Wednesday 17 January 2018

Ask the GP: Treating bloating and skin conditions

Burping and passing gas are normal bodily functions
Burping and passing gas are normal bodily functions

Nina Byrnes

GP Nina Byrnes on how to deal with bloating and what you should do about skin lesions.

Question: I burp a lot and also suffer from bloating and passing wind. I've tried making changes to my diet but nothing seems to improve things. It's very embarrassing what can I do to stop this?

Dr Nina replies: Burping and passing gas may be embarrassing but it's important to remember these are normal bodily functions. The average person passes wind 14 to 23 times daily.

Gas in the digestive tract occurs in two ways. It can occur when eating or drinking quickly, chewing gum or smoking. Gas may also be produced due to the break down of undigested food by bacteria in the large intestine.

Cruciferous foods such as cabbage, broccoli, Brussels sprouts and beans are known gas producers.

Lactose is commonly found in dairy products and may produce significant amounts of gas.

Fructose and sorbitol are sugars found in many fruits and are also used as sweeteners in drinks and sugar-free sweets.

Starches found in wheat, potatoes and corn also produce gas.

Lastly, soluble and insoluble fibre can produce gas as they pass through the gut. Excess gas is not dangerous but it may make you uncomfortable. You may experience large amounts of burping and passing wind.

Abdominal cramping and bloating can be particularly problematic. For simple excess wind try looking at your diet.

Keeping a food diary will help you identify which foods trigger symptoms of excess gas.

Avoiding obvious trigger foods can help. I've previously mentioned the Low FODMAP diet. This may be advised by a dietitian to help with uncomfortable symptoms of irritable bowel syndrome.

Other tips to reduce gas include eating food more slowly. Take time to chew food properly before swallowing.

Avoid beer or carbonated drinks. Avoid chewing gum. Smoking causes you to swallow air so avoid this to reduce gas.

Stay active. Exercising encourages gut motility making it less likely that food can stagnate and ferment.

Cut back on high-fibre foods or increase these slowly if they are new to your diet.

Consider medicine. There are a number of over-the-counter remedies that may help reduce intestinal gas.

Another popular remedy is peppermint tea. This can be quite soothing to the gut.

If simple measures aren't working do see your GP. Excess intestinal gas is occasionally associated with other conditions such as coeliac disease.

Question: I attended my GP recently because I noticed a new mole on my leg. She told me not to worry that it is called a dermatofibroma and it doesn't need to be removed. What are these and what causes them?

Dr Nina replies: Dermatofibromas are small benign skin lesions. They often feel slightly raised and are firm which tends to cause concern in many people.

Skin is made up of many layers. Dermatofibromas occur due to an overgrowth of cells in the deeper layer of skin called the dermis. It isn't known exactly why they occur but it has been suggested that they are more likely to occur in areas of previous trauma.

They are four times more common in women than men and occur mainly in adults. Dermatofibromas most commonly occur as small firm single nodules in the skin. They vary in size usually from 0.5cm to 1cm diameter. They are seen mainly on the limbs but can occur anywhere on the body.

They are normally a pink/ red to cream/white to brown colour. It is possible to have several dermatofibromas. There are few other skin lumps that feel this firm. Squeezing a dermatofibroma may create an overlying dimple.

Despite the somewhat unusual and alarming appearance these lesions are benign and don't do any harm.They tend to grow quickly at first but then stabilise and don't get any larger.

The only reason to remove a dermatofibroma is if it is cosmetically unacceptable. There are a number of ways they can be removed but it is likely that some form of scarring may occur so doctors advise leaving them alone.

It is worth seeing your doctor for a definitive diagnosis as other skin changes may look quite similar. However, if your GP was confident this is indeed a dermatofibroma then I would also agree to leave well enough alone.

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