Too Much Gas?

Too Much Gas?

"Doctor, Why Do I Have So Much Gas?"

The complaint of "too much gas" is one of the leading problems brought to doctors who specialize in bowel diseases. Many individuals see the doctor believing that their digestive tract is malfunctioning because of excessive gas. They may fear that some serious ailment is present. Fortunately, this is seldom the case. Gas in itself is not dangerous; its main consequence is usually embarrassment and social isolation for the person who can't "turn it off." Usually at the most inopportune moment, our body pulls a fast one, emitting offensive sounds or odors.

Besides being a social drawback, excess gas can be downright painful for some people. The abdomen can become painfully distended, especially right after eating. Bloating of the abdomen can be so severe that clothing doesn't fit. Such problems also lead some suffers to believe that there is something seriously wrong with their digestive tracts. Again, this is seldom the case.

A Normal Nuisance

Though the subject of gas is not one that most of us talk about, the truth is that all of us have gas in our intestinal tract and must get rid of it in some way. Most gas is odorless. Though proportions vary from person to person, gas is largely composed of hydrogen, nitrogen, and carbon dioxide, with a touch of oxygen. In addition, a third of the adult population produces copious quantities of methane, while the rest emits little or none. Much less than one percent of gas smells. Intestinal bacteria produce several sulfur-containing compounds that are primarily responsible for this odor. Unfortunately, the human nose can detect hydrogen sulfide in concentrations as low as one-half part per billion.

The passage of gas through the rectum and belching are normal and necessary functions that allow the body to rid itself of gas. It happens to all of us. Belching, or burping, is the passage of gas from the stomach. We all know the common term for passing gas through the rectum, but the correct medical term is flatulence, or passing flatus.

This problem is certainly not new. Strong winds from down under fuel some of the oldest and funniest jokes in the world - until they affect us, that is. In ancient times, Hippocrates investigated flatulence extensively, and physicians who specialized in it became known as "pneumatists." Anyone familiar with Chaucer will appreciate the fact that "breaking wind" has been the subject of humor and misery at least since the early days of the English language. And in early American history, such great men as Ben Franklin taxed their minds seeking a cure for "escaped wind."

How Much Gas Is Normal?

It varies from person to person. Studies done on young adults have shown that the average person generates 1 to 3 pints a day. It is of passing interest that the normal individual emits gas from below about 12 to 25 times per day. Anything over that is air pollution. However, individual ability to tolerate air in the stomach and intestines varies and some people simply produce more gas than others.

Where Does It All Come From?

The newborn infant is gasless until its first breath, after which air begins to appear in the digestive tract. Thus, with the infant's first breath is dated not only the loss of innocence, but also the onset of gassiness. Gas in the gut, like sin, is with us until death.

The two main sources of gas are swallowed air and gases that are produced within the intestine. For practical purposes, gas that is brought upward is swallowed air, whereas that rumbling in the lower region is produced locally.

Belching - Returning Swallowed Air

A belch is the sudden escape of gas from the stomach. In the England of King Henry VIII, a hearty belch after a meal was quite acceptable. Even today it is a gesture of appreciation for a meal in the Middle East. Victorian manners have stripped the belch of any respectability in our society. While belching might be an act of satisfaction in the fishing camp, it is a slip of sheer horror in the dining room. Despite this social stigma, release of gas from the stomach may relieve vague abdominal discomfort and, on occasion, is a necessity. A satisfying belch after meals is normal and eases distension caused from the meal and accumulated air.

Repeated belching, however, likely indicates air swallowing. Swallowing air is called aerophagia. With practice one may suck air into the esophagus which can then be forced upward. This art is often mastered by adolescents who delight in demonstrating their burping prowess to their peers.

We all swallow some air when we eat or simply swallow saliva. Drinking a glass of water can result in two times as much air in the stomach as water. It seems that some individuals repetitively swallow air and then return it with a belch.

Rapid, gulpy eaters trap air with their food. Eating while stressed can do the same thing. Gum chewing, smoking, and poorly fitting dentures can cause excessive production of saliva which must be swallowed. Repeated swallowing also occurs with a postnasal drip or dry mouth. A few people gulp air as a nervous tic - a trait often portrayed by cartoonists whose heroes "gulp" when faced with a crisis. Aerophagia may just be an intractable bad habit or a manifestation of stress. It is not usually a symptom of serious gastric disorder.

Flatulence - Homemade Gas

Gas that escapes from below has no status in any respectable society. In fact, in Ancient Rome, passing gas in public was illegal. But, whether we like it or not, gas is part of the human condition. Gas in the lower bowel never killed anyone-but that's about the best that can be said about it. Millions of people spend too much time worrying about foods they shouldn't eat and noises they shouldn't make.

The foods we eat can be a factor in the production of gas. The carbohydrates (sugars and starches) in some foods are not completely digested in the small intestine. When these undigested sugars reach the colon, they are fermented by the bacteria that normally live in the colon. This fermentation often results in gas - the same way fermenting grapes make champagne. (There is little gas production in the small intestine because the bacterial concentration is low.)

The most common source of undigested carbohydrate is lactose, or milk sugar, which is found in dairy products such a milk, skim milk, and cottage cheese. About 20% of whites and most non-white people lack the enzyme lactase, which is necessary to break apart and absorb lactose. Intestinal bacteria step in to aid the process and this fermentation causes gas.

Lactase deficiency is especially seen in blacks, Orientals, and those of Mediterranean origin. The results can be dramatic. Just two grams of lactose can release 1400 cc of hydrogen. One lactase-deficient patient, after drinking 2 pints of milk, produced flatus 141 times - a record that has been submitted to the Guiness Book of World Records.

The next most common source of gas is beans. Leave to doctors to study what cowboys have known for years. If a subject is switched from a normal diet to one in which half of the calories are provided by pork and beans, the result is a spectacular tenfold increase in gas production - truly an explosive situation. Though beans have acquired a nasty reputation, it's not the beans themselves that cause flatulence, but the inability to digest them properly. Beans contain a sugar that cannot be digested by the human intestine. Besides beans and dairy products, many other fruits and vegetables are gas producers.However, one creature's flatus is another's fulfillment. Certain colon bacteria are capable of digesting these substances producing hydrogen, methane, and carbon dioxide in the process. Excessive gas is the result.

Helpful Hints To Reduce Excessive Gas

  • Try to limit air swallowing. The prevention of air swallowing is important in limiting repetitive belching. A time-honored remedy for repeated burping is to grip a pencil between the teeth. It is impossible to suck air into the esophagus with the teeth parted this way.
  • Eat slowly and don't talk while eating. Chew your food thoroughly, instead of gulping it down.
  • Avoid using a straw or drinking out of a narrow-mouthed bottle. It promotes air swallowing.
  • Avoid carbonated beverages like soft drinks and beer. Carbonated beverages are an obvious source of swallowed gas as gusty belching is a familiar background sound in a barroom.
  • Avoid chewing gum, or sucking on candy.
  • Have loose dentures refitted. They trap air bubbles and saliva, causing you to swallow more frequently.
  • Treat postnasal drip.
  • Avoid smoking or chewing tobacco.
  • Some people have a nervous habit of swallowing air. Use relaxation techniques, such as deep breathing or yoga, to reduce stress.
  • Increase your physical activity. Any aerobic activity like running or even walking will speed up digestion and help eliminate gas, but might make things unpleasant for those bringing up the rear. If abdominal distension is a problem, try sit-ups to firm up the abdominal muscles. Walking after eating moves the air bubble to the upper stomach where it can be easily belched.
  • Reduce your lactose load. Lactose is found in dairy products such a milk, skim milk, and cottage cheese. Aged cheeses, such as Swiss or cheddar, have little lactose. Yogurt is usually well tolerated by lactose- intolerant people. If milk bothers you, try Lactaid or DairyEase.
  • Avoid sorbitol and fructose. Sodas and hard candies which contain sorbitol and fructose sugars cause extra gas and should be avoided.
  • Go slow on high fiber. Fiber is healthy but it will increase your gas, especially if you increase the amount too quickly.
  • Presoak dried beans and discard the water. This helps remove the gas-causing starches. You might also try a few drops of Beano before meals. This harmless natural enzyme can help reduce gas formation. It can be purchased without a prescription at your pharmacy.
Over-the-counter remedies.

If bacteria in the colon produce the gas, you might ask why not use an antibiotic to kill them. Unfortunately, this approach kills the beneficial bacteria as well as the gas-producers. The results are unpredictable and there may be serious side effects. You might try over-the-counter medications like simethicone. It may help reduce gas by dispersing gas pockets and preventing more from forming. It doesn't help everyone but it has no known side effects. It can be purchased without a prescription under the brand names of Mylicon, Phazyme, and Gas-X, It is also found in the antacids Maalox Plus and Mylanta II.

For those who have found no other solution to excess gas, activated charcoal sold in 250 mg capsules has been shown to relieve discomfort and reduce the volume of gas. Activated charcoal tablets help, too, acting like a magnet in your system, adsorbing many chemicals, like gas. No one knows exactly why activated charcoal works, but it probably inhibits gas-producing bacteria and absorbs hydrogen and carbon dioxide. Since activated charcoal can soak up medicine as well as gas, be sure not to take it within 2 hours of any important prescription medications This is a safe and inexpensive form of therapy, but one should be aware that charcoal will turn the stools black. Two brands are Charco-Caps and Flatulex.

When To See The Doctor

Though gas by itself is not usually a sign of a problem, persistent and troublesome symptoms may mean that something else is wrong. If bloating or abdominal discomfort are severe, or accompanied by other symptoms such as weight loss, rectal bleeding, or change in bowel habits, check with your doctor.

The Gas Crisis

"Gas" clearly means different things to different people. Typically gas is more of an annoyance than a serious medical problem. Apparently, when the human being was designed millions of years ago, there were few confining walls, so gas wasn't the social problem that it can be today. Remember that gas does you no harm, but if you have any questions, ask your doctor.

Text & Images Courtesy of Three Rivers Endoscopy Center
© Dr. Robert Fusco, Three Rivers Endoscopy Center, All Rights Reserved

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