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'''Type page name here Microchapters
Flatuelnce
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[[Type page name here|Home]]
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[[Flatulence]]
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[[Type page name here (patient information)|Patient Information]]
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[[Type page name here overview|Overview]]
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==Overview==
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Flatulence is the presence of a mixture of gases known as flatus in the [[gastrointestinal tract|digestive tract]] of [[mammals]] expelled from the [[rectum]]. It is more commonly known as '[[fart]]ing', 'passing gas', or 'passing wind' ([[UK]]).
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[[Type page name here historical perspective|Historical Perspective]]
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=References=
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[[Type page name here classification|Classification]]
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[[Category:primary care]]
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[[Category:Psychiatry]]
[[Type page name here pathophysiology|Pathophysiology]]
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[[Type page name here causes|Causes]]
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[[Type page name here differential diagnosis|Differentiating Type page name here from other Diseases]]
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[[Flatulence]]
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[[Type page name here epidemiology and demographics|Epidemiology and Demographics]]
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[[Type page name here risk factors|Risk Factors]]
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== Pathophysiology ==
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Flatus is expelled under pressure through the [[anus]], whereby, as a result of the voluntary or involuntary tensing of the [[anal sphincter]], the rapid evacuation of [[gases]] from the lower [[intestine]] occurs. Depending upon the relative state of the [[sphincter]] (relaxed/tense) and the positions of the [[buttock]]s, this often results in an audible crackling or trumpeting sound, but gas can also be passed quietly. The olfactory components of flatulence include [[skatole]], [[indole]], and [[sulfur]]ous compounds.<ref>{{cite web
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|url=http://www.patient.co.uk/showdoc/40000086/
[[Type page name here screening|Screening]]
|title=Flatulence, wind and bloating
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|publisher=Patient UK
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|accessdate=2006-12-11
}}</ref> The non-odorous gases are mainly [[nitrogen]] (ingested), [[carbon dioxide]] (produced by [[aerobic organism|aerobic microbes]] or ingested), and [[hydrogen]](produced by some microbes and consumed by others), as well as lesser amounts of [[oxygen]] (ingested) and [[methane]] (produced by [[anaerobic organism|anaerobic microbe]]s).<ref>{{cite journal| author=Suarez F| coauthors=Furne J, Springfield J, Levitt M| title=Insights into human colonic physiology obtained from the study of flatus composition| journal=Am J Physiol| year=1997| volume=272 (5 Pt 1)| pages=G1028–33}}</ref> Odors result from trace amounts of other components (often containing [[sulfur]]compounds, see below).


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[[Type page name here natural history, complications and prognosis|Natural History, Complications and Prognosis]]
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Diagnosis
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==Causes==
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Toxic epidermal necrolysis is a rare and usually severe adverse reaction to certain drugs. History of medication use exists in over 95% of patients with TEN. The drugs most often implicated in TEN are antibiotics such as sulfonamides, [[nonsteroidal anti-inflammatory drugs]], [[allopurinol]], [[antiretroviral drugs]], [[corticosteroids]] and[[anticonvulsant]]s such as [[phenobarbital]], [[phenytoin]], [[carbamazepine]], and [[valproic acid]].  The condition might also result from immunizations,  infection with agents such as ''[[Mycoplasma pneumoniae]]'' or  [[herpes virus]] and [[Organ transplant|transplant]]s of [[bone marrow]] or organs.
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[[Type page name here history and symptoms|History and Symptoms]]
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==Epidemiology and Demographics==
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The [[incidence (epidemiology)|incidence]] is between 0.4 and 1.2 cases per 100,000 each year.
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==Natural History, Complications and Prognosis==
[[Type page name here physical examination|Physical Examination]]
The mortality for toxic epidermal necrolysis is 30-40%.<ref name=garra>Garra, GP (2007). "[http://www.emedicine.com/EMERG/topic599.htm Toxic Epidermal Necrolysis]". Emedicine.com. Retrieved on December 13, 2007.</ref>  Loss of the skin leaves patients vulnerable to infections from fungi and bacteria, and can result in [[septicemia]], the leading cause of death in the disease.<ref name=garra/> Death is caused either by [[infection]] or by [[respiratory distress]] which is either due to [[pneumonia]] or damage to the linings of the airway. Microscopic analysis of tissue (especially the degree of dermal mononuclear inflammation and the degree of inflammation in general) can play a role in determining the prognosis of individual cases.<ref>{{cite journal |author=Quinn AM et al |title=Uncovering histological criteria with prognostic significance in toxic epidermal necrolysis |journal=Arch Dermatol |volume=141 |issue=6 |pages=683-7 |year=2005 |pmid=15967913}}</ref>
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==Diagnosis==
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===Laboratory Findings===
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Sometimes, however, examination of affected tissue under the microscope may be needed to distinguish it between other entities such as [[staphylococcal scalded skin syndrome]]. Typical histological criteria of TEN include mild infiltrate of lymphocytes which may obscure the dermoepidermal junction and prominent cell death with basal vacuolar change and individual cell necrosis.<ref>{{cite journal |author=Pereira FA, Mudgil AV, Rosmarin DM |title=flatuelnce |journal=J Am Acad Dermatol|volume=56 |issue=2 |pages=181-200 |year=2007 |pmid=17224365}}</ref>
[[Type page name here laboratory findings|Laboratory Findings]]
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Revision as of 02:57, 3 April 2013