Fighting flatulence

Dr Sandip Pal, Consultant Gastroenterologist, RTIICS, Kolkata, expounds about ways to prevent excessive gas formation in digestive system

Overview

Bloating and gas are common problems of the digestive system. It affects both men and women of all ages. The symptoms of this problem can be disturbing and often even embarrassing, however, it is good to note that this condition is unlikely to lead to any serious problems. At times, it may be associated with certain other digestive conditions like irritable bowel syndrome.

Gas is a normal byproduct of the foods we eat, which is released from the body. It can be released from the digestive system through the anus and sometimes smell bad. It can also be released from the mouth as burp. Bloating is the feeling of fullness and cramping in the stomach that occurs when gas builds up in the digestive system.

Normal amount of gas found in the intestine

At any given point of time, every individual has some gas present in the intestine. Experiments have shown that the average volume of gas is around 200 mL. This volume tends to be constant both in the fasting state and after eating.

Different forms of gas found in the intestine

The five most common forms of gas found in the intestine are:

• < Nitrogen
• < Oxygen
• < Hydrogen
• < Carbondioxide
• < Methane

Where do these gases come from?

Gas can enter into the digestive system in several ways. For instance, drinking a carbonated beverage produces the familiar belch, which is nothing but gas escaping from the stomach. In some people, the cause for gas in the digestive system is accidental swallowing of air.

Consumption of fatty food can cause the gas to be retained in the digestive system.

Bacteria that naturally exist in our system are responsible for the production of gas in the large intestine, by causing fermentation of the material in the large intestine.

Additional sources can include diffusion of gases from the bloodstream into the intestines and chemical reactions.

Causes of gas and bloating

• < Swallowing air, often while eating or drinking. Swallowed air usually comes back out as a burp.
• < Eating beans, broccoli, fruit, wheat, potatoes, corn and noodles. Bacteria in the intestine digests part of these food.
• < Trouble digesting certain foods, such as wheat or dairy products.
• < Malabsorption of carbohydrates can lead to increased intraluminal gas and result in complaints of gas, abdominal pain and flatulence.

Why it sometimes smell bad?

99 per cent of the gas that is expelled from the intestines consists of nitrogen, oxygen, carbon dioxide, hydrogen and methane. All these gases are odourless.

Minor gases containing sulphur, such as methanethiol, dimethyl sulfide, hydrogen sulfide as well as short-chain fatty acids, skatoles, indoles, volatile amines and ammonia leads to flatus. Oxygen is present in low concentrations while variable amount of carbon dioxide, hydrogen and methane are found.

In a day how often do individuals pass gas?

Scientists have observed that on an average, healthy individuals tend to pass gas around 10 to 20 times in a single day.

In a study, healthy human volunteers passed flatus 14 to 18 times per day, for a mean total volume ranging from 214 mL (on a low-fibre diet) to 705 mL (on a high-fibre diet) during a 24-hour period.

Factors which may account for bothersome flatus

• < A change in intestinal motility or composition of bacteria naturally present in the digestive system.
• < Dietary factors, such as an increased intake of lactose, fructose, sorbitol and undigestible starches in fruits, vegetables and legumes, and in carbonated beverages.
• < Products such as pork, upon digestion, may release trace concentrations of malodorous gases.

How to prevent formation of gas and bloating?

Avoid eating or drinking foods that can increase your symptoms:

• < Milk and dairy products: In some people it may lead to fermentation in the intestines, causing large amounts of gas to be released.
• < Beans: These can be digested by the bacteria in the digestive system and become a source of troublesome gas formation.
• < Certain vegetables, such as cabbage, potatoes and corn
• < Wwhole grains, such as wheat
• < Most types of fruits
• < Artificial sweeteners. These can contain indigestible carbohydrates, which are broken down by microorganisms, thereby releasing gas into the digestive tract
• < Soda and other fizzy drinks
• < Chewing gum leads to accidental swallowing of air.
• < Poorly fitting dentures can cause you to swallow excess air when you eat and drink.
• < Eat fewer fatty foods. Fat slows digestion, giving food more time to ferment.
• < Temporarily cut back on high-fibre foods. Fibre aids digestion, but many high-fibre foods are also great gas producers. After a break, slowly add fibre back into your diet.
• < Eat slowly. Try to make meals relaxed occasions. Eating when you’re stressed or on the run can interfere with the digestion.
• < Get moving. A short walk after eating will help.

Treatment

Treatment would depend on the cause for the flatulence symptoms:

If certain foods or drinks are causing the symptoms (bloating, burping, flatulus), avoid consuming these can help to reduce the symptoms.

Eating slowly can help reducing accidental swallowing of air and, hence, prevent burping.

Avoid chewing gum, smoking, drinking carbonated beverages, and gulping food and liquids. All of these increases the amount of air swallowed and thereby the amount of gas increases in the digestive system.

If motility or bacterial overgrowth is the cause of the symptoms, then you may be treated with medicines that can improve digestive motility and get rid of the bacterial overgrowth as required.

When to seek help?

• < It is important to visit a doctor:
• < Diarrhoea that lasts longer than five days
• < Unexplained weight loss
• < Stomach pain
• < Blood in the stool
• < Loss of appetite
• < Unexplained fever
• < Throwing up for longer than two days (48 hours)