Fermentation in the intestines. What foods cause gas formation and fermentation in the intestines?

Gas formation, also known as flatulence and bloating, often plagues the adult half of humanity. This problem is less common in children.

There are several reasons for this phenomenon, but the most common one is that people consume foods that cause gas in large quantities.

Causes of increased gas formation

The reasons leading to flatulence are different. Most often they are related to a person’s diet, what foods he consumes and how. But these are not the only factors that lead to gases beginning to accumulate in the digestive tract.


Factors contributing to gas formation are the following:

  1. A person consumes food by chewing it poorly and swallowing large pieces along with air.
  2. While eating, it is customary for adults to have conversations, this is especially noticeable during business dinners. And such a habit can cause gas formation due to air entering the esophagus and stomach.
  3. Lack of enzymes in adults is a common problem that causes increased gas formation. When there are not enough enzymes, the food in the stomach is poorly digested and enters the intestines in the wrong form. This causes fermentation and the formation of gases in the human intestines.
  4. Eating a large amount of food at once, or overeating, is also a reason that causes gas accumulation.
  5. Intense gas formation is also caused by fast eating and eating on the go - snacking on sandwiches and washing them down with coffee.
  6. Consumption of certain gas-forming products.
  7. Wrong food combinations are also a gas-forming cause. Some foods are well absorbed in the human body, but sometimes, if you add additional food to them, the body's reaction may be increased gas formation in the stomach or intestines.
  8. Intestinal dysbiosis often contributes to the formation of large amounts of gas, as well as bloating.
  9. Eating chewing gum causes air to enter the esophagus during swallowing, which causes it to remain in the stomach and try to find a way out, leading to gas in the human body.
  10. Smoking causes gas formation for the same reason.
One of the main causes of constipation and diarrhea is use of various medications. To improve bowel function after taking medications, you need to do it every day. drink a simple remedy ...

How does gas formation occur?

With gas formation, people often notice some symptoms, which will differ depending on which organ of the digestive tract the accumulation of gases occurs in.

Symptoms of gas accumulation in the stomachSymptoms of gas accumulation in the intestines
gases form burps, which can lead to heartburn in the futurebloating appears
there is a feeling of fullness in the stomachflatulence
loss of appetiteaccumulation of gas can cause constipation, especially in women during pregnancy
pain appears in the stomach area, at first acute, then becomes naggingsometimes mild paroxysmal pain occurs in the left or right half of the abdomen

To prevent such symptoms from occurring, it is better to prevent gas formation. To do this, you should adhere to simple rules, which we will talk about now.

Video

What foods cause gas?


People with increased gas formation should avoid eating certain foods that contribute to the accumulation of gases. Basically, these are foods that are rich in healthy, but difficult to digest fiber, that contain starch, as well as foods that are unusual for the body, which increase gas formation due to a lack of necessary enzymes for digesting new food.

Products that enhance and increase gas formation are as follows:

  • legumes (asparagus, beans, peas, lentils);
  • cabbage, especially white cabbage;
  • vegetables and fruits that have not undergone heat treatment (corn, turnips, potatoes, garlic, radishes; apples, peaches, pears, prunes, grapes);
  • carbonated drinks;
  • flour products rich in yeast, rye bread and bran; eating black bread also has a bad effect;
  • milk (especially people with low amounts of the lactase enzyme will have to give up milk);
  • eggs;
  • fatty meats and fish;
  • alcoholic drinks;
  • chewing candies and chewing gum.

Such gas-forming products are not always bad for the human body, but if you have a tendency to flatulence, then they increase the likelihood of this. In this case, you will have to avoid foods that cause gas accumulation or reduce their consumption to a minimum.

Wrong food combination

Sometimes products that normally do not form an accumulation of gases can give such an effect due to the incompatibility of some components with others. And then, in combination with each other, the products are gas-forming.

The list of such combinations is as follows:

  • eating flour and kefir at the same time;
  • combination of eggs and fish in one dish;
  • consumption of fresh fruits and vegetables with thermally processed ones;
  • combination of dairy and fermented milk products.

Knowing what foods cause gas if consumed incorrectly, you can build your diet so that similar foods are not encountered at one meal. This will help a person normalize the functioning of his body.

What foods will not cause gas?


Heat-treated vegetables do not cause gas formation.

To adjust your diet, you need to replace the above products with those that do not cause gas or even reduce it.

The list of such products is as follows:

  • rice and buckwheat;
  • chicken meat, turkey meat;
  • cod;
  • fermented milk products (kefir, yogurt, only fresh, non-fat ones are allowed, hard cheese is allowed);
  • boiled beets, carrots and other heat-treated vegetables;
  • wheat bread;
  • steamed egg omelet;
  • vegetable oils;
  • not strong teas and herbal mixtures to improve digestion.

Spices that reduce gas formation will come in handy in any dish. Therefore, try to add cumin, fennel, dill, marjoram, and ginger more often.

These are not only products that reduce gas formation, but also substances that relieve inflammation and abdominal pain.

What to do if you have increased gas formation?


If you are faced with a similar problem, then first review your diet and remove gas-forming foods from it.

  1. Food should be chewed thoroughly and eaten in small pieces.
  2. Snacking on the go is strictly prohibited.
  3. You should not drink large amounts of water with your food, as this will dilute the gastric juice. Take a small sip if necessary.
  4. While observing the drinking regime (up to 2 liters of clean water per day), remember that you should not drink water 20 minutes before meals and 20 minutes after.
  5. Leave the consumption of protein foods in the morning, in the evening only easily digestible foods.
  6. Try to eat at the table in a comfortable position, do not talk much while eating.
  7. If possible, give preference to boiled and steamed dishes, and avoid fried ones.
  8. Do not drink drinks through a straw.
  9. Do not overeat - the optimal portion for one meal is 300 grams.
  10. Don't overeat before bed.

Once you know which foods to avoid, you can start keeping a diary. Eat healthy foods, and sometimes add foods to your diet that cause gas. Record your body's reaction to them. This way you can set your individual diet. After all, maybe cabbage won’t cause bloating for you, while for someone else it will cause flatulence.

Remember that the health of your body depends entirely on you. If you succumb to temptation too often, then do not be surprised by belching, flatulence and abdominal pain.

It is best to stick to a diet and consume gas-forming foods extremely rarely.

Fermentative dyspepsia develops against the background of many provoking factors. If manifestations of this pathology are detected, it is recommended to immediately contact a gastroenterologist. The examination will help identify the cause of the malaise. Based on symptoms and laboratory tests, the doctor will prescribe appropriate therapy to help relieve signs of dyspepsia and eliminate fermentation.

The digestive system includes several organs. If there is a malfunction in any part of the gastrointestinal tract, this leads to disruption of the functioning of the entire digestive system. Therefore, you should not hesitate to treat dyspeptic syndrome. Strictly adhere to the prescribed diet and follow all doctor's recommendations.

Fermentation in the stomach and intestines is considered a clear signal of a pathological phenomenon occurring in the body. The reason for the accumulation of excessive amounts of gases lies, as a rule, in a broken system.

When it enters the stomach, for various reasons, completely, but moves forward in an unchanged state. Once in the intestinal cavity, such food is not able to leave the body, so it remains in the intestine. Under the influence of various microorganisms, it begins to rot, which causes the synthesis of pathogenic and toxic substances. This process occurs against the background of active gas formation. Over time, the amount of toxins and gases that slowly poison the human body increases.

Each person may have a different reaction to the same product. This is due to the fact that people have different acidity of gastric secretions and the ratio of food enzymes. Also, the process of food digestion depends on the intestinal microflora. The functioning of the gastrointestinal tract is influenced by age, concomitant pathologies and psychological factors.

How does pathology develop?

A common cause of fermentation is poor diet and consumption of foods that are difficult to digest. In some cases, the provocateur is the stomach itself, which is unable to function properly. The quality of food digestion is affected by gastric juice.

If flatulence occurs rarely, there is no cause for concern. It is enough to adjust your diet and lead an active lifestyle. If bloating and fermentation are observed regularly, it is recommended to visit a gastroenterologist. Since food often stagnates and rots in the intestine, special substances are released, namely cresol, skatole, methanol alcohol and phenol. These components are poisonous. If gases accumulate in large quantities, they put pressure on the intestinal walls, which provokes flatulence and colic. As a result, the mucous membrane of the organ becomes inflamed.

Flatulence occurs against a background of nausea, pain in the intestines, and constipation. If treatment is not started in time, there will be an accumulation of toxins that can lead to various pathologies.

Products that provoke fermentation

The provoking factor of fermentative dyspepsia is excessive consumption of carbohydrates and proteins. Mainly these are pastries, bread and sweets. Fermentation occurs against the background of abundant sugar consumption. It is recommended to minimize the amount of compotes, jams and other sweet products in the diet.

Potatoes, legumes and cabbage promote enhanced intestinal motility and stimulate fermentation in the intestines and stomach. You should exclude alcoholic and carbonated drinks, strong tea, coffee, sour berries and fruits, and preserves with vinegar from your diet. This product promotes active gas formation.

Features of therapeutic nutrition and therapy

The diet involves avoiding many foods that promote fermentation. In some cases, not a complete refusal is allowed, but a reduction in the amount of such products in the diet. It is recommended to consume such food before 14.00, between breakfast and lunch.

As for first courses, gastroenterologists recommend eating broths cooked with lean fish and meat. Dairy products are great for your diet. To stabilize and improve the activity of the gastrointestinal tract, you should adhere to the following rules:

  • It is forbidden to eat dry food. When eating sandwiches, it is advisable to wash them down with sweetened tea or water.
  • Chew every bite of food thoroughly.
  • Don't overeat before bed. It is recommended to have dinner 2-3 hours before going to bed.

Whenever pain syndrome Due to bloating, it is enough to stroke the stomach clockwise in the navel area. This will help relieve the gases, which will ease the pain.

In order for the process of treating fermentation in the intestines to proceed faster, it is necessary to take appropriate medications. Medicines should be taken only as prescribed by a doctor. To develop an adequate treatment strategy, the cause of the ailment is established, and the necessary diagnostic measures are carried out.

The gastroenterologist prescribes medications that help normalize the digestive process. Basically, these are anti-fermentation medications containing beneficial bacteria: Lactobacterin, Baktisubtil and Bifidumbacterin. In some cases, laxative medications are required. When taking such medications, you should strictly adhere to the dosage, as they can enhance the clinical picture of dysbiosis.

To solve the problem, you can seek help from traditional medicine. There are many recipes designed to treat the digestive system. Basically, herbal decoctions are used that eliminate rotting and fermentation. They are prepared on the basis of dill, chamomile, lemon balm, pomegranate peel, walnut leaves, and mint.

Treatment with medications and folk remedies will not have the desired effect if you do not adjust your diet. Therapy of the gastrointestinal tract must be comprehensive, so first of all you need to see a doctor and undergo diagnostics. A strict dietary restriction prescribed by a gastroenterologist is required. If pathology is observed in a newborn child, urgent consultation with a pediatrician is necessary.

Regularly observed fermentation in the intestines and stomach is a kind of signal from the body about the presence of a gastrointestinal tract malfunction. If you discover a suspicious clinical picture, seek medical help to avoid complications.

The rare disease is not accompanied by unclear symptoms. Those associated with diseases of the gastrointestinal tract often involve fermentation. We invite you to discuss treatment of fermentation in the stomach and diseases accompanied by this unpleasant symptom.

Causes of fermentation in the stomach

Fermentation in the stomach brings quite significant discomfort to a person’s life. And the symptoms can be quite vague.

  • Feeling fermentation in the stomach, a person may also feel a nagging pain in the epigastric region,
  • he feels heaviness
  • , pressure,
  • bloating after eating
  • nausea,
  • vomit,
  • heartburn,
  • loss of appetite
  • and bad breath.

But all this is quite conditional, since for some, fermentation in the stomach does not manifest itself in any way, except for a general malaise.

The main causes of fermentation in the stomach are poor nutrition, as a result of which food is poorly processed and absorbed. Moreover, the movement of food through the gastrointestinal tract is accelerated, resulting in increased bowel movements. Food that is not digested in the intestines undergoes fermentation and putrefaction. Both of these processes produce large amounts of toxins, which are absorbed into the blood and cause dangerous poisoning of the body, resulting in general malaise and then obesity.

Also, fermentation in the stomach causes the nervous system to suffer. Not only is it violated general state, but performance also decreases, muscle mass decreases, due to which there is a desire to consume more food. But this only intensifies the fermentation in the stomach. And it turns out to be some kind of vicious circle, as a result of which the gastrointestinal tract and the body as a whole are exposed to serious danger.

Treatment of fermentation in the stomach

As therapy, doctors can offer effective drug treatment for fermentation in the stomach and a number of special medications. But if this process is not running for you, you can try making fasting days for yourself. At least twice a week for several months. For example, to eliminate the causes of fermentation in the stomach, you can choose a day during which you drink only water, or eat cabbage, buckwheat porridge or some other foods that are beneficial to the gastrointestinal tract. Keep in mind that they should have a brushing effect, cleansing the intestines and removing all toxins from it.

Treatment of fermentation in the stomach by correcting the diet

To forget about fermentation in the stomach, you should carefully review your diet:

Eat lighter, healthier foods.

Include vitamins and as many cereals as possible in your meals.

Don't forget about the need to eat fresh vegetables and fruits.

Fermented milk products will also help make the treatment of fermentation in the stomach more effective, but in the initial stages it is better to limit yourself from their consumption.

What medications can be used to treat fermentation in the stomach?

To optimize the composition of the microflora in the stomach, special preparations that contain beneficial bacteria can be prescribed. For example: Lactobacterin, Bifidumbacterin, Mutaflor, Bactisuptil, and Omniflor. The dosage of the medicine and the scheme of its use are selected by the attending physician individually.

Absorbent drugs often help stop fermentation in the stomach. The most famous of them is activated carbon. To eliminate unpleasant pain, antispasmodics are prescribed, for example, No-shpu.

Disorders in the digestive tract are the result of a huge number of factors associated with pathological formations, poor nutrition and a number of additional conditions. Problems with the digestive process are always unpleasant - this applies to both individual situations and the general well-being of a person. The most common ailment, or rather, digestive disorder, at all ages is fermentation in the intestines.

Fermentation in the intestines: the essence of the problem

Fermentation in the intestines causes discomfort, painful sensations

Fermentation in the intestines as a problem is considered in the context of bloating and increased gas formation. Due to the processing of food under the influence of acids, products are broken down, and their individual components are absorbed through the intestinal walls for further transportation. Fermentation is an anaerobic process, meaning the reaction occurs in an environment without oxygen. One of the main elements that are formed during the reaction is carbon dioxide. It is he who causes such an unpleasant phenomenon as.

Fermentation can occur in both the large and small intestines, but in most cases the problem is localized in the small intestine. This is due to the fact that the level of absorption and release of digestive acids in the large intestine is tens of times less than in the small intestine. Products that actually do not have much energy value enter the large intestine; therefore, their breakdown does not cause the release of large amounts of acids and gases.

Features for a child

A feature of the process in children and adults is the sensitivity of the intestines to cleavage products. The larger and more complex the compounds, the more difficult it is for the digestive system to cope with the absorption of enzymes. In children, as we know, the intestines do not have the same quality potential as in adults, so most often the problem occurs in infants who are faced with new foods in their diet.

What causes the problem? Main reasons

The fermentation process begins in the body if the intestines cannot cope with the digestion of food, then the reaction becomes pathological. The main cause of the problem is poor nutrition, which leads to malfunctions of the digestive system. A negative process can be caused by certain products, which provoke the release of gases.

The syndrome is also diagnosed if the body does not have enough alkali that can completely break down food. Then large pieces of food in the intestines begin to decompose under the influence of released acids. Most often, this condition occurs if a person’s diet contains a large amount of acidic food.

The causes of the disease are many and varied. Fermentation can occur due to ineffective contraction of the intestinal walls, hence the slow passage of food. The disorder can also be caused by various pathological formations:

  • adhesions;
  • tumors of different types;
  • anatomical narrowing of the intestines, etc.

Doctor's opinion: disruption of microflora in the gastrointestinal tract is one of the main causes of fermentation in the intestines. This can occur due to complications of certain diseases, mechanical damage to the mucous membrane of the large and small intestines, etc.

It should be noted that pathogenic microorganisms that are present in the digestive system can provoke both disruption of the movement and decomposition of food, and the fermentation process itself.

Food products that can cause violations of this level:

  • sausages;
  • White cabbage;
  • plant products (fruits, berries, herbs, vegetables - especially those containing a large amount of acids);
  • sugar;
  • various spices;
  • food vinegar;
  • starch;
  • legumes

Photo gallery: foods that cause fermentation

Legumes cause gas formation, so they should be excluded from the diet. Most fruits can cause fermentation Cabbage contains a large amount of fiber, which is the cause of increased gas formation. Sausages are a fairly fatty product, so their consumption is not recommended

It is necessary to understand that healthy, measured consumption of the listed products cannot lead to any violations. However, if you eat something in large quantities, especially before going to bed, the negative consequences will immediately make themselves felt.

Manifestations of fermentation in the intestines

The disease can manifest itself with various symptoms based on the process of rotting undigested food. Among these constant manifestations, the following should be highlighted:

  • bloating due to increased gas content in the intestines;
  • rumbling in the peritoneal area;
  • stool disorder, which can manifest itself both in the form of constipation and in the form of mushy stool;
  • uncomfortable or even painful sensations, manifested in the form of colic.

Against the background of pathological changes in anatomical structures or in the presence of neoplasms, the symptomatic complex can acquire a number of more complex manifestations and signs indicating significant disturbances in the functioning of the body.

Therapeutic measures

Treatment most often comes down to normalizing the nutritional process, the correction of which in most cases is enough to normalize digestion and prevent fermentation reactions. However, in case of serious disorders of the gastrointestinal tract, it is necessary to resort to drug treatment, which will be aimed at treating the main disease, after which it will disappear.

Nutrition correction

In order to correctly develop a nutritional system for a specific disorder of the gastrointestinal tract, you should familiarize yourself with its main criteria, products that are allowed and prohibited for consumption. The main recommendations for creating a nutrition system include:

  • you should reduce the calorie content of food to 2 thousand kilocalories per day. This can be achieved by reducing the amount of fatty foods you eat;
  • significantly reduce the percentage of salt in dishes;
  • refuse solid foods, as well as too hot or cold, which can mechanically damage the intestinal mucosa;
  • give up difficult-to-digest and choleretic foods;
  • the main methods of processing food should be stewing, steaming, baking and boiling;
  • You should consume food in small portions, spreading it over 5-6 meals, etc.

Foods to be consumed:

  • stale bread, better made from wheat flour;
  • lean dietary meat;
  • lean fish;
  • milk and cottage cheese;
  • cereals (buckwheat, rice, wheat);
  • soups;
  • eggs - no more than one per day;
  • tea, etc.

Eggs contain phosphorus, potassium, sodium, magnesium and many other useful micro and macroelements, but you should not abuse the amount of eggs you eat
Soups help activate the stomach, are very healthy, it is recommended to dilute the broth Low-fat cottage cheese is an indispensable component of proper nutrition. Milk contains great amount useful substances that will help normalize intestinal function

Products whose consumption is prohibited:

  • fat meat;
  • fresh bread and pastries;
  • sour and salty foods;
  • almost all fruits and vegetables;
  • cocoa and coffee;
  • spices, etc.

Medicinal effects on the disease

Drug treatment is required in situations complicated by additional syndromes, the “arsenal” of which includes fermentation in the intestines. For this reason, special drugs are used to suppress the disease. Symptomatic treatment is also possible, which will consist of drugs that alleviate the patient’s general condition, removing gases and decay products due to fermentation from the intestines. The following medications are usually used for these purposes:

  • Activated carbon;
  • pepsin;
  • dimethicone;
  • polysorb;
  • sorbex;
  • laxatives, etc.

Important! To carry out treatment, you must consult a doctor who will prescribe the necessary medications. Taking medications without the doctor's knowledge is an ineffective and risky way to get rid of the disease, which often leads to complications, allergic reactions and drug poisoning.

Traditional treatment

Traditional methods of treatment can also be effective in relieving the condition of a patient suffering from severe gas formation. Decoctions and infusions from the following products are perfect for this:

  • dill;
  • Melissa;
  • chamomile;
  • walnut;
  • peppermint;
  • pomegranate peel, etc.

Photo gallery: folk remedies to relieve fermentation symptoms

Peppermint contains essential oil, flavonoids, tannins and bitterness, which are so necessary in the treatment of fermentation Chamomile has a calming effect and is used for various medicinal purposes.
Due to the presence of magnesium and iron salts in dill in a highly digestible form, hematopoietic processes are significantly enhanced.
Melissa is widely used for medicinal purposes

The method of preparing infusions from the described products is classic: you need to take a tablespoon of the main component per glass of boiling water. After infusion and complete cooling under the lid, the composition is filtered and taken. For example, mint infusion should be consumed one tablespoon every three hours.

Therapeutic exercises to prevent gas formation

In order to keep the digestive system in good shape, you should perform a number of gymnastic exercises that will prevent the occurrence or progression of diseases of the gastrointestinal system. Among these exercises it is necessary to highlight:

  • bicycle for 30 seconds (performed while lying on your back with your legs slightly raised and bent at the knees);
  • lying on your back, pull your bent legs towards your stomach (perform 10 times);
  • from a lying position on your back, you should try to throw your legs behind your head and touch the floor (15 approaches);
  • in a standing position, you should take a deep breath and draw in your stomach as much as possible, while exhaling, relax your abs (no more than 30 repetitions), etc.

How to avoid problems with intestinal disorders?

As part of preventive measures, diet and diet should be normalized. It is necessary to eat foods containing various acids in small quantities. This also applies to fried and fatty foods, the remains of which can remain on the intestinal walls, leading to fecal impactions. It is important to seek help from a specialist in a timely manner if discomfort in the intestinal area or peritoneum. Untreated diseases, the treatment of which has been delayed, can lead not only to disruption of the digestive process, but also to more complex problems.

Video: bloating and flatulence

The fermentation process in the intestines causes a number of extremely unpleasant symptoms and is a prerequisite for flatulence. The problem often plagues children when new foods are introduced into their diet. You can get rid of this phenomenon by normalizing your lifestyle and taking medications.

Some foods, combined with their irrational consumption, can cause increased gas formation. This is due to a lack of gastrointestinal enzymes, which are produced when food enters the stomach. Avoiding such products is advisable before diagnostic gastroenterological procedures: FGDS, abdominal ultrasound, MRI, colonoscopy, irrigoscopy.

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Increased fermentation: dangerous or not?

Fermentation in the intestines is a physiological process that occurs due to the production of enzymes. Normally, it happens all the time, but it does not always bring discomfort. Increased fermentation indicates problems in the human body. Most often it occurs after overeating or eating poor quality food, but sometimes it is a manifestation of some kind of gastrointestinal disease.

If a person has been bothered by the above manifestations and other gastrointestinal symptoms for a long time, this is an indication to contact a gastroenterologist and, if necessary, a proctologist and other highly specialized doctors.

How to cope with increased fermentation?

Treatment of excess gas can be carried out using both non-drug and medicinal methods.

Diet

The main condition for the treatment of this pathology will be a change in the nature of nutrition. Meals should be small and reach 5-6 times a day; a few hours before bedtime, avoid eating foods that are difficult to digest (meat dishes, flour, sweets).

It is allowed to consume low-fat dairy products that are 1-2 days old, since fresh dairy products have a good effect on. Be sure to exclude fatty, hot, spicy dishes, baked goods, legumes, and alcohol from the daily diet. It is recommended to exclude salt from the diet and steam food. Small amounts of food and chewing it thoroughly can significantly reduce the likelihood of developing flatulence in the future.

Nutritionists advise including in your diet:

Physiotherapy

Improving digestive function is based on strengthening the muscles of the anterior abdominal wall and improving the passage of gases.

  • The “Bicycle” exercise helps normalize intestinal function. The technique is simple to perform: a person needs to lie on his back and “pedal” with his feet for a minute. Of course, this exercise cannot be done immediately after eating.
  • The second effective exercise is bending the legs towards the stomach. The person, as in the “Bicycle” exercise, lies on his back.

Drug therapy

Treatment is aimed at treating the underlying disease.

  • Espumisan is prescribed symptomatically. It quickly relieves bloating and reduces pain.
  • For prolonged constipation (which can also cause increased fermentation), it is necessary to prescribe Duphalac.
  • To improve motility of the gastrointestinal tract, Ganaton is used.
  • For the adsorption of toxic substances and relief of intoxication syndrome - activated carbon, "Sorbex".
  • . Restore the balance of intestinal microflora, suppress excess fermentation, improve general condition - “Bifidumbacterin”, “Hilak-forte”, “Acipol”.

Treatment for each person is purely individual. For proper therapy, it is necessary to identify the root cause of the disease, otherwise the treatment will not bring the desired result. Therefore, before using medications, you need to consult a doctor to undergo a full diagnostic examination and exclude organic pathology.

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