Because gas symptoms may be caused by a serious disorder, those causes should be ruled out. The doctor usually begins with a review of dietary habits and symptoms. The doctor may ask the patient to keep a diary of foods and beverages consumed for a specific time period.
If lactase deficiency is the suspected cause of gas, the doctor may suggest avoiding milk products for a period of time. A blood or breath test may be used to diagnose lactose intolerance.
In addition, to determine if someone produces too much gas in the colon or is unusually sensitive to the passage of normal gas volumes, the doctor may ask patients to count the number of times they pass gas during the day and include this information in a diary.
Careful review of diet and the amount of gas passed may help relate specific foods to symptoms and determine the severity of the problem.
If a patient complains of bloating, the doctor may examine the abdomen for the sound of fluid movement to rule out ascites (build up of fluid in the abdomen) and for signs of inflammation to rule out diseases of the colon.
The possibility of colon cancer is usually considered in people 50 years of age and older and in those with a family history of colorectal cancer, particularly if they have never had a colon examination (sigmoidoscopy or colonoscopy). These tests may also be appropriate for someone with unexplained weight loss, diarrhea, or blood not visible in the stool.
For those with chronic belching, the doctor will look for signs or causes of excessive air swallowing. If needed, an upper GI series (x ray to view the esophagus, stomach, and upper small intestine) may be performed to rule out disease.
