It causes irritation, blistering, bleeding and discomfort. This results in abdominal pain or discomfort. Sadism involves deriving pleasure through others undergoing discomfort or pain. Patients may complain of bloating as abdominal distension, discomfort and pain from "trapped wind". The effects of stings range from mild discomfort to extreme pain and death. Adverse effects include headache and gastrointestinal discomfort. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Some believe it is due to gastrointestinal discomfort like intestinal cramping. Other symptoms may include coughing up mucus, wheezing, shortness of breath, fever, and chest discomfort. Symptoms include chest discomfort, headache, weakness and, in severe cases, collapse. Symptoms can range from mild discomfort to death. Dissonance causes feelings of unhappiness, discomfort, or distress. Operating personnel reported extreme discomfort and fatigue. Medications by mouth are often effective for less severe discomfort. Flatulence and bloating may also add to the intestinal discomfort.