There were several questions from our users about poor digestion, swelling and eructation. The answers of Dr. Beatrice Salvioli, a gastroenterologist from Humanitas, help us to clarify the situation.


I suffer from abdominal swelling, and lately I have heartburn, acidity and lazy bowel. I have tried to eliminate certain foods and take enzymes and other medicines, but the problem persists.

Burning and acidity suggest a problem related to the stomach and specifically to a possible gastritis or gastro esophageal reflux. An anti-secretive therapy and, if necessary, diagnostic studies such as gastroscopy with biopsies to detect the presence of Helicobacter Pylori will be prescribed on the basis of historical data.


I have serious digestion problems especially in the evening, and when I lie down the problem is associated with continuous tachycardia that also prevents me from sleeping. I can no longer eat vegetables.

Difficult digestion combined with an altered heartbeat suggests a gastro esophageal reflux or the presence of a hiatus hernia. Vegetables, especially filamentous and raw vegetables, are difficult to digest when there is an inflammation of the stomach, so it is normal not to tolerate them.


I suffer from continuous eructation and swelling in the mouth of my stomach, with frequent flatulence. What can it be?

The reported symptoms may result from a gastritis that needs to be verified by diagnostic tests such as gastroscopy. In addition, an abdominal ultrasound scan can exclude a problem with the gall bladder, such as the presence of stones or dense bile.


I suffer from aerophagia and eructation even away from meals and after walking. I underwent two gastroscopies and breath tests but they didn’t find anything. Aerophagia comes back at times, but digestion continues to be problematic. What can I do?

If the stomach-specific investigations were negative, other sources of origin of the problem should be considered. I would suggest that you have an abdominal ultrasound to check your gall bladder. Another useful evaluation can be that of a physiatrist who examines if there are any alterations in the dynamics of the diaphragm.


I have been suffering from digestive problems such as swelling, lazy bowel and gastritis for a long time. I would like to carry out intolerance tests, which are not recommended by the gastroenterologist because they are not valid. Is that true? If not, which tests are most suitable to have a complete assessment of possible intolerances?

To date, intolerance tests are not considered valid by the scientific community because they do not recognize pathology in itself. Moreover, there is no reliable reference test. The wisest attitude is to keep a diary with a report on the type of food you eat and the symptoms that can result. The results are then compared with those of the intolerance test that you choose to do. It would be necessary for all this to be supervised by a nutrition specialist.


By varying my diet and integrating whole meal pasta, whole meal rusks, spelt and the like, I got diverticulitis. Is there a link?

High quantities of unrefined fibers can irritate the diverticula. However, spelt has nothing to do with this, unless it is also whole meal. As a suggestion, for dietary indications in diverticular disease, the consumption of unrefined flours (e.g. whole meal), but in moderate quantities, is recommended.


My daughter was diagnosed with a hiatus hernia, but the prescribed treatments (pump inhibitors and antacids) did not produce any results. Today she is not fit and continues to lose weight. She no longer knows what to eat. What can be done?

The problem is probably not related to the presence of a hiatus hernia, which is rarely the main cause of symptoms. Slimming should be seen in more complex clinical settings such as celiac disease. So I suggest we do the blood tests and endoscopic tests to evaluate its presence.