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FlatulenceFlatulence (Gas) Overview Everyone has it. Most people think they have too much of it. And passing gas in the wrong place at the wrong time can cause great embarrassment. Flatulence is the state of having excessive stomach or intestinal gas This can result in uncomfortable feelings of bloating, as well as increased belching or passing of gas from the rectum. Most people produce about 1-3 pints a day and pass gas about 14 times a day. Flatulence itself, although not life threatening, can definitely cause social embarrassment. This embarrassment is often the reason why you might seek medical help for excessive gas. History has numerous anecdotal accounts of flatulence, including Hippocrates himself professing, “Passing gas is necessary to well-being.” The Roman Emperor Claudius equally decreed that “all Roman citizens shall be allowed to pass gas whenever necessary.” Unfortunately for flatulent Romans, however, Emperor Constantine later reversed this decision in a 315 BC edict. In the mid-1800s flatulence took centre stage with the French entertainer Joseph Pugol (“Le Petomane”). Pugol was able to pass gas at will and at varying pitch, thereby playing tunes for sold-out shows at the Moulin Rouge. Such was his success that lesser competitors began to appear, including the Spaniard “El Rey” and the female Angele Thiebeau (later revealed as a fake using hidden air bellows). More recently, flatulence was immortalized by Mel Brooks in the movie Blazing Saddles with his bean-eating cowboys. Nonetheless, if you are concerned about excess gas, it is not a laughing matter. It is a medical concern that you will want to talk about with your health care provider. The primary components of gas (known as flatus, pronounced FLAY-tuss) are 5 odourless gases: nitrogen, hydrogen, carbon dioxide, methane, and oxygen. The characteristic odour is attributed to trace gases such as skatole, indole, and sulphur-containing compounds. The flammable character of flatus is caused by hydrogen and methane. The proportions of these gases depend largely on the bacteria that live in the human colon that digest, or ferment, food that has not been absorbed by the gastrointestinal (GI) tract before reaching the colon. An estimated 30-150 grams of this undigested food reach the colon in the form of carbohydrate every day. But this amount can vary with diet and how well your GI tract is functioning. The unpleasant odour often associated with flatus is generally attributed to trace sulphur-containing compounds, produced only by particular bacteria not found in everyone. Flatulence (Gas) Causes Excess gas in the digestive tract (which is your oesophagus, stomach, small intestine, and colon/large intestine) can come from 2 sources: increased intake of gas, for example, from air you swallow; or increased production of gas as certain undigested foods are broken down by harmless bacteria normally found in your colon. Swallowed air (aerophagia): This can occur with improper swallowing while eating or even unconscious swallowing of air out of habit. Activities that cause you to swallow air include rapid drinking, chewing gum, use of tobacco products, sucking on hard candy, drinking carbonated beverages, loose dentures, and hyperventilation in anxious people. Most people burp or belch to expel this excess swallowed air. The remaining gas moves into your small intestine. Air can be absorbed, but some moves along to the large intestine for release through the rectum. Analysis of the gas can help determine if it originated from aerophobia (mostly nitrogen, also oxygen and carbon dioxide) or GI production (mainly carbon monoxide, hydrogen, and methane). Breakdown of undigested foods: Your body does not digest and absorb some carbohydrates (for example, the sugar, starches, and fibre found in many foods) in the small intestine because of a shortage or absence of certain enzymes there. So this undigested food then passes from the small intestine into the large intestine, where normal, harmless bacteria break down the food, producing hydrogen, carbon dioxide, and, in about a third of all people, methane. Eventually these gases exit through the rectum. Foods that produce gas in one person may not cause gas in another. Some common bacteria in the large intestine can destroy the hydrogen that other bacteria produce. The balance of the 2 types of bacteria may explain why some people have more gas than others. Most foods that contain carbohydrates can cause gas . By contrast, fats and proteins cause little gas. These common foods and their natural components may create gas: Beans: Beans contain large amounts of the complex sugar known as raffinose. Smaller amounts are found in cabbage, Brussels sprouts, broccoli, asparagus, and in other vegetables and whole grains. Starches: Most starches (potatoes, corn, noodles, and wheat) produce gas as they are broken down in the large intestine. Rice is the only starch that does not cause gas. Onions: The sugar known as fructose occurs naturally in onions, artichokes, pears, and wheat. It is also used as a sweetener in some soft drinks and fruit drinks. Dark beer and red wine Sorbitol: This sugar is found naturally in fruits including apples, pears, peaches, and prunes. It's also used as an artificial sweetener in sugar-free gum, candy, and other diet products. Fibre: Many foods contain soluble and insoluble fibre. Soluble fibre dissolves easily in water and takes on a soft, gel-like texture in the intestines. Found in oat bran, beans, peas, and most fruits, soluble fibre is not broken down until it reaches the large intestine, where digestion causes gas. Insoluble fibre, on the other hand, passes essentially unchanged through the intestines and produces little gas. Wheat bran and some vegetables contain this kind of fibre. Lactase deficiency: Another major source of flatulence is lactase deficiency, which results in a decreased ability to digest lactose, a natural sugar found in milk and other dairy products such as cheese and ice cream and in certain processed food such as bread, cereal, and salad dressing. This flatulence is often associated with diarrhoea and cramping but can appear as only gas. Many people, particularly those of African, Native American, or Asian background, normally have low levels of the enzyme lactase needed to digest lactose after childhood. Also, as people age, their enzyme levels decrease. As a result, over time people may experience increasing amounts of gas after eating food containing lactose. Other problems: Certain conditions can result in other foods being poorly absorbed in the GI tract, allowing for increased bacterial activity. Malabsorption syndromes can be the result of decreased production of enzymes by the pancreas or problems with the gallbladder or lining of the intestines. If transit through the colon is slowed down for any reason, bacteria have increased opportunity to ferment remaining material. Therefore, if you are constipated or have decreased bowel function for any reason, flatulence can follow. Alterations in bowel habits can be a result of the following: Poor dietary fibre Parasites Inflammatory bowel disease Intestinal obstruction (including cancer) Diverticulitis or diverticulitis Poor thyroid function Narcotic and other drug use Flatulence (Gas) Symptoms Symptoms of flatulence are increased passage of gas, abdominal bloating or pain, and belching. Embarrassment can be caused by the increased passage of flatus or the often-offensive odor it causes. Gas: Everyone passes gas normally each day. A certain amount of gas is present in your GI tract at any one time, mainly in your stomach and colon. The average person passes gas about 10 times each day and up to 20-25 times normally. More than that may be excessive. Belching: An occasional belch during or after meals is normal and releases gas when the stomach is full of food. But if you belch frequently, you may be swallowing too much air and releasing it before the air enters the stomach. Some people swallow air to make themselves belch, thinking it will relieve their discomfort. This practice may turn into an annoying habit. Belching may signal a more serious upper GI disorder such as peptic ulcer disease, gastroesophageal reflux disease (GERD), or gastroparesis. Abdominal bloating: Many people believe that too much gas causes abdominal bloating. However, people who complain of bloating from gas often have normal amounts of gas. They actually may be unusually aware of gas in the digestive tract. A diet of fatty foods may delay stomach emptying and cause bloating and discomfort, but not necessarily too much gas . Certain conditions may cause bloating, such as irritable bowel syndrome, Crohn’s disease, or colon cancer. People with scar tissue (adhesions) from abdominal operations or internal hernias may have a sensation of bloating because of increased sensitivity to gas. Abdominal pain and discomfort: Some people have pain when gas is present in the intestine. When pain is on the left side of the colon, it can be confused with heart disease. When the pain is on the right side of the colon, it may mimic gallstones or appendicitis. When to Seek Medical Care Visiting your health care provider is the best place to start. Seek medical attention whenever symptoms other than simply excess flatulence occur, such as these: Crampy discomfort Change in bowel habits Blood in the stool Vomiting Abdominal pain and swelling Flatulence (Gas) Treatment Experience has shown that the most common ways to reduce the discomfort of gas are changing diet, taking medicines, and reducing the amount of air swallowed. Flatulence is most often related to diet, and sometimes to those habits that cause you to swallow air. You can begin by trying to remove the problem foods from your diet. For many people, this is a trial-and-error procedure. This may take some careful observation to notice what foods cause increased gas. Keep a food diary and note excess passage of gas. Any of the gas-producing foods can be removed from your diet one group at a time until you see relief. Sorbitol and fructose are common offenders, so try these first. If this method does not work, a more restrictive approach is to start with a very limited number of safe foods, and add one new food every 48 hours in order to determine what food or food group causes difficulty. If the offending food is found, then you can avoid eating that food or be prepared for its consequences. If you suspect lactose intolerance is the problem, remove all dairy foods from your diet for 10-14 days to assess the effect on flatulence (using a diary). The enzyme lactase, which aids with lactose digestion, is available in liquid and tablet form without a prescription (Lactaid, Lactase, and Dairy Ease are familiar brand names). Adding a few drops of liquid lactase to milk before drinking it or chewing lactase tablets just before eating helps digest foods that contain lactose. Also, lactose-reduced milk and other products are available at many grocery stores (Lactaid and Dairy Ease). If odour is a concern, there is also some reported success with charcoal filter undergarments. If belching is a problem, you should avoid the behaviours that cause you to swallow air, such as chewing gum or eating hard candy. Eat slowly. Make sure your dentures fit properly if you wear them. In general, avoid overeating because this contributes to flatulence as well as obesity. Limit high-fat foods to reduce bloating and discomfort. Your stomach will empty faster, allowing gases to move into the small intestine. Essential oils described as carminative will help to expel gas from the digestive system and ease the pain which accompanies it. Massage the essential oils diluted in carrier oil into the abdomen working round the tummy in a clockwise direction. Suitable oils would be Bergamot, Black Pepper, Chamomile German, Chamomile Roman, Fennel, Lavender and Marjoram. Supplement this treatment with eating natural yoghurt and drinking plenty of water. |
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