author(s): Madden JA, Hunter JO. Source: The British Journal of Nutrition. 2002 September; 88 Suppl 1: S67-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215182&dopt=Abstract

•

Abdominal distension--discussion. Author(s): Hu J. Source: J Tradit Chin Med. 1994 June; 14(2): 157-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7967701&dopt=Abstract

•

Absence of gaseous symptoms during ingestion of commercial fibre preparations. Author(s): Zumarraga L, Levitt MD, Suarez F. Source: Alimentary Pharmacology & Therapeutics. 1997 December; 11(6): 1067-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9663831&dopt=Abstract

•

Administration of charcoal, Yucca schidigera, and zinc acetate to reduce malodorous flatulence in dogs. Author(s): Giffard CJ, Collins SB, Stoodley NC, Butterwick RF, Batt RM. Source: J Am Vet Med Assoc. 2001 March 15; 218(6): 892-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11294313&dopt=Abstract

•

Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Author(s): Nobaek S, Johansson ML, Molin G, Ahrne S, Jeppsson B. Source: The American Journal of Gastroenterology. 2000 May; 95(5): 1231-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10811333&dopt=Abstract

•

Anal incontinence after childbirth. Author(s): Eason E, Labrecque M, Marcoux S, Mondor M. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 February 5; 166(3): 326-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868640&dopt=Abstract

•

Aniseed oil increases glucose absorption and reduces urine output in the rat. Author(s): Kreydiyyeh SI, Usta J, Knio K, Markossian S, Dagher S. Source: Life Sciences. 2003 December 19; 74(5): 663-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14623036&dopt=Abstract

Alternative Medicine 31

•

Auricular-plaster therapy plus acupuncture at zusanli for postoperative recovery of intestinal function. Author(s): Wan Q. Source: J Tradit Chin Med. 2000 June; 20(2): 134-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11039005&dopt=Abstract

•

Behavioral treatment of irritable bowel syndrome: a 1-year follow-up study. Author(s): Schwarz SP, Blanchard EB, Neff DF. Source: Biofeedback Self Regul. 1986 September; 11(3): 189-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3300787&dopt=Abstract

•

Behaviorally treated irritable bowel syndrome patients: a four-year follow-up. Author(s): Schwarz SP, Taylor AE, Scharff L, Blanchard EB. Source: Behaviour Research and Therapy. 1990; 28(4): 331-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2222390&dopt=Abstract

•

Biochemistry of black gram (Phaseolus mungo L.): a review. Author(s): Reddy NR, Salunkhe DK, Sathe SK. Source: Critical Reviews in Food Science and Nutrition. 1982; 16(1): 49-114. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7037311&dopt=Abstract

•

Bitters and carminatives. Author(s): Kinloch JD. Source: The Practitioner. 1971 January; 206(231): 44-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5540193&dopt=Abstract

•

Botanical perspectives on health peppermint: more than just an after-dinner mint. Author(s): Spirling LI, Daniels IR. Source: J R Soc Health. 2001 March; 121(1): 62-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11329700&dopt=Abstract

•

Breath hydrogen and methane expiration in men and women after oat extract consumption. Author(s): Behall KM, Scholfield DJ, van der Sluijs AM, Hallfrisch J. Source: The Journal of Nutrition. 1998 January; 128(1): 79-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9430606&dopt=Abstract

•

Breath hydrogen and methane responses of men and women to breads made with white flour or whole wheat flours of different particle sizes. Author(s): Hallfrisch J, Behall KM.

32

Flatulence

Source: Journal of the American College of Nutrition. 1999 August; 18(4): 296-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12038471&dopt=Abstract •

Characterization of alpha-galactosidases from germinating soybean seed and their use for hydrolysis of oligosaccharides. Author(s): Guimaraes VM, de Rezende ST, Moreira MA, de Barros EG, Felix CR. Source: Phytochemistry. 2001 September; 58(1): 67-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11524115&dopt=Abstract

•

Characterization of the melA locus for alpha-galactosidase in Lactobacillus plantarum. Author(s): Silvestroni A, Connes C, Sesma F, De Giori GS, Piard JC. Source: Applied and Environmental Microbiology. 2002 November; 68(11): 5464-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406739&dopt=Abstract

•

Chemistry and technology of green gram (Vigna radiata [L.] Wilczek). Author(s): Adsule RN, Kadam SS, Salunkhe DK. Source: Critical Reviews in Food Science and Nutrition. 1986; 25(1): 73-105. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3539530&dopt=Abstract

•

Clinical picture of diverticular disease of the colon. Author(s): Thompson WG, Patel DG. Source: Clin Gastroenterol. 1986 October; 15(4): 903-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3536213&dopt=Abstract

•

Combined traditional Chinese medicine and Western medicine. Relieving effects of Chinese herbs, ear-acupuncture and epidural morphine on postoperative pain in liver cancer. Author(s): Li QS, Cao SH, Xie GM, Gan YH, Ma HJ, Lu JZ, Zhang ZH. Source: Chinese Medical Journal. 1994 April; 107(4): 289-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8088198&dopt=Abstract

•

Commentary on common alimentary symptoms. Author(s): Jones FA. Source: Trans Med Soc Lond. 1965; 81: 126-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5825320&dopt=Abstract

•

Dietary analysis in symptomatic patients with coeliac disease on a gluten-free diet: the role of trace amounts of gluten and non-gluten food intolerances. Author(s): Faulkner-Hogg KB, Selby WS, Loblay RH.

Alternative Medicine 33

Source: Scandinavian Journal of Gastroenterology. 1999 August; 34(8): 784-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10499479&dopt=Abstract •

Effect of domestic processing on flatus producing factors in ricebean (Vigna umbellata). Author(s): Kaur M, Kawatra BL. Source: Die Nahrung. 2000 December; 44(6): 447-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11190844&dopt=Abstract

•

Effect of processing on flatus producing oligosaccharides in cowpea (Vigna unguiculata) and the tropical African yam bean (Sphenostylis stenocarpa). Author(s): Nwinuka NM, Abbey BW, Ayalogu EO. Source: Plant Foods for Human Nutrition (Dordrecht, Netherlands). 1997; 51(3): 209-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9629861&dopt=Abstract

•

Elimination of flatus factors in soya bean preparation for a rural community. Author(s): Kay T. Source: Journal of Tropical Pediatrics. 1981 April; 27(2): 108-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7194921&dopt=Abstract

•

Flatulence and other discomforts associated with consumption of cowpea (Vigna unguiculata). Author(s): Ndubuaku VO, Uwaegbute AC, Nnanyelugo DO. Source: Appetite. 1989 December; 13(3): 171-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2596840&dopt=Abstract

•

Flatulence: pathophysiology and treatment. Author(s): Van Ness MM, Cattau EL Jr. Source: American Family Physician. 1985 April; 31(4): 198-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3984823&dopt=Abstract

•

Flatus inducing effect of processed legumes in pre-school children. Author(s): Geervani P, Theophilus F. Source: The Indian Journal of Medical Research. 1979 November; 70: 750-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=535974&dopt=Abstract

•

Flavor and flatulence factors in soybean protein products. Author(s): Rackis JJ, Honig DH, Sessa DJ, Steggerda FR. Source: Journal of Agricultural and Food Chemistry. 1970 November-December; 18(6): 977-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5529935&dopt=Abstract

34

Flatulence

•

In praise of canine flatulence research. Author(s): Lavac F. Source: J Am Vet Med Assoc. 2001 May 1; 218(9): 1416. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11345301&dopt=Abstract

•

Removal of flatulence principles from legumes by mold fermentation. Author(s): Jha K, Verma J. Source: Indian J Exp Biol. 1980 June; 18(6): 658-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7439954&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMD®Health: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to flatulence; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Ascariasis Source: Integrative Medicine Communications; www.drkoop.com Cystic Fibrosis Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 35

Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.drkoop.com Guinea Worm Disease Source: Integrative Medicine Communications; www.drkoop.com Heartburn Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Prima Communications, Inc.www.personalhealthzone.com Hookworm Source: Integrative Medicine Communications; www.drkoop.com Irritable Bowel Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Loiasis Source: Integrative Medicine Communications; www.drkoop.com Lymphatic Filariasis Source: Integrative Medicine Communications; www.drkoop.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Pancreatic Insufficiency Source: Healthnotes, Inc.; www.healthnotes.com Pinworm Source: Integrative Medicine Communications; www.drkoop.com Proctitis Source: Integrative Medicine Communications; www.drkoop.com Rectal Inflammation Source: Integrative Medicine Communications; www.drkoop.com River Blindness Source: Integrative Medicine Communications; www.drkoop.com Roundworms Source: Integrative Medicine Communications; www.drkoop.com

36

Flatulence

Threadworm Source: Integrative Medicine Communications; www.drkoop.com Trichinosis Source: Integrative Medicine Communications; www.drkoop.com Visceral Larva Migrans Source: Integrative Medicine Communications; www.drkoop.com Whipworm Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Chi Nei Tsang Ii Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html

•

Chinese Medicine Shanzha Huazhi Wan Alternative names: Shanzha Huazhi Pills; Shanzha Huazhi Wan (Shan Zha Hua Zhi Wan) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China

•

Herbs and Supplements 5-HTP Source: Integrative Medicine Communications; www.drkoop.com 5-Hydroxytryptophan (5-HTP) Source: Integrative Medicine Communications; www.drkoop.com Achillea Millefolium Source: Integrative Medicine Communications; www.drkoop.com Activated Charcoal Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,832,00.html Anise Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Caraway Alternative names: Carum carvi Source: Healthnotes, Inc.; www.healthnotes.com

Alternative Medicine 37

Catnip Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Chamomile Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,766,00.html Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com Fennel Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Feverfew Alternative names: Tanacetum parthenium, Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com Fructo-Oligosaccharides (FOS) and Other Oligosaccharides Source: Healthnotes, Inc.; www.healthnotes.com Gentian Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Ginger Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,787,00.html Glucomannan Source: Healthnotes, Inc.; www.healthnotes.com Grapefruit Seed Extract Source: Healthnotes, Inc.; www.healthnotes.com Green-lipped Mussel Source: Healthnotes, Inc.; www.healthnotes.com Lemon Balm Alternative names: Melissa officinalis, Melissa Source: Integrative Medicine Communications; www.drkoop.com Melissa Source: Integrative Medicine Communications; www.drkoop.com Melissa Officinalis Source: Integrative Medicine Communications; www.drkoop.com

38

Flatulence

Peppermint Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,812,00.html Plantago Psyllium Alternative names: Psyllium, Ispaghula; Plantago psyllium/ovata Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Psyllium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,814,00.html Tanacetum Parthenium Source: Integrative Medicine Communications; www.drkoop.com Trigonella Alternative names: Fenugreek; Trigonella foenum graecum L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Turmeric Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10062,00.html Wild Yam Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Yarrow Alternative names: Achillea millefolium, Milfoil Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

39

CHAPTER 4. PATENTS ON FLATULENCE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “flatulence” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on flatulence, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Flatulence By performing a patent search focusing on flatulence, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

40

Flatulence

example of the type of information that you can expect to obtain from a patent search on flatulence: •

Antiflatulent composition Inventor(s): Day; Charles E. (1434 Sunbeam Rd., Leitchfield, KY 42754) Assignee(s): None Reported Patent Number: 6,200,605 Date filed: October 29, 1998 Abstract: An antiflatulent composition is disclosed which comprises a polysaccharide and a preservative. The composition is useful to control gas formation at the site of generation of flatulence. Excerpt(s): The invention relates to a composition useful as an antiflatulent dietary supplement. Flatulence is a normal human excretory function socially stigmatized in the United States. Flatulence is the result of the production of gases in the large intestine by anaerobic microbes, primarily bacteria, that are nourished by the contents of the intestinal lumen. Other than the bacteria themselves, which can number as great as one trillion per gram of colonic lumenal contents, the contents of the lumen of the large intestine include, aside from water and ions and other minor components, foodstuffs not digested during prior transit through the proximal portions of the alimentary canal: the mouth, esophagus, stomach and small intestine. It is these otherwise undigested lumenal contents which the microbes themselves may digest. End-products of the metabolism of these contents by the anaerobic microbes include various gases, including H.sub.2, CH.sub.4, etc. and short-chain fatty acids (SCFAs) such as acetic, propionic, and butyric acids. One of the primary loci of absorption of SCFAs out of the lumen and into colonic epithelia is the proximal portion of the colon, i.e. the cecum and ascending (right) colon. Gases are excreted through the lungs or via the external anal sphincter (EAS). Digestive processes in the colon are reviewed in: Cummings J H, Macfarlane G T (1991) The control and consequences of bacterial fermentation in the human colon. Journal of Applied Bacteriology 70, 443-459; Nordgaard I, Mortensen P B (1995) Digestive processes in the human colon. Nutrition 11, 37-45; Gibson G R, Roberfroid M B (1995) Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. Journal of Nutrition 125, 1401-1412. Previous inventions to relieve flatulence have in general been medications based upon compounds such as simethicone that lower the surface tension of gas bubbles evolved in the bowel lumen, hence lessening individual bubble volume and easing passage. Some such compositions are described in U.S. Pat. Nos. 4,127,650, 5,599,577, and 5,612,054. Useful as such inventions may be, they do not address the root cause of flatulence, i.e. the production of gas by the resident microbes. The use of a microbial galactosidase to prevent flatulence is known in the art but is limited in its potential effectiveness to flatulence caused by the fermentation of galactose-containing oligosaccharides. Moreover, such enzymatic preventatives are limited in their effectiveness by the ability of the enzyme to withstand the rigors of the environment of the stomach and the small intestine and by the uncertain probability that enzyme and substrate will productively collide. Web site: http://www.delphion.com/details?pn=US06200605__

Patents 41

•

Aromatic amides of heterocyclic compounds and therapeutic compositions containing same Inventor(s): Noverola; Armando V. (Barcelona, ES), Soto; Jose P. (Barcelona, ES), Spickett; R. G. W. (Barcelona, ES) Assignee(s): Anphar, S.a. (madrid, Es) Patent Number: 4,138,492 Date filed: March 17, 1975 Abstract: The invention relates to aromatic amides N-substituted by heterocyclic groups. More particularly, the invention relates to substituted benzoic acid amides of 1arylalkylamino or aminoalkyl-N-heterocyclic rings and to pharmaceutical compositions thereof, which have the ability to antagonize the effects of dopamine or dopaminergic agents of endogenous or exogenous origin and which may be used for the treatment of nausea and vomiting resulting from gastrointestinal disorders, congestive heart failure, post operative conditions, etc., other gastrointestinal disorders such as dyspepsia, flatulence, bile regurgitations, hiatus hernia, peptic ulcer, reflux aerophagitis, gastritis, duodenitis, and cholethiasis, and a variety of conditions affecting the central nervous system such as acute and chronic psychoses, maniacal psychosis, schizophrenias, serious disturbances of behavior and non-melancholic depressive state and migraine. Excerpt(s): Or a pharmaceutically acceptable salt thereof. Illustrative examples of the acylamino group include formamido, acetamido, propionamido, chloroacetamido, trifluoroacetamido, aminoacetamido, 1-piperidylacetamido, ureido, N-alkylureido, butyramido, pentanoamido and hexanoamido. Each of the aryl, aroyl or heterocyclic groups represented by the radical R.sub.3 or Ar may be substituted with 1 or 3 identical or different groups selected from the following: C.sub.1 -C.sub.6 -alkoxy, hydroxyl, amino, mono- or di-lower alkylsubstituted amino, nitro, halogen (fluoro, chloro or bromo) trifluoromethyl, C.sub.1 -C.sub.6 straight or branched chain alkyl or sulphonamido. The number x is preferably 0 or 1. Web site: http://www.delphion.com/details?pn=US04138492__

•

Bathroom odor eliminator Inventor(s): O'Brien; John W. (607 S. Kelly St., Harrison, AR 72601) Assignee(s): None Reported Patent Number: 5,307,525 Date filed: September 28, 1992 Abstract: As an improvement for eliminating lingering bathroom odor, a few drops of an appropriate fluid mixture such as a chlorinated hydrocarbon containing a small amount of a volatile fragrant fluid is added to water in a toilet bowl prior to the use of the toilet. A unique property of the first fluid causes the resultant mixture to spread quickly over the entire surface of the water, forming a nonpermeable film across which the odor emanating from unflushed feces cannot pass. The second fluid quickly vaporizes from this film allowing the resulting concentrated fragrance to neutralize within the toilet bowl the flatulence odor produced during a bowel movement. A person sitting upon the toilet seat actuates a semiautomatic fluid dispenser. Excerpt(s): This invention relates to an improved method of eliminating bathroom odor by trapping and neutralizing it at its source within the toilet bowl. Bathroom odor is

42

Flatulence

currently reduced by exhausting the foul smelling air out of the building by means of an exhaust fan and associated duct work, or by neutralizing the odor through the use of air fresheners which release into the air a stronger less obnoxious scent, or by adding a pleasant scent to the toilet flushing water using slowly dissolving solids. The exhaust fan method requires expensive installation, generates considerable noise when in operation, requires the toggling of an on-off switch for operation, and is not available in older houses or in all bathrooms in many newer houses. Exhausting the air requires either heating or dehumidifying and cooling the incoming replacement air. The fan uses electric power during its operation. Normally neither the fan shutters or exhaust ducts are insulated, and there is a small amount of air leakage through the shutters, all of which constitute additional energy loss. So this odor handling method is both inconvenient and uses energy for its operation. Web site: http://www.delphion.com/details?pn=US05307525__ •

Device for reduction of flatulence Inventor(s): Kahl; Melvin R. (19 Carlotia Dr., Jeffersonville, IN 47130) Assignee(s): None Reported Patent Number: 6,221,004 Date filed: July 9, 1999 Abstract: A device to reduce flatulence includes a shaft with at least one axial groove in its outer surface. The shaft is enlarged and rounded at the insertion end. This enlarged end is inserted beyond the sphincter muscle. The muscle then closes in on shaft itself, but the grooves provides a path for the continual relief of gas pressure. Excerpt(s): The present invention relates to a device to reduce problems with discharge of intestinal gas. All individuals emit a certain amount of flatus or intestinal gas continually during the chemical action of the digestive process. The amount of intestinal gas depends to a large extent upon the diet and the particular digestive chemistry. Some individuals have a sphincter that does not seal completely, so they unconsciously pass or ooze small amounts of intestinal gas continually with no backup or pressure build up. Some other individuals have a sphincter that seals against such leakage. For those people, as intestinal gas is formed, pressure builds up in the anal area. The pressure buildup may cause severe pain. When pressure builds up sufficiently, it exceeds the sealing properties of the sphincter at the anus, causing a sudden escape of a sizable volume of this intestinal gas under pressure. This sudden discharge of intestinal gases vibrates membranes near the anus causing noise which can be very embarrassing to the person. Some people also experience "brown spots" on the underwear in conjunction with such intestinal gas emissions. The prior art (See Ghedina Patent 4,943,276) teaches a device with a hollow inner tube as a pathway for the relief of intestinal gases and has small openings to allow the intestinal gases to reach the thin, hollow inner tube. However, these small openings are easily plugged by excreta and other material in the digestive tract, rendering this device ineffective. Web site: http://www.delphion.com/details?pn=US06221004__

Patents 43

•

Feed composition for ruminant animals and method of feeding ruminant animals with the same Inventor(s): Isobe; Yoshio (Suginami-ku, JP), Ito; Toshio (Suita, JP), Shibata; Fumio (Fujisawa, JP) Assignee(s): Takeda Chemical Industries, Ltd. (osaka, Jp) Patent Number: 5,589,186 Date filed: April 6, 1995 Abstract: A feed composition containing fumaric acid or a salt thereof, a concentrate feed and, if necessary, a roughage is fed to ruminants. The ratio of the concentrate to the roughage is about 90-10/10-90 (% by weight). When fumaric acid or a salt thereof in a granular form such as mean particle diameter of not less than 75 mesh is added to a ration, the proportion of acetic acid and propionic acid among volatile fatty acids (VFA) in the ruminant animal is increased for a sustained time to enhance the efficiency of milk and meat production and improve the quality of meat. The proportion of fumaric acid or a salt thereof is about 0.1 to 10% by weight. The addition of fumaric acid or a salt thereof helps to suppress flatulence which tends to occur on feeding with concentrates. Excerpt(s): The present invention relates to a feed composition for ruminant animals and a method of feeding ruminant animals with the feed composition. Incorporated in diets for domestic animals is a variety of additives. For example, it is described in Japanese Patent Laid open No. (JP-A) 58-155050 that the administration of hydroxycarboxylic or polybasic carboxylic acids such as citric acid, tartaric acid, fumaric acid, etc. or their salts to poultry results in improvements in egg production rate and egg quality. Moreover, Japanese Patent Laid open No. (JP-A) 56-121436 discloses a formula feed comprising a milk replacer supplemented with C.sub.4-6 carboxylic acids or salts thereof for improved palatability and accelerated growth of calves. It has also been reported that supplementing a cattle ration with fumaric acid is effective in the prophylaxis and therapy of mastitis in cows [Journal Japanese Veterinarians Association 39 (Supplemental Issue) (1985)]. Web site: http://www.delphion.com/details?pn=US05589186__

•

Five-membered ring systems with bonded imidazolyl ring substituents Inventor(s): Baker; Raymond (Much Hadham, GB2), Saunders; John (Bishops Standford, GB2), Swain; Christopher (Duxford, GB2) Assignee(s): Merck Sharp & Dohme Ltd. (hertfordshire, Gb2) Patent Number: 5,140,034 Date filed: March 8, 1990 Abstract: A class of 5-membered heterocyclic compounds having at least one heteroatom, substituted on the heterocyclic ring by an imidazolyl moiety, are useful in the treatment of psychotic disorders (e.g. schizophrenia and mania); anxiety; alcohol or drug withdrawal or dependence; pain; gastric stasis; gastric dysfunction (such as occurs with dyspepsia, peptic ulcer, reflux oesophagitis and flatulence); migraine, nausea and vomiting; movement disorders; and presenile and senile dementia. Excerpt(s): This invention relates to a class of 5-membered heterocyclic compounds having at least one heteroatom, which are useful in the treatment of psychotic disorders (e.g. schizophrenia and mania); anxiety; alcohol or drug withdrawal or dependence;

44

Flatulence

pain; gastric stasis; gastric dysfunction (such as occurs with dyspepsia, peptic ulcer, reflux oesophagitis and flatulence); migraine, nausea and vomiting; movement disorders; and presenile and senile dementia (also known as Alzheimer's disease and senile dementia of the Alzheimer type respectively). R.sup.3, R.sup.4 and R.sup.5 independently represent hydrogen, C.sub.1-6 alkyl, C.sub.2-6 alkenyl, C.sub.2-6 alkynyl or aryl. The ring shown as formula I may be, for example, a furan, thiophene, pyrrole, oxazole, thiazole, oxazoline, isoxazoline, thiazoline, oxadiazole, thiadiazole or imidazole ring, in particular a 1,2,4-oxadiazole, 1,3,4-oxadiazole, 1,2,4-thiadiazole or 1,3,4thiadiazole ring. Preferably the ring is a 1,2,4-oxadiazole, 1,2,4-thiadiazole or oxazoline ring. Web site: http://www.delphion.com/details?pn=US05140034__ •

Flatulence deodorizer Inventor(s): Conant; Brian J (94-1068 Akaku St., Mililani, HI 96789), Conant; Myra M (941068 Akaku St., Mililani, HI 96789) Assignee(s): None Reported Patent Number: 6,313,371 Date filed: April 12, 2000 Abstract: The present invention 10 discloses a pad to be worn by a user 12 for absorbing gas due to flatulence. The pad is constructed of activated charcoal cloth 16 disposed between a pair of laminations or layers 18 having multiple perforations 20 therein. The method of use of the present invention is also simple. The pad 10 is non-intrusively taped inside briefs or panties 24 in the anal area using double-sided adhesive tape 28 and due to its slim profile, the wearer is comfortably unaware of its presence. A continuous roll or portion of double-sided tape 28 is provided with perforated section intended for tearing off for one time, disposable use with the washable and reusable filter pads 10. A double-compartment ziplocked plastic bag 33 is also provided for carrying and separating the tape and pads for sanitary purposes. This makes the present invention 10 a safe, effective, cost efficient, comfortable and least intrusive method of dealing with this embarrassing problem. Excerpt(s): The present invention relates generally to intestinal discharge control products and, more specifically, to flatulence deodorizers. There are various devices in this field for dealing with the problems of intestinal discharges with some degree of success. However, all of them are somewhat cumbersome and/or bulky to use. The present invention, the Flatulence Deodorizer, is the first product for this application to use activated charcoal cloth as a deodorizer because it is so much more effective in removing odor than other known agents and because of its highly efficient filtering action, the thickness of the cloth can be significantly reduced without loosing effectiveness. The filter is worn taped to the inside of briefs or panties and because of its slim profile, the wearer is comfortable and virtually unaware of its presence. The activated charcoal cloth filter is also washable and reusable. This makes the present invention the most effective, cost efficient, comfortable and least intrusive means of deodorizing gassy discharges. There are other protective devices designed for shielding against, filtering and/or capturing intestinal exudations of various kinds. Typical of these is U.S. Pat. No. 4,182,335 issued to C. James Matrullo on Jan. 8, 1980. Another patent was issued to Randolph E. Campbell on Dec. 25, 1984 as U.S. Pat. No. 4,490,145. Yet another U.S. Pat. No. 4,880,417 was issued to Alexander A. Yabrov on Nov. 14, 1989

Patents 45

and still yet another was issued on Nov. 1, 1994 to David W. Revelle as U.S. Pat. No. 5,360,421. Web site: http://www.delphion.com/details?pn=US06313371__ •

Hemorrhoid retainers Inventor(s): Becklin; Wallace W. (10510 Holly La., Maple Grove, MN 55369), Gianopoulos; Thomas J. (8070 12th Ave. South, Bloomington, MN 55420) Assignee(s): None Reported Patent Number: 4,702,237 Date filed: August 27, 1986 Abstract: A flexible yet strong member having an adhesive on one side which can be secured to the anal area to physically hold the hemorrhoids within the anal orifice with the member including means such as orifices to permit bowel gas or flatulence to rapidly escape therethrough without dislodging the hemorrhoid retainer from the anal area. Excerpt(s): This invention relates primarily to medical devices and, more specifically, to disposable hemorrhoid retainers that can be quickly applied to securely and firmly hold hemorrhoids within the anal orifice. External protruding hemorrhoids generally cause pain and discomfort. In addition, if the hemorrhoids become bruised, they may bleed which may cause the person alarm and concern. Bleeding hemorrhoids may eventually require surgery since the available ointments, creams, jells and the like offer only temporary relief to the pain and itching and do not protect the hemorrhoid membranes from further bruising and bleeding. Typically, when external protruding hemorrhoids become bothersome, one must push the hemorrhoids into the anal area with one's fingers. However, insertion of the hemorrhoids into the anal area does not prevent the hemorrhoids from coming out again particularly if the person moves about. If the hemorrhoids continually protrude, usually the only option is to have surgery to remove them. A disadvantage of available hemorrhoid preparations is that many people are hesitant about using them because they are, to some extent, invasive since some of the hemorrhoid preparations have to be placed inside the anal orifice. Web site: http://www.delphion.com/details?pn=US04702237__

•

Ibuprofen antacid combinations Inventor(s): Gates; Thomas N. (Doylestown, PA), Sims; Robert T. (Holicong, PA), Slivka; William (Philadelphia, PA) Assignee(s): Mcneill-ppc, Inc. (fort Washington, Pa), Merck & Co., Inc. (rahway, Nj) Patent Number: 5,288,507 Date filed: July 29, 1992 Abstract: This invention relates to a pharmaceutical composition for use in the treatment of pain and inflammation and the treatment of acid indigestion, sour stomach, heartburn and symptoms of upset stomach associated with these conditions in a mammalian organism, said composition comprising:(i) an analgesically and antiinflammatory effective amount of (S)-ibuprofen, or a salt thereof, substantially free of (R)-ibuprofen;(ii) an amount effective in the treatment of acid indigestion, sour stomach

46

Flatulence

and/or heartburn of at least one of the antacids; and(iii) optionally, an amount effective in treating excess gas and flatulence of an anti-gas agent. Excerpt(s): The non-steroidal anti-inflammatory drugs (NSAID) have been utilized in the treatment of pain/inflammation and have been disclosed as useful in the treatment, management and mitigation of cold symptoms and the pain associated therewith. Ibuprofen (2-(4-isobutylphenyl)propionic acid) is a well known and commonly employed NSAID. Recently, it has been found that a faster onset of pain relief and an enhanced analgesic response can be obtained by the utilization of the single enantiomer (S)-ibuprofen in comparison to racemic ibuprofen, (see for example U.S. Pat. No. 4,877,620). Antacids are useful for the treatment of acid indigestion, heartburn, sour stomach, and symptoms of upset stomach associated with these conditions. Antacids work by neutralizing the excess stomach acid, thereby preventing inflammation, relieving pain, and allowing the mucous layer and lining to mend. In optional combination with an anti-gas agent, such as simethicone, antacids may offer relief or reduction of flatuence. Anti-gas remedies have a defoaming action that relieves or reduces flatulence by dispersing and preventing the formation of mucous-surrounded gas pockets in the gastrointestinal tract. Additionally, products which are combined with alginates float on the contents of the stomach and produce a neutralizing layer to subdue acid that can rise into the esophagus, causing heartburn. Web site: http://www.delphion.com/details?pn=US05288507__ •

Method and product for eliminating undesirable side effects of eating vegetables such as onion or garlic Inventor(s): Chaykin; Sterling (1027 Maple La., Davis, CA 95616) Assignee(s): None Reported Patent Number: 6,007,809 Date filed: May 13, 1993 Abstract: A method for reducing the undesirable side effects normally resulting from eating certain vegetables. Specifically, the malodorous breath and perspiration from eating garlic, onion, etc. and the burping and flatulence resulting from eating cucumber, beans, etc., can be avoided by ingesting active dry yeast protected by an enteric coating. Excerpt(s): The present invention relates to a method of reducing undesirable side effects of eating certain vegetables (e.g. onion and garlic). A person eating certain vegetables, such as onion and garlic, typically exhibits malodorous breath and perspiration within a few hours. The digestion of these and other vegetables such as cabbage, cucumber, radish and beans can lead to digestive distress, including burping and flatulence. The malodorous breath and perspiration tend to be caused by sulfurcontaining compounds, such as dimethylsulfide, methymercaptan, and hydrogen sulfide. Intestinal distress results from a buildup of these and other gases (including carbon dioxide and methane) in the intestine. The escape of intestinal gases produces burping and flatulence. The passage of such sulfur-containing compounds across the intestinal wall and into the blood stream causes them to be exhaled through the lungs and secreted as sweat, saliva and other bodily fluids. A variety of techniques have been used for alleviating certain of the undesirable side effects. In general, these techniques are cosmetic and involve masking malodors and other aromas, or removing them from the mouth through chemistry, for example, chlorophyll-containing products. Further,

Patents 47

intestinal gas buildup is minimized by facilitating the elimination of microbubbles. These approaches do no change the underlying digestive processes. Web site: http://www.delphion.com/details?pn=US06007809__ •

Method of making soybean beverages Inventor(s): Bright; Roselie Ann (Cambridge, MA), Hsieh; Dean Shui-Tien (Brookline, MA), Rha; ChouKyun (Boston, MA) Assignee(s): Massachusetts Institute of Technology (cambridge, Ma) Patent Number: 4,119,733 Date filed: May 13, 1977 Abstract: Soybean beverages are prepared by grinding dry, whole soybeans to a powder having a particle size less than about 420 microns. The powder is mixed with hot water to form a slurry, to soften the particles and to inactivate lipoxygenase. The slurry is homogenized and the pectin and cellulose components and the flatulence factors of the homogenized slurry are broken down by adding enzymes to the homogenized slurry. Excerpt(s): This invention relates to a process for making a soybean beverage base such as soy milk or food products made therefrom. The use of soybeans as a protein source in foods is well-known. In spite of their high protein content, marketing of soybean products has had limited success primarily due to an objectional flavor described as "beany flavor." This objectional flavor is not present in the original intact, whole soybeans, but develops immediately after maceration of the bean. The beany flavor is believed to result from the lipid oxidation by lipoxygenase (formerly known as lipoxidase). This undesirable oxidative reaction is accelerated in a liquid medium, especially in the presence of water. Conventional processes for preparing soybean milk include the step of soaking the soybeans in water for many hours and then grinding the beans in water to dissolve or suspend the proteinaceous and other components in the aqueous medium. The suspension or slurry thereby obtained is filtered to remove undesirable large particles and the filtrate is heated. The resultant product is high in protein content. However, as the soaking time for soybeans increases (for example, overnight), larger quantities of water-soluble solids leak out from the beans into the soak water, which is discarded in the conventional methods and that disclosed in U.S. Pat. No. 3,901,978. Analysis of the dry solids found in the soak water showed the following composition: 23.3% crude protein, 2.8% fat, 0.5% sucrose and 63.7% other carbohydrates. Web site: http://www.delphion.com/details?pn=US04119733__

•

N-phenoxy(or thio)hydrocarbon 3,4,5-trihydroxypiperidine derivatives, their use in medicine and in animal nutrition Inventor(s): Junge; Bodo (Wuppertal, DE), Krause; Hans-Peter (Wuppertal, DE), Muller; Lutz (Wuppertal, DE), Sitt; Rudiger (Wuppertal, DE), Stoltefuss; Jurgen (Haan, DE) Assignee(s): Bayer Aktiengesellschaft (leverkusen, De) Patent Number: 4,407,809 Date filed: February 5, 1981

48

Flatulence

Abstract: The invention relates to 3,4,5-trihydroxypiperidine compound of Formula (I) as methods for the preparation of said compounds. Also included in the invention are compositions containing said piperidine compounds and methods for the use of said piperidine compounds and compositions. The invention further includes veterinary compositions containing said piperidine compounds and their use in animal nutrition.The piperidine compounds of Formula (I) are useful as agents against prediabetes, gastritis, constipation, infections of the gastro-intestinal tract, meteorism, flatulence, caries, arteriosclerosis and hypertension and in particular against diabetes, hyperlipaemia and adiposity, and also in animal nutrition for influencing the meat/fat ratio in favor of the meat content. Excerpt(s): The present invention relates to certain new 3,4,5-trihydroxypiperidine compounds, to processes for their production and to their use as agents against prediabetes, gastritis, constipation, infections of the gastro-intestinal tract, meteorism, flatulence, caries, arteriosclerosis and hypertension and in particular against diabetes, hyperlipaemia and adiposity, and also in animal nutrition for influencing the meat/fat ratio in favour of the meat content. R.sup.1, R.sup.2 and R.sup.3 are identical or different and independently of one another denote a hydrogen or halogen atom, an alkyl, aryl, alkoxy, aroxy, alkylthio, nitro, amino, hydroxyl, cyano, alkyl- and di-alkyl-amino, aminoalkyl, hydroxyalkyl, acylamino, sulfonylamino, acyloxy, carboxyl, carbalkoxy, alkylcarbonyl or formyl radical or an optionally substituted carbonamide or sulphonamide radical. The invention preferentially relates to compounds of the formula (I) in which X denotes a saturated or mono-, di- or poly-unsaturated alkyl radical with 1 to 10 and preferably 2 to 5 carbon atoms and Y, R.sup.1, R.sup.2 and R.sup.3 have the meaning indicated above. R.sup.1, R.sup.2 and R.sup.3 preferably independently denote a hydrogen atom, an alkyl or alkoxy group, a halogen atom or a carboxyl, carbalkoxy, amino, acylamino, aryl or aminoalkyl group. Web site: http://www.delphion.com/details?pn=US04407809__ •

Prevention of fiber-induced intestinal gas production by chitosan Inventor(s): Day; Charles E. (1224 Bear Creek Rd., Leitchfield, KY 42754) Assignee(s): None Reported Patent Number: 5,773,427 Date filed: May 31, 1996 Abstract: The tendency of an orally-ingestible dietary fiber composition to cause excessive flatulence upon oral administration is reduced considerably by the incorporation therein, in addition to other dietary fiber components, a flatulencereducing amount of chitosan, or by administering such a flatulence-reducing amount of chitosan concurrently with the other dietary fiber components, illustratively the usual antihyperlipidemic pharmaceutical dietary fiber composition or dietary supplement composition. A preferred dietary fiber composition according to the invention incorporates a plurality of dietary fiber components other than chitosan, preferably acacia gum, pectin, and guar gum, together with a flatulence-reducing amount of chitosan. Excerpt(s): Dietary fiber consumption and therapy with dietary fiber compositions, amelioration of flatulation effects arising therefrom by the employment of a flatulationreducing amount of chitosan in admixture or concurrently with other dietary fibers, and certain dietary fiber compositions incorporating a flatulation-reducing amount of

Patents 49

chitosan. Dietary fiber consumption offers protection from a variety of diseases including coronary artery disease, constipation, diverticulosis, appendicitis, obesity, diabetes, and colon cancer (1). Because of the widespread recognition of its many healthful benefits, a plethora of food products and dietary supplements is readily available to the consumer and is widely utilized. Also, increased consumption of fresh fruits, whole grains, beans, and vegetables, high in dietary fiber content, is widely recommended by most health authorities. The recommended daily value (DV) for dietary fiber consumption in this country is currently thirty (30) grams per day for an adult. Dietary fiber formulations useful for the control of serum cholesterol concentrations and for reducing the risk of coronary artery disease (2,3) have been developed previously. In addition to their many healthful benefits, dietary fibers also cause some undesirable side effects, primarily increased intestinal gas formation which can induce socially embarrassing and/or malodorous flatulence as well as bloating, abdominal pains and discomfort (4,5). Unfortunately, nothing is presently available to effectively prevent intestinal gas formation induced by a wide variety of dietary fibers.alpha.-Galactosidase enzyme preparations are widely used to prevent intestinal gas formation caused by ingesting beans and various other legumes. These preparations are effective since they digest the galactose-containing oligosaccharides found in beans, which are the primary cause for the gas production (6). However, such enzyme preparations are not useful for preventing intestinal gas production brought about by increased dietary fiber consumption. Because of the increased consumption of foods and dietary supplements enriched with various dietary fibers, a growing need exists to find effective methods and means for controlling intestinal gas production induced by dietary fibers when ingested by a person for whom such gas production would cause a problem and hence inhibit or curtail their use and consequent healthful benefits thereof. Web site: http://www.delphion.com/details?pn=US05773427__ •

Process for obtaining light and crispy soybean proteins of agreeable taste and product thus obtained Inventor(s): Ferrero; Aldo (Via Ampere 9, Milan, IT), Ferrero; Mauro (Via Ampere 9, Milan, IT) Assignee(s): None Reported Patent Number: 4,490,406 Date filed: October 13, 1983 Abstract: A process for obtaining soybean protein flakes, granules, or powder, suitable for the direct human consumption, easily digestible and which do not lead, when eaten, to flatulence, consisting of subjecting, through a puffing process, to a further cooking and consequent expansion - lightening the granules of soybean proteins formerly extruded, that is already heat-treated and expanded. The obtained product may be further heat-treated for a period from 30 minutes to 10 hours, but preferably from one and two hours for obtaining flakes, granules or powder of soybean proteins light, agreeable to eat as such and easily digestible.The flakes, granules or powder of soybean proteins may be mixed to soy lecithin paste or an edible oil, in a dosage varying from 2% to 40% by weight. Excerpt(s): This invention relates to a process for obtaining soybean protein flakes and/or granules of agreable taste suitable for the direct human consumption, easily digestible and almost devoided of the flatulence. As known, the necessary components of a complete nurishement are the proteins, the lipids and the glucydes. As to the

50

Flatulence

proteinic influence of a nurishment, the soybean seeds, especially if defatted, allow several advantages. Web site: http://www.delphion.com/details?pn=US04490406__ •

Process for removal of water-soluble carbohydrates in the production of plant protein products Inventor(s): Hansen; Ole Kaae (Aarhus, DK) Assignee(s): Aarhus Oliefabrik A/s (aarhus, Dk) Patent Number: 4,008,334 Date filed: June 3, 1975 Abstract: This invention provides a method for removal of all water soluble carbohydrates in the production of plant protein products, including oligosaccharides containing alpha-1,6-galactosidic bonds which are known to cause flatulence in man and animals. In the method an aqueous solution or dispersion of the plant protein material containing 1-60%, and preferably 15-50% of the dry matter is fermented with particular strains of Saccharomyces that have been found to degrade and assimilate flatus-causing carbohydrates. The fermentation is effected at a temperature between 20.degree. and 40.degree. C for from 12 to 48 hours, on which, if desired, the fermented material is dried. Excerpt(s): The present invention relates to a method for removal of water-soluble carbohydrates in the production of plant protein products, more specific removal of water-soluble carbohydrates causing flatulence in man and animals. The term watersoluble carbohydrates as employed herein includes as well such carbohydrates that are also soluble in aqueous solutions of ethanol such as glucose, galactose, sucrose, raffinose and stachyose. The term plant protein products as employed herein refers to all such products as meal, grits, milk concentrates and isolates that are produced from plants rich in protein such as soybean, rapeseed, navy beans, lima beans, cottonseed, peanut etc., and containing protein as a predominant constituent. Web site: http://www.delphion.com/details?pn=US04008334__

•

Process for removing flatulence-causing oligosaccharides in legumes Inventor(s): Bettle, III; Griscom (Sarasota, FL), Bush; Condon S. (Knoxville, TN), Rutzinski; Joseph L. (Morristown, TN) Assignee(s): Bush Brothers & Company (knoxville, Tn) Patent Number: 6,238,725 Date filed: January 22, 1999 Abstract: The present invention is directed to a method of preparing a legume in which the flatulence-causing oligosaccharides are removed. It is also directed to a process for reducing the flatulence of a flatulence-causing legume. Excerpt(s): The present invention relates to a process for preparing legumes exhibiting reduced flatulence when digested by mammals and a process for reducing flatulence in legumes when digested by mammals and the products thus prepared. Legumes are important foodstuffs and are likely to become more so in the future. For example, many

Patents 51

legumes, especially those in some of the legume genuses, such as Phaseolus, Soja and Lens, are high in protein and provide an inexpensive alternative to animal protein. Unfortunately, ingestion of some of the most nutritious and abundant legumes can be accompanied by severe flatulence as well as abdominal distress and poor digestibility. More specifically, the flatulence results in discomfort, diarrhea, loss of appetite, and poor growth, all of which have prevented the wide-scale use of these vegetable nutrients. Web site: http://www.delphion.com/details?pn=US06238725__ •

Process for removing flatulence-causing sugars from bean products Inventor(s): Lawhon; James T. (College Station, TX), Lusas; Edmund W. (Bryan, TX) Assignee(s): The Texas A&m University System (college Station, Tx) Patent Number: 4,645,677 Date filed: December 4, 1984 Abstract: Flatulence-causing sugars can be removed from beans that contain such sugars through ultrafiltration. An ultrafiltration membrane system with a molecular weight cut-off between 30,000 and 100,000 daltons will permit the sugars to permeate through it, but it will retain most proteins. Excerpt(s): The present invention concerns beans which contain flatulence-causing sugars, and more specifically, methods of processing such beans that remove flatulencecausing sugars while leaving most of the protein content intact. Beans are a source of protein which has not been utilized yet to the extent it might. One reason why other sources of protein are sometimes preferred over beans is the gastrointestinal stress they can cause. This distress is the result of the presence of certain sugars in beans, such as raffinose, stachyose, and verbascose. Enzymes such as.alpha.-galactosidases and.beta.D-fructosidases are needed to hydrolyze these sugars so they can be absorbed in the digestive tract. However, humans do not have those enzymes, so the sugars listed above are not absorbed. Instead, they are fermented by microorganisms in the intestines, producing flatus. Web site: http://www.delphion.com/details?pn=US04645677__

•

Process to shorten the cooking time of dried legume beans Inventor(s): Seguin; James J. (615 Vistamont Ave., Berkeley, CA 94708) Assignee(s): Seguin; James J. (berkeley, Ca) Patent Number: 5,863,591 Date filed: January 16, 1996 Abstract: A process to shorten the cooking time of dried legume beans by subjecting the beans to a short-timed, high-pressure, hydration. Significantly reduced cooking time follows, or cooking can be postponed for several months by storage in a refrigerator or more than several months in a freezer with no increase in cooking time for tablereadiness and no degradation of quality. Also, the process diminishes the discomforts of flatulence.

52

Flatulence

Excerpt(s): This invention is a process to shorten substantially the cooking time of dried legume beans. The seasonal production of agricultural staples is usually larger than the immediate consumer demand; therefore, food processors dry a a large portion of crop surpluses in order to provide a year-round supply and to minimize spoilage. Fresh vegetables take little time to cook; dried beans, especially, require much longer preparation. I visited several large food supermarkets to compare the cooking instructions printed on packages of dried beans. An assortment of beans sold under national brand names and house brands in Safeway, Lucky, Raley, and Andronico stores indicated very similar preparation instructions: Great Northern, Small White, Pinto beans and lentils require overnight soaking or 6 to 8 hours of soaking before cooking for 1 to 11/2 hours. Dried Navy beans need 3 hours of cooking after overnight soaking. Dried Lima beans require the least preparation time: "bring to a boil for three minutes, let stand for one hour, then simmer for 1 to 11/2 hours." Dried beans are inexpensive; the median price per pound is 65 cents and 50 cents for bulk beans sold from an open barrel. Unfortunately, the demand for these inexpensive, wholesome foods is lukewarm; only a small percentage of consumers buy unprepared dried beans because of the advance planning required to cook them for a meal. In addition, some varieties of dried beans cooked in this manner give rise to digestive system discomforts in the form of flatulence. Web site: http://www.delphion.com/details?pn=US05863591__ •

Protective underwear with malodorous flatus filter Inventor(s): Weimer; Chester L. (419 W. 22nd St., Pueblo, CO 81003) Assignee(s): None Reported Patent Number: 5,593,398 Date filed: May 25, 1994 Abstract: Protective underwear made of air-tight polyurethane-coated nylon (10) with elastic sewn around the waist (12) and around the bifurcated legs (14a, 14b). An exit hole (24) for the flatus is cut from the back, near the bottom, of the underwear. The exit hole is covered with a pocket (16a, 16b) made of porous fabric, and designed in the same shape as the exit hole (24), only larger. The bottom layer of the pocket (16b) is sewn (22) around the edge of the exit hole (24) connecting it to the underwear. The top layer (16a) is sewn (20) around the edge of the bottom layer (16b) and onto the underwear, except at the top, leaving the pocket opening. The pocket opening is kept closed by a fastener. The replaceable filter is large all around than the exit hole (24), but smaller all around than the pocket (16). The top and bottom layers are of wool felt (26a, 26b); and both layers are cut larger than all other layers to facilitate sewing (28). The second layers, on top and bottom, are of polypropylene non-woven fabric (30a, 30b); followed by layers, top and bottom, of fiber glass wool (32a, 32b). In the middle of the filter is a single layer of activated carbon (34). Excerpt(s): This invention relates to protective underwear, specifically to the filtering of foul smelling human flatus. Heretofore, the health care industry has provided protective underwear for individuals suffering from urine and feces incontinence. However, for those millions suffering from inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, no protective underwear are available to filter the malodorous flatus that accompany these diseases. Some protective underwear are air tight but provide no relief from foul human gas, especially for that segment of the United States population experiencing lactase deficiency or diverticulitis.

Patents 53

Web site: http://www.delphion.com/details?pn=US05593398__ •

Reduced-flatulence, legume-based snack foods Inventor(s): Kazemzadeh; Massoud (10025 Beard Ave. South, Bloomington, MN 55431) Assignee(s): None Reported Patent Number: 6,274,189 Date filed: March 21, 1997 Abstract: A reduced-flatulence, legume-based snack food including legumes, additional grain-based ingredients, an aqueous solvent, and processing aids. The legumes have greater than 45 percent by weight of the oligosaccharides and saccharides removed therefrom. The legumes, additional grain-based ingredients, aqueous solvent, and processing aids are processed together to provide the snack food with a developed matrix so that the snack food exhibits a high crunch texture and a low fat absorption when cooked. Excerpt(s): The present invention relates generally to a food products made from legumes. More particularly, the present invention relates to high-fiber, high-protein, reduced-flatulence snack foods. Many types of legumes possess a variety of nutritional components, such as protein and fiber, in advantageous concentrations so that it is desirable to incorporate legumes into food products. In spite of these potentially beneficial sources of nutrients, the use of legumes in food products has been limited because many legumes produce flatulence after their digestion. Flatus produced in a person's intestinal tract not only leads to the potential for social embarrassment, but also causes personal discomfort, including abdominal rumblings, cramps, pain, and diarrhea. Attempts have been made to process legumes to reduce the amount of flatus generated during digestion. A primary drawback of these processes is that in addition to removing sugars that cause flatus, the processes also remove other desirable ingredients, such as vitamins, minerals, and soluble carbohydrates, from the legumes. Because these desirable ingredients are removed from legumes, the nutritional value of legumes is reduced. Web site: http://www.delphion.com/details?pn=US06274189__

Patent Applications on Flatulence As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to flatulence:

6

This has been a common practice outside the United States prior to December 2000.

54

•

Flatulence

Device using membranous valve to produce sound Inventor(s): Fenster, Mrako; (Basehor, KS), Gautieri, Steven; (Gladstone, MO), Guerra, Larry; (Shawnee, KS), Kemnitzer, Jonathon K.; (Kansas City, MO) Correspondence: Hovey Williams Timmons & Collins; 2405 Grand BLVD., Suite 400; Kansas City; MO; 64108 Patent Application Number: 20030132055 Date filed: January 17, 2002 Abstract: A device (10) for producing sound, such as, for example, simulated animal calls for hunting or flatulence or other bodily noises for entertainment, using a membranous valve (17) including one or more vibrating thermoplastic or thermoset plastic membranes (18,20), wherein said vibration is mechanically induced by a gas, such as air, releasing from a reservoir (12). In a preferred embodiment, the device (10) is hand-held, portable, and broadly comprises the reservoir (12); a return (14); a focuser (16); the membranous valve (17); and an emitter (22). Gas released from the reservoir (12) is directed by the focuser (16) to pass across the one or more membranes (18,20) which are held in their operating positions by the emitter (22). Vibration of an edge portion of each membrane (18,20) produces the desired sound. Excerpt(s): The present invention relates broadly to devices for producing sound using vibrating membranes. More particularly, the present invention relates to a portable device for producing sound, such as, for example, simulated animal calls or flatulence or other bodily noises, using a membranous valve including one or more vibrating thermoplastic orthermoset plastic membranes, wherein said vibration is mechanically induced by a gas, such as air, releasing from a reservoir. It is often desirable to artificially produce a realistic sound, such as, for example, simulated animal calls for hunting or flatulence or other bodily noises for entertainment. Numerous devices exist for this purpose, being either electrical or mechanical in nature and varying greatly in complexity and cost. Unfortunately, these existing devices typically produce a cold, unlifelike, and unrealistic sound. Furthermore, such sound is typically identical and without realistic variation with each activation. Due to this lack of realism, these existing devices are unlikely to satisfactorily serve their desired purpose. One existing batterypowered electronic device, for example, is operable to replay a limited number of prerecorded sounds using a small speaker or other electroacoustic mechanism. It will be appreciated, however, that, where the device is intended for use under relatively extreme operating conditions, such as, for example, in rough-and-tumble outdoor or social settings, it is desirable that the device be inexpensively and simply constructed so as to either avoid damage or be economically replaceable if damaged. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Venting/filter assembly, bag incorporating same and method of venting flatus gasses Inventor(s): Villefrance, Tine; (Herlev, DK) Correspondence: Marshall, Gerstein & Borun; 6300 Sears Tower; 233 South Wacker; Chicago; IL; 60606-6357; US Patent Application Number: 20030100870 Date filed: December 13, 2002

Patents 55

Abstract: A bag for receiving waste discharge from a human body, and the venting/filter assembly for such a bag, are disclosed. The combination includes a filter for deodorizing gas vented through an aperture in one wall of the bag and a gaspermeable barrier membrane disposed between the filter and the interior of the bag so that all gas exiting the bag flows through the membrane. The barrier membrane comprises an unlaminated microporous film of ultra high molecular weight polyethylene impermeable to waste liquids and solids and having a porosity capable of blocking the passage of bacteria and, preferably, at least some viruses. A method of so venting flatus gasses while preventing the escape of microorganisms is also disclosed. Excerpt(s): This application is a Continuation of U.S. patent application Ser. No. 09/568,318, filed May 9, 2000. The present invention relates to a bag or pouch for receiving discharge from the human body, said bag comprising a distal wall and a proximal wall, each of a gas and liquid impermeable, heat sealable thermoplastic material and having the edges thereof sealed together and defining the interior of the bag between the walls, the proximal wall having a stomal aperture, and one of the walls having a gas venting aperture spaced from the stomal aperture, a filter for de-odorizing gas vented through the gas venting aperture and arranged such that all the gas exiting the bag through the venting aperture flows through the filter and an intermediate barrier membrane arranged intermediate the filter and the interior of the bag such that all the gas exiting the bag through the filter flows through the barrier membrane and for preventing liquids and solids in the interior of the bag from contacting the filter while allowing gas to flow through the barrier membrane from the interior of the bag to the filter. Bags or pouches for the use of colostomy and ileostomy patients require a very efficient and reliable venting of flatus gasses combined with a highly effective deodorization of the gasses before being released to the surroundings. Filters of various kinds are known for de-odorizing the vented flatus gasses. A recurring problem in connection with many of the known filter/venting arrangements is that the filter becomes clogged by liquid/slurry/solids present in the material discharged to the bag thereby giving rise to an unacceptable build-up of pressure in the bag during use. This problem is particularly serious for ileostomy patients because of the relatively liquid character of the discharged material. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with flatulence, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “flatulence” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on flatulence. You can also use this procedure to view pending patent applications concerning flatulence. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

57

CHAPTER 5. BOOKS ON FLATULENCE Overview This chapter provides bibliographic book references relating to flatulence. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on flatulence include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “flatulence” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on flatulence: •

Wind Breaks: Coming to Terms With Flatulence Source: New York, NY: Bantam Books. 1993. 86 p. Contact: Available from Distribution Department, Bantam Doubleday Dell Publishing Group, Inc. 2451 S. Wolf Road, Des Plaines, IL 60018. (800) 323-9872. PRICE: $5.99. ISBN: 0553375377. Summary: This book provides readers with basic information about flatulence in a humorous, straightforward manner. Written in a question and answer format, the authors cover the anatomy and physiology of the digestive system, why gas is produced, normal levels of gas production, aging and flatulence, the impact of dietary intake on gas production, gender differences in gas production, ways to produce less gas, and how moods and emotions affect gas production. The book is illustrated with cartoon figures and flatulence-related quotations from famous people; a glossary of terms is also included.

58

Flatulence

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “flatulence” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “flatulence” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “flatulence” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Flatulence denied! : stalking the fartological imperative : an intraluminal production by E. Slove Promblés; ISBN: 094108602X; http://www.amazon.com/exec/obidos/ASIN/094108602X/icongroupinterna

•

It's a Gas: A Study of Flatulence by Eugene M. Silverman (Contributor), Eric S. Rabkin; ISBN: 1879378043; http://www.amazon.com/exec/obidos/ASIN/1879378043/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “flatulence” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:7 •

Flatulence and shock. Author: Crookshank, F. G. (Francis Graham), 1873-1933; Year: 1912

•

Restoration of nervous function: flatulence, indigestion, nervous debility, and functional nervous disorders of the reproductive organs. With remarks upon the hypodermic treatment of neuralgic affections. Author: Harvey, John; Year: 1865

Chapters on Flatulence In order to find chapters that specifically relate to flatulence, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and flatulence using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and 7

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

Books

59

language you prefer, and the format option “Book Chapter.” Type “flatulence” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on flatulence: •

Flatulence Source: in Edmundowicz, S.A., ed. 20 Common Problems in Gastroenterology. New York, NY: McGraw-Hill, Inc. 2002. p. 145-157. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Website: www.bookstore.mcgraw-hill.com. PRICE: $45.00;plus shipping and handling. ISBN: 0070220557. Summary: Flatulence (gasiness) is generally diet-dependent, but can in rare cases be a symptom of more serious disease. It is a common general medical complaint and is most often treated empirically unless the history and physical dictate otherwise. This chapter on flatulence is from a book that focuses on the most common gastroenterological problems encountered in a primary practice setting. The chapter is organized to support rapid access to the information necessary to evaluate and treat most patients with this problems. Topics include incidence and background; principal diagnoses, including aerophagia (swallowing air), carbohydrate malabsorption, irritable bowel syndrome (IBS), dysmotility, and other causes; the typical presentation; key points to the patient history; the physical examination and ancillary tests, including blood tests, stool tests, plain x rays, endoscopy, and breath testing for hydrogen and carbon dioxide; treatment options; patient education; common clinical errors; controversies; and emerging concepts. The chapter includes an outline for quick reference, the text itself, a diagnostic and treatment algorithm, and selected references. 3 figures. 3 tables. 29 references.

•

Gas and Flatulence Source: in Brandt, L., et al., eds. Clinical Practice of Gastroenterology. Volume One. Philadelphia, PA: Current Medicine. 1999. p. 646-651. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: Gas related gastrointestinal (GI) complaints usually take one of three forms: excessive or repetitive belching; abdominal pain, bloating and distention; or excessive passage of flatus (gas) per rectum. This chapter on gas and flatulence is from a lengthy textbook that brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. The author of this chapter outlines a rational approach to the treatment of the flatulent patient based on studies of the normal physiology of intestinal gas production, composition, and excretion and the proven role of gas in the production of GI symptoms. The author contends that physicians often order complex and expensive diagnostic studies and prescribe a variety of drugs that have little chance of brining relief to their patients. Gas can enter the gut as the result of air swallowing, bacterial metabolism, or diffusion from the blood. Chronic, repetitive belching is usually a manifestation of a nervous habit, although the person with this complaint often is convinced that there must be serious disease causing excessive gas production in the upper tract. Patients with the common complaint of abdominal pain and bloating usually have irritable bowel syndrome (IBS) that manifests as a motility disorder that interferes with the orderly passage of gas through the gut. The passage of large volumes of intestinal gas per rectum may just be an annoying cause of social

60

Flatulence

embarrassment, or it may cause a person to think something is seriously wrong. However, when manifesting without other symptoms (diarrhea or weight loss), this common symptom is virtually never caused by serious organic disease. 2 figures. 5 tables. 13 references.

61

CHAPTER 6. MULTIMEDIA ON FLATULENCE Overview In this chapter, we show you how to keep current on multimedia sources of information on flatulence. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on flatulence is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “flatulence” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “flatulence” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on flatulence: •

When Milk Doesn't Do a Body Good Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1996. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 032096A. Summary: Lactose, the sugar component of milk, is made of glucose and galactose. The intestine cannot digest complex sugar, so the body needs the enzyme lactase to break lactose into these simpler sugars. Without adequate lactase levels, symptoms of lactose intolerance can become problematic. This videotape is one in a series of health promotion programs called 'Picture of Health,' produced by the University of Wisconsin. In this program, moderated by Mary Lee and featuring gastroenterologist Mark Lloyd, the common symptoms, diagnosis, and management of lactose intolerance

62

Flatulence

are covered. Dr. Lloyd explains why some people cannot digest milk, defines lactose intolerance, notes who is most affected, and reviews treatment options. Rarely, an infant is born with no lactase; these few children become sick early in life and are usually diagnosed quickly. However, most humans (and other mammals) have no problems with milk in the early years. About 75 percent of the world's population has some problems with lactose; levels vary by ethnic group. The symptoms of lactose intolerance include stomach rumbling and bloating, gas (flatulence), and diarrhea. Dr. Lloyd reviews the differences between lactose intolerance and milk allergy, which is an immunologic reaction. The program then focuses on the diagnosis and management of lactose intolerance. Lactose withdrawal (removing milk and milk products from the diet) or lactose tolerance testing (blood sugar tests and breath hydrogen tests) are used for diagnosis; sometimes biopsy is indicated. The program lists foods high in lactose and offers readers suggestions for dietary modification and the use of lactase supplements. The program concludes by referring viewers to the National Digestive Diseases Information Clearinghouse (NDDIC). •

Your Digestive System Source: Los Angeles, CA: National Health Video, Inc. 1999. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Blvd., Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail: [email protected]. PRICE: $89.00 plus shipping and handling. Summary: This health education videotape program reviews the digestive system and basic digestive problems. Narrated by a registered dietitian, the program defines digestion as the process by which food is changed to nourishment for the body. The program first reviews the anatomy of the digestive system, including the mucosa of the mouth, stomach and small intestine; the role of the muscle movements of swallowing and peristalsis; and the lower esophageal sphincter. Swallowing disorders are mentioned briefly. The program then discusses the causes of and therapy for heartburn (gastroesophageal reflux disease, or GERD), gas (belching and flatulence), constipation, hemorrhoids, and peptic ulcers. Lifestyle changes are emphasized as the least invasive, most effective treatment for most digestive problems; the role of exercise is also noted. Drug therapy is discussed as a useful option, but caution is advised when using long term drug therapy for digestive concerns. The videotape includes footage of everyday people, interviews between physicians and patients, and graphics to help explain the physiology and anatomy covered in the discussion.

•

Ulcerative Colitis: The Disease and Enema Therapy Source: Marietta, GA: Solvay Pharmaceuticals, Inc. 1996. (videocassette). Contact: Available from Solvay Pharmaceuticals, Inc. 901 Sawyer Road, Marietta, GA 30062. (800) 354-0026. PRICE: Single copy free. Summary: This videotape program provides information and reassurance for people recently diagnosed with ulcerative colitis (UC). The program notes that UC can have a great impact on a person's life, but that following the prescribed treatment can help relieve symptoms and return a sense of normalcy. The narrator reviews the possible causes of UC, including genetic, infectious, and autoimmune theories, noting that UC is not contagious or caused by stress or food sensitivity. UC is most often found in the developing world, and people are usually diagnosed in their teens or twenties. The program then features brief interviews with six women who describe how they felt when they first received the diagnosis. Reactions ranged from fear and anxiety to relief

Multimedia 63

that they finally had a name for their symptoms. The narrator then lists the common symptoms of UC: diarrhea, rectal bleeding, bloody stool, loss of appetite, anemia, abdominal pain, weight loss, fever, and gas (flatulence). Less common symptoms can include joint pain, skin lesions, and eye inflammation. The program then features a man and two women talking about symptoms, particularly urgency and frequency, and the impact of these symptoms on their lifestyles. The narrator notes that there are rectal agents, oral medications, antibiotics, and combination therapies, but that the video will focus on enema therapy. The program then interviews three patients who use Rowasa (mesalamine in a rectal suspension enema form). The patients talk about enema therapy and the improved quality of life they have found using this form of the drug. The program then uses line drawings to demonstrate how to give oneself an enema. The medication should be given when the patient can stay prone for 30 minutes or, preferably, overnight. The program concludes by encouraging viewers to ask their health care provider to answer any questions they may have. The address and tollfree telephone number (800-343-3637) of the Crohn's and Colitis Foundation of America are also provided.

65

CHAPTER 7. PERIODICALS AND NEWS ON FLATULENCE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover flatulence.

News Services and Press Releases One of the simplest ways of tracking press releases on flatulence is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “flatulence” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to flatulence. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “flatulence” (or synonyms). The following was recently listed in this archive for flatulence: •

Flatulence test sniffs out gut bugs Source: Reuters Health eLine Date: May 19, 2003

•

Anti-flatulence dog food nothing to sniff at Source: Reuters Health eLine Date: May 25, 2000

66

Flatulence

•

Device reduces flatulence odor Source: Reuters Health eLine Date: July 16, 1998

•

Sniffing Out Flatus Secrets Source: Reuters Health eLine Date: June 25, 1997

•

Wasn't Me! -- Flatus Findings Source: Reuters Health eLine Date: August 30, 1996 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “flatulence” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “flatulence” (or synonyms). If you know the name of a company that is relevant to flatulence, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

Periodicals and News

67

BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “flatulence” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “flatulence” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on flatulence: •

10 Tips on How to Fend Off Embarrassing Flatulence Source: Environmental Nutrition. 22(10): 2. October 1999. Contact: Available from Environmental Nutrition, Inc. 52 Riverside Drive, New York, NY 10024-6599. (800) 829-5384. Summary: This brief newsletter article reviews the issue of flatulence (gas) and offers strategies to prevent the problem. The author first reassures readers that flatulence is as normal a physiologic function as blinking or sneezing. Nonetheless, it is still socially unacceptable, so the author lists 10 suggestions on how to reduce flatulence problems. The suggestions are incorporate dietary fiber increases gradually, learn about which foods are trigger foods, soak and cook gassy foods in water, check for lactose intolerance, try the product named Beano (a digestive enzyme), try Pepto Bismol (the bismol acts as a binder with the odiferous sulfur in intestinal gas), avoid swallowing air, do not use activated charcoal (it does not help the flatulence and it can interfere with the absorption of some medications), do not rely on simethicone (it may help reduce gas, but does nothing to prevent or reduce odor), and skip antacids (they do not relieve gas and those that contain carbonate or bicarbonate may even add to the discomfort of flatulence). One sidebar briefly reviews natural remedies that may sooth the digestive tract, including peppermint and chamomile teas, and seasonings including anise, caraway, coriander, fennel, and turmeric.

Academic Periodicals covering Flatulence Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to flatulence. In addition to these sources, you can search for articles covering flatulence that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.”

68

Flatulence

If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

69

APPENDICES

71

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

8

These publications are typically written by one or more of the various NIH Institutes.

72

Flatulence

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

73

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

9

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.

74

Flatulence

•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “flatulence” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1208 19 16 9 61 1313

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “flatulence” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

12

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

75

Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

16 Adapted 17

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

77

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on flatulence can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to flatulence. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to flatulence. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “flatulence”:

78

•

Flatulence

Other guides Chagas Disease http://www.nlm.nih.gov/medlineplus/chagasdisease.html Colonic Diseases http://www.nlm.nih.gov/medlineplus/colonicdiseases.html Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Giardia Infections http://www.nlm.nih.gov/medlineplus/giardiainfections.html Leishmaniasis http://www.nlm.nih.gov/medlineplus/leishmaniasis.html Parasitic Diseases http://www.nlm.nih.gov/medlineplus/parasiticdiseases.html Stomach Disorders http://www.nlm.nih.gov/medlineplus/stomachdisorders.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on flatulence. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Gas and Flatulence Prevention Diet Source: Camp Hill, PA: Chek-Med Systems, Inc. 1995. 4 p. Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011. (800) 451-5797. Fax (717) 761-0216. PRICE: $1.45 each, plus shipping (as of 1995). Order no. D-12. Summary: This patient education brochure, one of a series of 17 brochures, provides dietary recommendations for patients requiring a gas and flatulence prevention diet. The brochure explains the purpose of the special diet; summarizes relevant nutrition facts; provides information about belching, bloating, and rectal gas; and describes an intestinal gas trial diet and a carbohydrate elimination diet. The brochure includes a list of carbohydrates and foods that produce gas. The brochure concludes with a sample menu for low intestinal gas production. The brochure is printed in two colors and contains graphics.

Patient Resources

79

The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to flatulence. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to flatulence. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with flatulence. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about flatulence. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at

80

Flatulence

http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “flatulence” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “flatulence”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “flatulence” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “flatulence” (or a synonym) into the search box, and click “Submit Query.”

81

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.19

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

19

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

82

Flatulence

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)20: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

20

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries 83 •

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

84

Flatulence

•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries 85 •

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

86

Flatulence

•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

87

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

89

FLATULENCE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Cramps: Abdominal pain due to spasmodic contractions of the bowel. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acacia: Any leguminous woody vine or tree of the genus Acacia, also called locust or wattle. The gums and tanning agents obtained from Acacia are called gum arabic. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerophagia: A condition that occurs when a person swallows too much air. Causes gas and frequent belching. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the

90

Flatulence

stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alginates: Salts of alginic acid that are extracted from marine kelp and used to make dental impressions and as absorbent material for surgical dressings. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alpha-Galactosidase: An enzyme that catalyzes the hydrolysis of terminal, non-reducing alpha-D-galactose residues in alpha-galactosides including galactose oligosaccharides, galactomannans, and galactolipids. EC 3.2.1.22. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of

Dictionary 91

organic materials during a large number of metabolically important reactions. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimycotic: Suppressing the growth of fungi. [EU] Antipruritic: Relieving or preventing itching. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH]

92

Flatulence

Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] Arachidonate 15-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 15-hydroperoxyarachidonate (15-HPETE) which is rapidly converted to 15-hydroxy5,8,11,13-eicosatetraenoate (15-HETE). The 15-hydroperoxides are preferentially formed in neutrophils and lymphocytes. EC 1.13.11.33. [NIH] Arachidonate Lipoxygenases: Enzymes catalyzing the oxidation of arachidonic acid to hydroperoxyarachidonates (HPETES). These products are then rapidly converted by a peroxidase to hydroxyeicosatetraenoic acids (HETES). The positional specificity of the enzyme reaction varies from tissue to tissue. The final lipoxygenase pathway leads to the leukotrienes. EC 1.13.11.- . [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Astringent: Causing contraction, usually locally after topical application. [EU] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of

Dictionary 93

donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]

Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzocaine: A surface anesthetic that acts by preventing transmission of impulses along nerve fibers and at nerve endings. [NIH] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blinking: Brief closing of the eyelids by involuntary normal periodic closing, as a protective measure, or by voluntary action. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [NIH]

94

Flatulence

Bone Cements: Adhesives used to fix prosthetic devices to bones and to cement bone to bone in difficult fractures. Synthetic resins are commonly used as cements. A mixture of monocalcium phosphate, monohydrate, alpha-tricalcium phosphate, and calcium carbonate with a sodium phosphate solution is also a useful bone paste. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Butyric Acid: A four carbon acid, CH3CH2CH2COOH, with an unpleasant odor that occurs in butter and animal fat as the glycerol ester. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Camphor: A bicyclic monoterpene ketone found widely in plant (primarily the camphor tree, Cinnamomum camphora). Natural camphor is used topically as a skin antipruritic and as an anti-infective agent. [NIH] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated,

Dictionary 95

unsaturated, or aromatic. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical Plexus: A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm. [NIH]

96

Flatulence

Chamomile: Common name for several daisy-like species native to Europe and Western Asia, now naturalized in the United States and Australia. The dried flower-heads of two species, Anthemis nobilis (Chamaemelum nobile) and Matricaria recutita, have specific use as herbs. They are administered as tea, extracts, tinctures, or ointments. Chamomile contains choline, coumarins, cyanogenic glycosides, flavonoids, salicylate derivatives, tannins, and volatile oils. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clotrimazole: An imidazole derivative with a broad spectrum of antimycotic activity. It inhibits biosynthesis of the sterol ergostol, an important component of fungal cell membranes. Its action leads to increased membrane permeability and apparent disruption of enzyme systems bound to the membrane. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH]

Dictionary 97

Colitis: Inflammation of the colon. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colonic flora: The bacteria normally residing within the colon. [EU] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques

98

Flatulence

for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Coumarins: Synthetic or naturally occurring substances related to coumarin, the deltalactone of coumarinic acid. Coumarin itself occurs in the tonka bean. The various coumarins have a wide range of proposed actions and uses including as anticoagulants, pharmaceutical aids, indicators and reagents, photoreactive substances, and antineoplastic agents. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Criterion: A standard by which something may be judged. [EU] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Decongestant: An agent that reduces congestion or swelling. [EU]

Dictionary 99

Defaecation: The act or process of defecating, discharge of feces. [EU] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermatologic Agents: Drugs used to treat or prevent skin disorders or for the routine care of skin. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU]

100

Flatulence

Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dispenser: Glass, metal or plastic shell fitted with valve from which a pressurized formulation is dispensed; an instrument for atomizing. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulosis: A condition marked by small sacs or pouches (diverticula) in the walls of an organ such as the stomach or colon. These sacs can become inflamed and cause a condition called diverticulitis, which may be a risk factor for certain types of cancer. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenitis: An irritation of the first part of the small intestine (duodenum). [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesias: Abnormal involuntary movements which primarily affect the extremities, trunk, or jaw that occur as a manifestation of an underlying disease process. Conditions which feature recurrent or persistent episodes of dyskinesia as a primary manifestation of disease may be referred to as dyskinesia syndromes (movement disorders). Dyskinesias are also a relatively common manifestation of basal ganglia diseases. [NIH] Dysmenorrhea: Painful menstruation. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH]

Dictionary 101

Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emetic: An agent that causes vomiting. [EU] Emollient: Softening or soothing; called also malactic. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Eucalyptus: A genus of Australian trees of the Myrtaceae family that yields gums, oils, and resins which are used as flavoring agents, astringents, and aromatics, and formerly to treat

102

Flatulence

diarrhea, asthma, bronchitis, and respiratory tract infections. [NIH] Evacuation: An emptying, as of the bowels. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extracellular: Outside a cell or cells. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]

Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Galactosidases: A family of galactoside hydrolases that hydrolyze compounds with an Ogalactosyl linkage. EC 3.2.1.-. [NIH] Galactosides: Glycosides formed by the reaction of the hydroxyl group on the anomeric carbon atom of galactose with an alcohol to form an acetal. They include both alpha- and beta-galactosides. [NIH]

Dictionary 103

Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Inhibitory Polypeptide: A gastrointestinal hormone consisting of a 43-amino acid polypeptide (molecular weight 5105). It inhibits gastric secretion and motility and stimulates release of insulin. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastritis: Inflammation of the stomach. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrointestinal Transit: Passage of food (sometimes in the form of a test meal) through the gastrointestinal tract as measured in minutes or hours. The rate of passage through the intestine is an indicator of small bowel function. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genital: Pertaining to the genitalia. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH]

104

Flatulence

Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Gum Arabic: Powdered exudate from various Acacia species, especially A. senegal (Leguminosae). It forms mucilage or syrup in water. Gum arabic is used as a suspending agent, excipient, and emulsifier in foods and pharmaceuticals. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage;

Dictionary 105

craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hematuria: Presence of blood in the urine. [NIH] Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoid: An enlarged or swollen blood vessel, usually located near the anus or the rectum. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

106

Flatulence

Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolases: Any member of the class of enzymes that catalyze the cleavage of the substrate and the addition of water to the resulting molecules, e.g., esterases, glycosidases (glycoside hydrolases), lipases, nucleotidases, peptidases (peptide hydrolases), and phosphatases (phosphoric monoester hydrolases). EC 3. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypodermic: Applied or administered beneath the skin. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of

Dictionary 107

psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH]

108

Flatulence

Intravenous: IV. Into a vein. [NIH] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemic Colitis: Decreased blood flow to the colon. Causes fever, pain, and bloody diarrhea. [NIH] Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketoprofen: An ibuprofen-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis. [NIH] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed

Dictionary 109

data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]

Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lubricants: Oily or slippery substances. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] Maceration: The softening of a solid by soaking. In histology, the softening of a tissue by soaking, especially in acids, until the connective tissue fibres are so dissolved that the tissue components can be teased apart. In obstetrics, the degenerative changes with discoloration

110

Flatulence

and softening of tissues, and eventual disintegration, of a fetus retained in the uterus after its death. [EU] Macronutrients: Nutrients in the diet that are the key sources of energy, namely protein, fat, and carbohydrates. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Mastitis: Inflammatory disease of the breast, or mammary gland. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH] Meteorism: Tympanites; the presence of gas in the abdomen or intestine. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH]

Dictionary 111

Miconazole: An imidazole antifungal agent that is used topically and by intravenous infusion. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Mineral Oil: A mixture of liquid hydrocarbons obtained from petroleum. It is used as laxative, lubricant, ointment base, and emollient. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nalbuphine: A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors. [NIH] Naproxen: An anti-inflammatory agent with analgesic and antipyretic properties. Both the acid and its sodium salt are used in the treatment of rheumatoid arthritis and other rheumatic or musculoskeletal disorders, dysmenorrhea, and acute gout. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH]

112

Flatulence

Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Obstruction: Any hindrance to the passage of air into and out of the nose. The obstruction may be in the nasal vestibule, fossae, or other areas of the nasal cavity. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH]

Dictionary 113

Obsessional: Neurosis characterized by the repetitive intrusion into the mind, against volition, of ideas, numinations and phobias, often associated with compulsive actions. [NIH] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Occult Blood: Chemical, spectroscopic, or microscopic detection of extremely small amounts of blood. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oesophagitis: Inflammation of the esophagus. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orderly: A male hospital attendant. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU]

114

Flatulence

Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic enzymes: A group of proteins secreted by the pancreas which aid in the digestion of food. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Perspiration: Sweating; the functional secretion of sweat. [EU] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH]

Dictionary 115

Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacology, Clinical: The branch of pharmacology that deals directly with the effectiveness and safety of drugs in humans. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phobias: An exaggerated and invariably pathological dread of some specific type of stimulus or situation. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phrenic Nerve: The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. [NIH]

Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plant Oils: Oils derived from plants or plant products. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile

116

Flatulence

strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Porosity: Condition of having pores or open spaces. This often refers to bones, bone implants, or bone cements, but can refer to the porous state of any solid substance. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Protective Devices: Devices designed to provide personal protection against injury to individuals exposed to hazards in industry, sports, aviation, or daily activities. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU]

Dictionary 117

Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psyllium: Dried, ripe seeds of Plantago psyllium, P. indica, and P. ovata (Plantaginaceae). Plantain seeds swell in water and are used as demulcents and bulk laxatives. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pupil: The aperture in the iris through which light passes. [NIH] Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Pyrilamine: A histamine H1 antagonist. It has mild hypnotic properties and some local anesthetic action and is used for allergies (including skin eruptions) both parenterally and locally. It is a common ingredient of cold remedies. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH]

118

Flatulence

Radiata: The hyaline or faintly radially striated oesinophilic membrane in immediate contact with the outer wall of the ovum. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Raffinose: A trisaccharide occurring in Australian manna (from Eucalyptus spp, Myrtaceae) and in cottonseed meal. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Reassurance: A procedure in psychotherapy that seeks to give the client confidence in a favorable outcome. It makes use of suggestion, of the prestige of the therapist. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]

Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH]

Dictionary 119

Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Roentgenography: Production of an image of an object on film, or other kind of sensitized plate, usually by means of X-radiation or gamma radiation, the contrast between different areas of the image being the result of differential interaction of the radiation in the object. [NIH]

Ruminants: A suborder of the order Artiodactyla whose members have the distinguishing feature of a four-chambered stomach. Horns or antlers are usually present, at least in males. [NIH]

Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sanitary: Relating or belonging to health and hygiene; conductive to the restoration or maintenance of health. [NIH] Satiation: Full gratification of a need or desire followed by a state of relative insensitivity to that particular need or desire. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of

120

Flatulence

old age. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Simethicone: A mixture of dimethyl polysiloxanes and silica gel used as an antiflatulent. Without the addition of silica gel (dimethicone), it is used as an ointment base ingredient and skin protectant. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Spasmodic: Of the nature of a spasm. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectroscopic: The recognition of elements through their emission spectra. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of

Dictionary 121

a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stool test: A test to check for hidden blood in the bowel movement. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styptic: Astringent. [NIH] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of

122

Flatulence

homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tetracaine: A potent local anesthetic of the ester type used for surface and spinal anesthesia. [NIH]

Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU]

Dictionary 123

Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheotomy: Surgical incision of the trachea. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Troglitazone: A drug used in diabetes treatment that is being studied for its effect on reducing the risk of cancer cell growth in fat tissue. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in dialysis separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as hemofiltration or hemodiafiltration (if combined with hemodialysis). [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH]

124

Flatulence

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Venous: Of or pertaining to the veins. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] Wart: A raised growth on the surface of the skin or other organ. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Zinc Acetate: A salt produced by the reaction of zinc oxide with acetic acid and used as an astringent, styptic, and emetic. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

125

INDEX A Abdomen, 15, 89, 93, 94, 101, 107, 109, 110, 114, 121, 122 Abdominal Cramps, 19, 89 Abdominal Pain, 4, 7, 11, 13, 49, 59, 63, 89, 114, 123 Acacia, 48, 89, 104 Acceptor, 89, 113 Acetaminophen, 10, 89 Acidosis, 11, 89 Acne, 10, 89, 119 Adaptation, 5, 11, 89 Adjustment, 6, 89 Adrenergic, 89, 100, 101, 121 Adverse Effect, 9, 12, 89, 120 Aerophagia, 15, 16, 17, 18, 21, 22, 23, 24, 59, 89 Affinity, 89, 90, 120 Age of Onset, 90, 123 Agonist, 90, 100, 111, 112 Airway, 16, 90 Albumin, 9, 90, 115 Alginates, 46, 90 Algorithms, 90, 93 Alimentary, 3, 7, 29, 30, 32, 40, 90, 99, 101, 114 Alkaline, 89, 90, 94 Alkaloid, 90, 94, 111, 112 Alpha-1, 50, 90 Alpha-Galactosidase, 32, 90 Alternative medicine, 66, 90 Amino acid, 90, 94, 99, 103, 104, 110, 114, 116, 121, 122, 123 Ammonia, 90, 121, 123 Anaerobic, 40, 91 Anal, 21, 24, 30, 40, 42, 44, 45, 91, 101, 102 Analgesic, 4, 46, 89, 91, 106, 108, 111, 113 Anemia, 5, 63, 91 Anesthesia, 90, 91, 122 Anions, 90, 91, 108 Antibacterial, 91, 120 Antibiotic, 12, 91, 120 Antibody, 90, 91, 97, 106, 107 Anticoagulant, 91, 116 Antifungal, 10, 91, 111 Antigen, 89, 91, 97, 106, 107 Anti-infective, 91, 94

Anti-inflammatory, 45, 46, 89, 91, 92, 106, 108, 111, 119 Anti-Inflammatory Agents, 91, 92 Antimycotic, 91, 96 Antipruritic, 91, 94 Antipyretic, 89, 91, 108, 111 Anus, 11, 42, 91, 94, 97, 101, 102, 105, 118 Anxiety, 43, 62, 91 Aperture, 55, 91, 117 Apolipoproteins, 91, 109 Appendicitis, 12, 49, 92 Aqueous, 47, 50, 53, 92 Arachidonate 15-Lipoxygenase, 92, 109 Arachidonate Lipoxygenases, 92, 109 Aromatic, 41, 92, 95 Arterial, 92, 96, 106, 116, 122 Arteries, 92, 93, 98, 109, 110 Arterioles, 92, 93 Arteriolosclerosis, 92 Arteriosclerosis, 48, 92 Artery, 49, 92, 98 Aspirin, 10, 92 Astringent, 92, 121, 124 Attenuation, 7, 92 Autonomic, 13, 92, 112 Autonomic Neuropathy, 13, 92 B Bacteria, 6, 40, 55, 91, 92, 93, 97, 102, 103, 111, 120, 122 Bacterial Physiology, 89, 92 Bactericidal, 92, 101 Base, 47, 92, 99, 108, 111, 114, 120 Belching, 5, 11, 13, 17, 24, 26, 59, 62, 78, 89, 93 Benign, 92, 93, 104 Benzocaine, 10, 93 Benzoic Acid, 41, 93 Bile, 14, 41, 93, 103, 109 Bile Acids, 14, 93, 103 Bile Acids and Salts, 93 Bile duct, 93, 103 Bilirubin, 90, 93, 103 Biopsy, 4, 62, 93 Biotechnology, 15, 58, 66, 73, 93 Bladder, 12, 92, 93, 97, 107, 123, 124 Blinking, 67, 93 Bloating, 5, 9, 11, 13, 14, 17, 22, 26, 30, 49, 59, 62, 78, 93, 103, 107, 112

126

Flatulence

Blood Coagulation, 93, 94, 122 Blood Glucose, 10, 13, 93, 105, 107 Blood pressure, 10, 93, 106, 111, 120 Blood vessel, 93, 95, 105, 120, 122, 124 Body Fluids, 93, 100, 120 Body Mass Index, 13, 93 Body Regions, 93, 96 Bone Cements, 94, 116 Bowel Movement, 41, 94, 99, 121 Branch, 85, 94, 114, 115, 120, 122 Breakdown, 6, 94, 99, 103 Bronchitis, 94, 102 Burns, 10, 94 Burns, Electric, 94 Butyric Acid, 40, 94 C Calcification, 92, 94 Calcium, 11, 94, 96, 97 Callus, 10, 94 Camphor, 10, 94 Capsaicin, 10, 94 Carbohydrate, 9, 59, 78, 94, 104, 116 Carbon Dioxide, 18, 21, 23, 46, 59, 94, 118 Carboxy, 94 Carboxylic Acids, 43, 94 Carcinoma, 12, 95 Cardiac, 21, 95, 101, 103, 105, 111 Cardiovascular, 92, 95 Cardiovascular System, 92, 95 Case report, 15, 24, 95 Catecholamine, 95, 100 Cations, 95, 108 Causal, 95, 101 Cecum, 6, 40, 95, 108 Cell, 89, 90, 92, 93, 95, 96, 97, 99, 101, 102, 107, 108, 112, 113, 115, 118, 122, 123 Cell Division, 92, 95, 115 Cell membrane, 95, 96, 115 Cell proliferation, 92, 95 Cellobiose, 95 Cellulose, 47, 95, 115 Central Nervous System, 41, 95, 105, 111 Central Nervous System Infections, 95, 105 Cervical, 95, 115 Cervical Plexus, 95, 115 Chamomile, 37, 67, 96 Character, 55, 96, 99, 104 Chlorophyll, 46, 96 Cholesterol, 9, 35, 49, 93, 96, 103, 109 Cholesterol Esters, 96, 109 Choline, 96

Cholinergic, 96, 112 Chronic, 4, 8, 17, 41, 59, 96, 107, 123 Chylomicrons, 96, 109 Citric Acid, 43, 96 Citrus, 96 Clinical trial, 14, 73, 96, 100, 118 Cloning, 93, 96 Clotrimazole, 10, 96 Cofactor, 96, 116, 122 Cohort Studies, 96, 101 Colic, 13, 96 Colitis, 62, 63, 97 Collapse, 94, 97 Colloidal, 90, 97, 114 Colon, 7, 12, 14, 23, 24, 29, 32, 40, 49, 97, 100, 107, 108, 120, 123 Colonic flora, 5, 97 Colonoscopy, 7, 97 Colorectal, 21, 97 Colostomy, 55, 97 Complement, 97, 115 Complementary and alternative medicine, 29, 38, 97 Complementary medicine, 29, 97 Compliance, 8, 97 Computational Biology, 73, 97 Concomitant, 8, 9, 98 Congestion, 98 Congestive heart failure, 41, 98 Conjugated, 93, 98 Connective Tissue, 98, 109, 119 Consciousness, 91, 98, 99, 117 Constipation, 4, 7, 10, 12, 13, 14, 18, 29, 48, 49, 62, 98, 114 Consumption, 5, 6, 19, 31, 33, 48, 49, 98, 118 Contraindications, ii, 98 Coronary, 49, 98, 110 Coronary Thrombosis, 98, 110 Cortisol, 90, 98 Coumarins, 96, 98 Cranial, 98, 104 Craniocerebral Trauma, 98, 105 Creatinine, 9, 98 Criterion, 9, 98 Cross-Sectional Studies, 98, 101 Curative, 98, 122 Cutaneous, 95, 98, 108 D Decongestant, 10, 98 Defaecation, 21, 99 Defecation, 12, 99

Index 127

Degenerative, 99, 109, 111, 113 Delusions, 99, 117 Dementia, 43, 44, 99 Denaturation, 5, 99 Density, 9, 93, 99, 109, 113, 115 Dermatologic Agents, 99 Deuterium, 99, 106 Diabetes Mellitus, 13, 35, 99, 104, 105 Diagnostic procedure, 39, 66, 99 Diaphragm, 95, 99, 115 Diarrhea, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 51, 53, 60, 62, 63, 99, 102, 108 Diarrhoea, 22, 99 Diastolic, 99, 106 Dietary Fiber, 7, 13, 48, 67, 99 Dietitian, 62, 99 Digestion, 5, 6, 9, 11, 29, 46, 53, 62, 90, 93, 94, 99, 100, 103, 107, 109, 114, 121 Digestive system, 11, 13, 52, 57, 62, 99, 103 Digestive tract, 42, 51, 67, 92, 99, 120 Dilation, 21, 99 Dimethyl, 99, 120 Diploid, 99, 115 Direct, iii, 49, 99, 100, 118 Disinfectant, 100, 101 Dispenser, 41, 100 Distal, 55, 100, 103, 117 Distention, 4, 12, 14, 15, 59, 100 Diverticula, 7, 12, 100 Diverticulitis, 7, 12, 52, 100 Diverticulosis, 12, 49, 100 Diverticulum, 100 Dopamine, 41, 100, 112 Double-blind, 8, 100 Drug Interactions, 100 Drug Tolerance, 100, 122 Duct, 42, 100, 102, 119, 121 Duodenitis, 41, 100 Duodenum, 93, 100, 103, 114, 121 Dyskinesias, 100, 111 Dysmenorrhea, 100, 111 Dyspepsia, 4, 41, 43, 44, 100, 107 Dysphagia, 5, 35, 100 E Efficacy, 8, 9, 100 Elastic, 52, 101, 104 Elasticity, 92, 101 Electrocardiogram, 7, 101 Electrolyte, 14, 101, 105, 116, 120 Emetic, 101, 124 Emollient, 101, 104, 111, 113 Empirical, 7, 101

Endogenous, 41, 100, 101 Endoscopy, 12, 59, 101 Enema, 7, 12, 62, 63, 101 Enteral Nutrition, 14, 101 Environmental Health, 72, 74, 101 Enzymatic, 40, 90, 94, 97, 101, 106 Epidemiologic Studies, 3, 101 Epidural, 32, 101 Epigastric, 101, 114 Epinephrine, 89, 100, 101, 112, 123 Erythrocytes, 91, 101 Esophagus, 40, 46, 99, 101, 103, 105, 109, 113, 115, 118, 121 Ethanol, 50, 101, 102 Eucalyptus, 10, 101, 118 Evacuation, 98, 102, 103, 108, 117 Exocrine, 102, 114 Exogenous, 41, 101, 102, 123 Expiration, 31, 102, 118 Extracellular, 98, 102, 120 Extrapyramidal, 100, 102 F Faecal, 20, 99, 102 Family Planning, 73, 102 Fat, 12, 14, 19, 21, 47, 48, 53, 93, 94, 102, 109, 110, 119, 123 Fatty acids, 6, 40, 43, 90, 94, 102, 109 Fecal Incontinence, 23, 102, 107 Feces, 41, 52, 98, 99, 102, 121 Fermentation, 6, 19, 34, 40, 50, 102 Fetus, 102, 110, 124 Fibrin, 93, 102, 114, 122 Flatus, 18, 19, 20, 21, 22, 23, 24, 26, 33, 42, 50, 51, 52, 53, 54, 55, 59, 66, 102, 103 Flavoring Agents, 101, 102 Flushing, 42, 102 Forearm, 93, 102 Fructose, 102, 108 Fungi, 91, 102, 111 Fungistatic, 93, 102 G Galactosidases, 51, 102 Galactosides, 90, 102 Gallbladder, 89, 99, 103 Gallstones, 6, 93, 103 Gastric, 6, 9, 13, 14, 21, 43, 44, 103, 105, 106, 113, 114 Gastric Emptying, 13, 103 Gastric Inhibitory Polypeptide, 9, 103 Gastric Juices, 103, 114 Gastric Mucosa, 103, 114 Gastritis, 41, 48, 103

128

Flatulence

Gastroenterologist, 61, 103 Gastroenterology, 4, 15, 17, 30, 33, 59, 103 Gastroesophageal Reflux, 35, 62, 103 Gastrointestinal, 3, 4, 5, 7, 9, 10, 11, 13, 26, 41, 46, 51, 59, 101, 102, 103, 108, 121 Gastrointestinal tract, 46, 101, 102, 103, 108 Gastrointestinal Transit, 7, 103 Gastroparesis, 13, 103 Gastrostomy, 101, 103 Gene, 58, 93, 103 Genital, 92, 103 Gestation, 20, 103 Gland, 103, 110, 114, 119, 121, 122 Glomerular, 104, 108 Glucose, 8, 9, 13, 30, 50, 61, 93, 95, 99, 104, 105, 107 Glucose Intolerance, 99, 104 Glucose tolerance, 9, 104 Glucose Tolerance Test, 104 Gluten, 27, 32, 104 Glycerol, 94, 104, 115 Glycine, 90, 93, 104, 112 Glycosidic, 95, 104, 113 Gout, 104, 111 Governing Board, 104, 116 Gravis, 23, 104 Growth, 6, 43, 51, 91, 95, 102, 104, 110, 115, 123, 124 Gum Arabic, 89, 104 H Habitual, 96, 104 Halitosis, 13, 104 Haploid, 104, 115 Headache, 4, 7, 104, 105 Headache Disorders, 105 Health Education, 62, 105 Health Promotion, 61, 105 Heart failure, 105 Heartburn, 4, 6, 10, 12, 13, 35, 45, 46, 62, 105, 107 Hematuria, 9, 105 Hemodiafiltration, 105, 123 Hemodialysis, 105, 123 Hemofiltration, 105, 123 Hemoglobin, 8, 9, 13, 91, 101, 105 Hemorrhage, 98, 104, 105 Hemorrhoid, 45, 105 Hepatic, 90, 104, 105 Hereditary, 104, 105, 111 Heredity, 103, 105 Hernia, 17, 41, 105

Herpes, 9, 106 Herpes Zoster, 106 Histamine, 106, 117 Histology, 106, 109 Hormone, 98, 101, 103, 106, 107, 110, 119 Host, 106, 124 Hydration, 7, 51, 106 Hydrogen, 4, 5, 6, 11, 31, 44, 46, 48, 59, 62, 89, 92, 94, 99, 106, 111, 113, 117 Hydrolases, 102, 106 Hydrolysis, 32, 90, 95, 106, 116, 117 Hydrophobic, 106, 109 Hypertension, 48, 92, 105, 106 Hypnotic, 106, 117 Hypodermic, 58, 106 Hypoglycemia, 8, 9, 106 I Ibuprofen, 3, 10, 45, 46, 106, 108 Id, 27, 34, 79, 84, 86, 106 Ileostomy, 55, 106 Ileum, 95, 106 Imidazole, 44, 96, 106, 111 Immune system, 106 Immunologic, 62, 106 Impairment, 106, 110, 117 In vitro, 6, 107 In vivo, 6, 18, 107 Incision, 107, 108, 123 Incompetence, 103, 107 Incontinence, 12, 20, 23, 30, 52, 107 Indicative, 58, 107, 114 Indigestion, 5, 10, 22, 45, 46, 58, 107, 108 Infarction, 98, 107, 110 Infection, 107, 108, 112, 119 Inflammation, 12, 35, 45, 46, 63, 89, 90, 91, 92, 94, 97, 100, 103, 106, 107, 113, 114, 115, 119, 123 Inflammatory bowel disease, 52, 107 Infusion, 14, 107, 111 Ingestion, 30, 51, 104, 107, 115 Inotropic, 100, 107 Insulin, 8, 9, 11, 13, 103, 104, 107, 123 Insulin-dependent diabetes mellitus, 13, 107 Internal Medicine, 19, 26, 103, 107 Intestinal, 5, 9, 30, 31, 40, 42, 44, 46, 48, 49, 53, 59, 67, 78, 104, 107, 110 Intestine, 6, 40, 46, 61, 93, 94, 103, 107, 108, 110, 114, 124 Intoxication, 107, 124 Intracellular, 107, 110, 116 Intravenous, 107, 108, 111

Index 129

Inulin, 6, 108 Invasive, 45, 62, 108 Involuntary, 93, 100, 102, 108, 111, 120 Ions, 40, 92, 101, 106, 108 Ischemic Colitis, 12, 108 J Jejunostomy, 101, 108 Joint, 63, 108, 113 K Kb, 72, 108 Ketoprofen, 10, 108 L Lactose Intolerance, 4, 5, 61, 67, 108 Large Intestine, 6, 40, 95, 99, 107, 108, 118, 120, 124 Laxative, 6, 108, 111 Least-Squares Analysis, 108, 118 Leishmaniasis, 78, 108 Leucocyte, 90, 108 Library Services, 84, 108 Ligaments, 98, 108 Likelihood Functions, 108, 118 Linear Models, 109, 118 Linkage, 95, 102, 109 Lipid, 9, 47, 91, 92, 96, 104, 107, 109, 123 Lipoprotein, 9, 109 Lipoxygenase, 47, 92, 109 Liver, 12, 32, 89, 90, 93, 99, 102, 103, 104, 105, 109, 123 Liver cancer, 32, 109 Localized, 107, 109, 115, 123 Locomotion, 109, 115 Logistic Models, 109, 118 Loop, 105, 106, 109 Low-density lipoprotein, 109 Lower Esophageal Sphincter, 62, 103, 109 Lubricants, 10, 109, 114 Lumen, 40, 109 M Maceration, 47, 109 Macronutrients, 13, 110 Malabsorption, 4, 14, 19, 59, 110 Malignant, 92, 109, 110 Malnutrition, 90, 110 Mammary, 110 Mania, 43, 110 Manic, 110, 117 Manic-depressive psychosis, 110, 117 Mastitis, 43, 110 Meat, 43, 48, 110 Medial, 92, 110 Mediate, 100, 110

MEDLINE, 73, 110 Membrane, 51, 54, 55, 95, 96, 97, 110, 111, 113, 115, 117, 118 Membrane Proteins, 110, 117 Memory, 99, 110 Meninges, 95, 98, 110 Menopause, 35, 110, 116 Mental, iv, 14, 72, 74, 99, 107, 110, 117, 119 Mental Disorders, 110, 117 Menthol, 10, 110 Meteorism, 17, 48, 110 Methionine, 99, 110, 121 MI, 13, 87, 110 Miconazole, 10, 111 Microbe, 111, 122 Microbiology, 32, 89, 111 Mineral Oil, 10, 111 Modification, 62, 90, 111, 117 Molecular, 51, 55, 73, 75, 91, 93, 98, 103, 105, 111, 122 Molecule, 91, 92, 97, 104, 106, 111, 113, 118 Monitor, 98, 111 Monotherapy, 8, 9, 111 Morphine, 32, 111, 112, 113 Motility, 7, 14, 23, 59, 103, 111 Motion Sickness, 10, 111, 112 Motor nerve, 111, 115 Movement Disorders, 24, 43, 44, 100, 111 Mucins, 111, 119 Mucocutaneous, 108, 111 Mucosa, 12, 62, 103, 111, 112 Mucus, 111, 123 Mydriatic, 99, 111 Myocardium, 110, 111 N Nalbuphine, 23, 111 Naproxen, 10, 111 Narcosis, 111, 112 Narcotic, 7, 111, 112 Nasal Cavity, 112 Nasal Obstruction, 16, 112 Nasogastric, 101, 112 Nausea, 4, 7, 12, 13, 41, 43, 44, 103, 107, 112 Need, 3, 12, 13, 49, 52, 57, 58, 61, 67, 80, 112, 119, 122 Nerve, 23, 89, 91, 93, 95, 103, 111, 112, 115, 119, 123 Nerve Endings, 93, 112 Nerve Fibers, 93, 95, 112, 115 Nervous System, 95, 112, 121, 122 Neurons, 112, 121

130

Flatulence

Neuropathy, 10, 92, 112 Neurotransmitter, 90, 100, 104, 106, 112, 121, 122 Nicotine, 10, 112 Nonulcer Dyspepsia, 6, 112 Norepinephrine, 89, 100, 112 O Obsessional, 23, 113 Obstetrics, 20, 109, 113 Occult, 4, 113 Occult Blood, 4, 113 Odour, 22, 92, 113 Oesophagitis, 43, 44, 113 Ointments, 45, 96, 113 Oligosaccharides, 9, 18, 32, 33, 37, 40, 49, 50, 53, 90, 113 Omeprazole, 113, 117 Opacity, 99, 113 Opiate, 111, 113 Opium, 111, 113 Oral Hygiene, 104, 113 Orderly, 59, 113 Osmotic, 90, 113 Osteoarthritis, 108, 113 Outpatient, 7, 113 Ovum, 103, 113, 118 Oxidation, 47, 89, 92, 113 P Palliative, 113, 122 Pancreas, 11, 89, 99, 103, 107, 114 Pancreatic, 6, 14, 35, 103, 114 Pancreatic enzymes, 6, 114 Pancreatic Juice, 103, 114 Pathogenesis, 7, 19, 114 Pathologic, 4, 23, 24, 89, 93, 98, 114 Pathophysiology, 20, 33, 114 Patient Education, 59, 78, 82, 84, 87, 114 Pelvis, 89, 114, 124 Pepsin, 114 Pepsin A, 114 Peptic, 5, 12, 41, 43, 44, 62, 114 Peptic Ulcer, 12, 41, 43, 44, 62, 114 Peptide, 9, 90, 106, 114, 116 Perforation, 8, 91, 114, 124 Peristalsis, 62, 114 Peritoneum, 114 Peritonitis, 7, 114, 124 Perspiration, 46, 114 Petrolatum, 10, 114 Petroleum, 111, 114 Pharmaceutical Preparations, 95, 101, 115 Pharmacologic, 91, 115, 122

Pharmacology, Clinical, 9, 115 Pharynx, 103, 112, 115 Phobias, 113, 115 Phospholipids, 102, 109, 115 Phosphorus, 94, 115 Phrenic Nerve, 15, 115 Physical Examination, 59, 115 Physiologic, 12, 67, 90, 108, 115, 118 Physiology, 5, 10, 12, 13, 22, 57, 59, 62, 103, 115 Plant Oils, 113, 115 Plants, 50, 90, 94, 96, 104, 108, 112, 115, 122, 123 Plasma, 8, 9, 90, 95, 96, 104, 105, 115 Plasma protein, 90, 115 Pneumonia, 98, 115 Poisoning, 107, 112, 115 Polyethylene, 55, 115 Polysaccharide, 40, 91, 95, 116 Porosity, 55, 116 Posterior, 91, 114, 116 Postoperative, 23, 31, 32, 116 Postprandial, 9, 13, 116 Post-traumatic, 105, 111, 116 Potassium, 14, 116 Practice Guidelines, 74, 116 Precursor, 96, 100, 101, 112, 116, 123 Premenopausal, 23, 116 Prevalence, 20, 116 Progressive, 92, 99, 100, 104, 113, 116 Prone, 63, 116 Prophylaxis, 43, 116, 119 Protective Devices, 44, 116 Protein C, 47, 51, 90, 91, 109, 116, 123 Protein S, 47, 50, 58, 93, 116 Proteins, 49, 51, 90, 91, 95, 97, 110, 111, 114, 115, 116, 120 Proteolytic, 90, 97, 116 Proton Pump, 6, 113, 117 Proton Pump Inhibitors, 6, 117 Protons, 106, 117, 118 Protozoa, 108, 117 Proximal, 40, 55, 100, 112, 117 Psychoactive, 117, 124 Psychosis, 41, 117 Psychotherapy, 117, 118 Psyllium, 38, 117 Public Policy, 73, 117 Pulmonary, 93, 98, 105, 117 Pulmonary Artery, 93, 117 Pupil, 99, 111, 117 Purgative, 108, 117

Index 131

Pyrilamine, 10, 117 Q Quality of Life, 63, 117 R Race, 4, 46, 117 Racemic, 46, 117 Radiata, 32, 118 Radiation, 118, 119 Radioactive, 106, 118 Raffinose, 50, 51, 118 Randomized, 8, 100, 118 Reality Testing, 117, 118 Reassurance, 62, 118 Receptor, 6, 14, 89, 91, 100, 118 Rectal, 12, 35, 63, 78, 118 Rectum, 12, 23, 59, 91, 94, 97, 99, 102, 103, 105, 107, 108, 118, 120 Refer, 1, 97, 102, 106, 109, 116, 117, 118, 122 Reflux, 10, 41, 43, 44, 103, 118 Refraction, 118, 120 Refractory, 5, 118 Regimen, 100, 118 Regression Analysis, 4, 118 Regurgitation, 13, 103, 105, 118 Resection, 8, 118 Respiration, 94, 111, 118 Restoration, 58, 118, 119 Retinoids, 119, 124 Retrospective, 3, 119 Rheumatism, 106, 119 Rheumatoid, 108, 111, 119 Rheumatoid arthritis, 108, 111, 119 Rigidity, 115, 119 Risk factor, 20, 100, 101, 109, 119 Roentgenography, 12, 119 Ruminants, 43, 119 S Salicylate, 96, 119 Saliva, 46, 119 Salivary, 99, 119 Salivary glands, 99, 119 Sanitary, 44, 119 Satiation, 18, 119 Schizoid, 119, 124 Schizophrenia, 43, 119, 124 Schizotypal Personality Disorder, 119, 124 Sclerosis, 92, 119 Screening, 96, 119 Secretion, 14, 103, 106, 107, 111, 113, 114, 119 Senile, 43, 44, 119

Sepsis, 8, 120 Serum, 9, 49, 90, 97, 109, 114, 120 Shock, 58, 120 Side effect, 8, 9, 10, 11, 46, 49, 89, 120, 122 Sigmoid, 8, 120 Sigmoid Colon, 120 Simethicone, 10, 40, 46, 67, 120 Skeleton, 108, 120 Small intestine, 11, 40, 62, 95, 96, 100, 106, 107, 112, 120 Smooth muscle, 106, 111, 120, 121 Sneezing, 67, 120 Social Environment, 117, 120 Sodium, 14, 94, 104, 111, 120, 121 Solvent, 53, 101, 104, 113, 120 Spasmodic, 89, 120 Specialist, 79, 99, 120 Species, 6, 94, 96, 101, 104, 108, 117, 120, 121, 124 Spectroscopic, 113, 120 Spectrum, 7, 96, 120 Sphincter, 40, 42, 121 Spinal cord, 95, 96, 101, 110, 112, 121 Stasis, 43, 44, 121 Stimulant, 10, 106, 121 Stomach, 5, 11, 13, 14, 16, 40, 45, 46, 62, 78, 89, 93, 99, 100, 101, 103, 104, 106, 109, 112, 114, 115, 117, 118, 119, 120, 121, 124 Stool, 7, 10, 13, 14, 59, 63, 97, 107, 108, 121 Stool test, 59, 121 Stress, 5, 51, 62, 95, 98, 102, 112, 119, 121 Stupor, 111, 112, 121 Styptic, 121, 124 Subarachnoid, 104, 121 Subspecies, 120, 121 Substance P, 119, 121 Substrate, 40, 106, 121 Sulfur, 46, 67, 110, 121 Supplementation, 8, 121 Sweat, 46, 114, 121 Sweat Glands, 121 Sympathomimetic, 100, 101, 112, 121 Symptomatic, 5, 32, 121 Synaptic, 112, 121, 122 Synaptic Transmission, 112, 122 Systemic, 6, 93, 101, 107, 122 Systolic, 106, 122 T Tetracaine, 10, 122 Therapeutics, 3, 7, 29, 30, 122 Thorax, 89, 122 Threshold, 106, 122

132

Flatulence

Thrombin, 102, 116, 122 Thrombomodulin, 116, 122 Thrombosis, 116, 122 Thyroxine, 90, 122 Tissue, 91, 92, 93, 98, 100, 102, 105, 108, 109, 110, 111, 112, 113, 118, 120, 121, 122, 123 Tolerance, 3, 5, 11, 62, 104, 122 Tooth Preparation, 89, 122 Topical, 10, 92, 101, 114, 122 Toxic, iv, 112, 122 Toxicity, 3, 100, 122 Toxicology, 74, 122 Toxin, 122 Trachea, 115, 123 Tracheotomy, 16, 123 Transfection, 93, 123 Transmitter, 100, 112, 123 Trees, 101, 123 Triglyceride, 9, 123 Troglitazone, 11, 123 Tunica, 111, 123 Type 2 diabetes, 8, 9, 11, 123 Tyrosine, 100, 123 U Ulcer, 112, 114, 123 Ulcerative colitis, 52, 62, 107, 123 Ultrafiltration, 51, 105, 123 Ultrasonography, 12, 123 Unconscious, 106, 123

Urea, 121, 123 Ureters, 123 Urethra, 12, 123, 124 Urinary, 9, 12, 23, 107, 123 Urinary tract, 9, 12, 123 Urine, 12, 23, 30, 52, 93, 98, 105, 107, 123, 124 Uterus, 95, 110, 124 V Vagina, 124 Vaginal, 10, 23, 124 Vasodilator, 100, 106, 124 Venous, 116, 124 Vestibule, 112, 124 Veterinary Medicine, 73, 124 Virulence, 122, 124 Viruses, 55, 111, 124 Visceral, 7, 8, 36, 92, 108, 114, 124 Vitamin A, 14, 124 Vitro, 124 Vivo, 124 Volition, 108, 113, 124 Volvulus, 24, 124 W Wart, 10, 124 Weight Gain, 11, 124 Withdrawal, 43, 62, 124 Z Zinc Acetate, 30, 124 Zymogen, 116, 124