Rotten belching is the regurgitation of gastric or intestinal gases with a putrid odor, accompanied by a characteristic sound. The symptom can be combined with pain or discomfort in the abdomen, dyspeptic disorders. Eructation most often occurs with diseases of the digestive system, enzyme deficiency, and some parasitic infections. To identify the cause of belching with rotten eggs, ultrasound, X-ray, endoscopic and laboratory methods are used. To reduce the frequency of erection, drugs (prokinetics, enzymes, laxatives), cleansing enemas are used.
Causes of rotten belching
In most cases, the prerequisite for the occurrence of erection, which has an unpleasant odor, are inflammatory and non-inflammatory diseases of the gastrointestinal tract and the hepatobiliary system. Rotten belching occurs with congenital intolerance to carbohydrates - lactose and fructose due to enzyme deficiency. The cause of regurgitation of gases with the smell of hydrogen sulfide can be intestinal helminthiases and giardiasis. Sometimes rotten erection is noted with functional dyspepsia and is associated with a violation of the processes of chyme movement along the digestive tract.
Errors in nutrition
The physiological causes of rotten belching include excessive consumption of foods containing sulfur: meat and eggs, dairy and vegetable products (legumes, cabbage). It is this microelement that causes the fetid smell of belching gastric gases. The likelihood of erection increases with the simultaneous intake of carbonated drinks, which cause excessive formation of carbon dioxide in the stomach and stretching of its walls, and the use of indigestible proteins that linger in the stomach.
Stomach diseases
The appearance of putrefactive erection is due to two main reasons: a decrease in the secretion of hydrochloric acid and stagnation of the contents in the stomach. In a hypoacid state, the processes of activation of digestive enzymes are disrupted, fermentation reactions develop, which are accompanied by the release of hydrogen sulfide gas with an unpleasant rotten odor. With stagnation of food masses in the stomach due to atony of smooth muscles or spasm of the pylorus, food also rots, which causes a fetid eructation. Belching rotten provoke:
- Chronic atrophic gastritis . Progressive atrophy of the glandular epithelial cells and mucous membrane causes a decrease in the production of hydrochloric acid with a violation of the digestion of protein products. Rotten erection is associated with excessive stretching of the organ walls, fermentation and stagnation of food masses. With low acidity, secondary bacterial flora joins, which aggravates the patient's condition.
- Achlorhydria . As a result of the absence of free hydrochloric acid, there is no activation of digestive enzymes, so the chyme lingers for a long time in the stomach, where fermentation processes occur. The situation is aggravated by the addition of violations of the motor function of the organ and its stretching, which is accompanied by belching with a taste of rotten eggs. The disease is characterized by the appearance of nausea, heaviness in the abdomen, flatulence.
- Atony of the stomach . Violation of the contractility of the gastric muscles leads to a decrease in both motor and secretory activity of the organ. This provokes a prolonged stagnation of partially digested food, which causes distension of the stomach and regurgitation of gases. Rotten belching is often combined with discomfort and a feeling of heaviness in the abdominal cavity, worsening after eating.
- gastroptosis . Eructation during prolapse of the stomach often occurs in the later stages of the disease, is associated with significant hypotension of the organ and squeezing of the duodenum, which potentiates the stagnation of the contents. In the clinical picture, chronic constipation, nausea, a feeling of early satiety are observed. If gastroptosis is combined with damage to the underlying gastrointestinal tract, intestinal symptoms may join.
- Pyloric stenosis . The combination of rotten erection with heaviness in the abdomen, loss of appetite, weight loss is typical even for the compensated stage of the disease. With the progression of pyloric stenosis, daily vomiting is observed, in severe cases it occurs after each meal, while the vomit contains a large amount of incompletely digested products. In the decompensated stage, severe exhaustion is noted.
- Adenocarcinoma of the stomach . A rotten eructation with an unpleasant odor is typical of a large tumor, which is localized in the pyloric part of the organ. The neoplasm prevents the evacuation of chyme into the cavity of the duodenum, causes overstretching of the gastric wall and decreased motility. The symptom is combined with other dyspeptic disorders: intense epigastric pain, stool disorders, lack of appetite.
Pathology of the pancreatoduodenal zone
Diseases of the duodenum and pancreas are often manifested by putrefactive belching. It can occur due to a violation of duodenal motility, which provokes stagnation of the contents and activation of fermentation processes. Rotten erection in pathological conditions of the pancreas mainly develops due to enzymatic deficiency, which leads to impaired digestion and absorption of food ingredients, stagnation of chyme in the intestine. The symptom is typical for diseases such as:
- Duodenal stenosis . The narrowing of the lumen of the duodenum of organic or functional origin inevitably leads to a slowdown in the passage of digestive masses through the intestines with stretching of the overlying sections. This causes contraction of the gastric muscles and potentiates putrefactive erection. Often rotten belching is combined with regurgitation of gastric contents, profuse vomiting, after which the patient's condition improves.
- Duodenostasis . When chyme stagnates in the duodenum, pressure in the upper gastrointestinal tract increases, the muscles of the stomach and esophagus contract reflexively, causing belching. The rotten smell is associated with the processes of protein decay and fermentation, due to a decrease in the synthesis of enzymes. Eructation is associated with nausea, bloating and rumbling in the abdomen. Vomiting often begins after eating and brings relief to patients.
- pancreatitis . Regurgitation of putrefactive gases is more typical of chronic pancreatitis, in which the exocrine function of the pancreas always worsens. In case of insufficiency of digestive enzymes, the processes of splitting and absorption of proteins, fats, carbohydrates are disturbed. Undigested food lingers in the intestine for a long time, causing it to stretch, reflex belching, regurgitation of chyme.
Bowel disease
Rotten belching in intestinal pathology is associated with a reflex reaction of the smooth muscle of the gastric wall to the stagnation of fecal masses. The resulting unpleasant odor is due to the processes of decay and decomposition caused by the activation of opportunistic microorganisms that live in the large intestine. Rotten erection can be observed with enteropathies of various origins, which are accompanied by violations of the digestive processes, an increase in pressure inside the intestines and stomach due to increased gas formation.
- Chronic enterocolitis . Belching during inflammatory processes in the intestine is due to both a violation of digestion and changes in the rate of passage of chyme. Regurgitation of fetid gas is often combined with polymorphic clinical symptoms: abdominal pain, discomfort, stool disorders (diarrhea or constipation), nausea and vomiting. In severe situations, stool retention occurs with the release of blood and mucus from the anus.
- celiac disease Atrophy of the small intestinal mucosa and concomitant malabsorption of nutrients lead to polymorphic dyspeptic disorders. With celiac disease, rotten belching develops due to increased gas formation in the intestine, a violation of the coordinated contractions of the pyloric and cardiac sphincters. Also, patients are worried about diarrhea, diffuse abdominal pain, nausea, and vomiting are often observed.
- Dysbacteriosis . The predominance of opportunistic microflora in the small and large intestines causes rotting and fermentation of the chyme, which ends with the formation of fetid gases. Rotten erection occurs in response to overstretching of the walls of the digestive tract. Patients may complain of irregular stool frequency and stool consistency, abdominal pain, and nausea. With a long course of dysbacteriosis, a decrease in appetite, weight loss is possible.
- Intestinal polyps . Putrefactive regurgitation is observed with large benign epithelial neoplasms that cause mechanical obstruction of the intestinal lumen. The involuntary release of putrefactive gases is associated with a reflex contraction of the smooth muscles of the stomach during stretching and delayed emptying of the intestinal tract. Rotten belching is often associated with cramping pains in the abdomen.
- Colorectal Cancer . Erection in malignant neoplasia is associated with both mechanical obstruction of the colon and disruption of intramural autonomic ganglia. Permanent constipation is accompanied by insufficiency of the bauginian valve and the reflux of fecal contents into the overlying sections of the gastrointestinal tract. Belching sometimes develops against the background of pain in the left side of the abdomen, bleeding from the rectum.
- Pneumatosis of the intestine . The formation of air cavities in the colonic wall slows down peristaltic contractions and causes stool retention. Chronic constipation leads to the development of belching with putrefactive gases that appear during the decomposition of feces and the formation of toxic products. Stool retention may be replaced by diarrhea with a lot of mucus in the stool. Patients also experience nausea and vomiting.
Intestinal obstruction
Stagnation of feces in the intestine, caused by mechanical obstruction or lesions of the autonomic innervation, in the early stages is manifested by belching of air, which quickly acquires a fetid odor. Reflex regurgitation is due to an increase in pressure in the intestines and stomach, insufficiency of the obturator function of the bauhinia valve, leading to retrograde movement of feces. With the progression of the process, duodenogastric reflux is formed, which results in fecal vomiting.
Diseases of the hepatobiliary system
Various diseases of the liver and biliary tract, as a rule, are accompanied by bitter eructation, which occurs due to excessive flow of bile into the duodenum. In chronic diseases, combined with malabsorption and maldigestion syndrome, regurgitation can acquire a rotten smell. More often regurgitation of fetid gases is observed with hypomotor dyskinesia of the bile ducts, chronic cholecystitis, liver cysts. Belching is usually combined with pulling pains and discomfort in the right hypochondrium, loss of appetite.
Surveys
Examination of patients with complaints of putrefactive erection is carried out by a gastroenterologist. Since rotten belching most often indicates the presence of a pathological condition, a diagnostic search is aimed at identifying the root cause of the symptom. The patient undergoes a comprehensive examination to study the morphological and functional features of the digestive and biliary system. The most valuable are the following methods:
- Sonography . Ultrasound of the abdominal organs is an affordable non-invasive study that is prescribed for express diagnostics. The method is not accompanied by radiation exposure and allows you to detect non-specific signs of inflammatory diseases, volumetric formations. According to indications, targeted ultrasound examination of individual organs is performed.
- Endoscopy . Endoscopy is used in the diagnosis of the pathology of the upper gastrointestinal tract to detect motor disorders, dysregulation of the pyloric sphincter, and signs of hypoacid conditions. With colonic symptoms, colonoscopy is informative, if necessary, allowing a biopsy of the affected areas. Video capsule endoscopy is rarely used.
- X-ray methods . X-ray with oral contrast is used to visualize all parts of the gastrointestinal tract, the performance of delayed images allows you to assess the speed of the passage of contents through the intestines and the coordination of the work of muscle sphincters. To study the biliary and pancreatic ducts, ERCP and percutaneous cholangiopancreatography are prescribed.
- Fecal analysis . Diseases accompanied by rotten erection often cause pathological changes in the stool. The standard coprogram can be supplemented by studies on helminth eggs, an extended bacteriological study. If neoplasms or ulcerative-destructive processes are suspected, the Gregersen reaction to occult blood is performed.
Laboratory methods are recommended to clarify the diagnosis, patients may be prescribed liver tests, determining the levels of pancreatic enzymes in the blood and urine, measuring the concentration of gastrin and pepsinogen in the blood. To assess gastric secretion, a 24-hour pH-metry is performed.
A patient with complaints of rotten belching undergoes a comprehensive gastroenterological examination
Symptomatic therapy
If a rotten eructation is caused by an enzymatic deficiency, a dietary correction is necessary to eliminate unpleasant sensations with the exception of milk, fresh fruits, bread and other provoking foods. To reduce the frequency of regurgitation, it is recommended to avoid bending over and heavy physical work immediately after eating. To cope with the reflux of rotten gases at night, it is useful to sleep on a high pillow. Enzyme preparations, prokinetics can be used to reduce belching until the diagnosis is verified. With constipation, laxatives and cleansing enemas help.