What is flatulence?
Flatulence is the presence of excess wind or gas in the digestive
tract. This gas consisting primarily of carbon dioxide, oxygen,
hydrogen and methane gas is formed in the large intestines as a
result of action of bacteria on undigested food. It is natural to
pass gas 12-14 times in a day, both as burping (or belching) and
as flatus.
Flatulence results from fermentation or the chemical breakdown of
food by bacteria that live normally in intestine or colon. There
are different types of these bacteria, and the amount and type of
gas produced depends on the mix of bacteria present in the
intestine.
What are the causes?
Gas in the digestive tract comes from two sources:
* Normal breakdown of certain undigested foods by harmless
bacteria naturally present in the large intestines.
* Air swallowing (aerophagia): Everyone swallows small amounts of
air when eating and drinking. Eating or drinking rapidly, chewing
gum, smoking or wearing loose dentures can also cause some people
to take in more air.
Other causes are:
* Eating large amounts of non-digestible foods such as fibre.
* Eating foods that are not tolerated, as in lactose intolerance.
* Acute pancreatitis
* Irritable bowel syndrome
* Malabsorption or inadequate absorption of nutrients from the
intestinal tract, often accompanied by diarrhoea.
* Use of oral antibiotics
* Gastrointestinal cancer and its treatment
Which foods cause gas?
Most foods that contain carbohydrates may cause gas. These include
sugars, starches and dietary fibre.
Sugars: The sugars that cause gas are raffinose, lactose, fructose
and sorbitol. Raffinose is present in large amounts in beans and
small amounts are present in cabbage, broccoli, other leafy
vegetables and whole grains.
Lactose is the natural sugar in milk. It is also present in milk
products, such as cheese and ice cream, and processed foods such
as milk breads and salad dressings. Lactase is an enzyme present
in the body that helps in breakdown of lactose. However, it may be
absent or present in inadequate amounts in certain people,
resulting in a condition known as lactose intolerance. Also, as
people age, their enzyme levels decrease. As a result, they may
experience increased amounts of gas after eating foods containing
lactose.
Fructose is naturally present in fruits, onions, and wheat. It is
also used as a sweetener in some soft drinks and fruit drinks.
Sorbitol is a sugar found naturally in fruits, including apples,
pears, peaches and prunes. It is also used as an artificial
sweetener in many diabetic foods and sugar-free candies and gums.
Starches: Most starches including potatoes, corn, noodles and
wheat produce gas. Rice is the only starch that does not cause
gas.
Fibre: Many foods contain soluble and insoluble fibre. Soluble
fibre dissolves easily in water and makes a soft, gel-like texture
in the intestines. Soluble fibre present in certain foods like
beans, peas and most fruits, is not broken down until it reaches
the large intestines where its digestion causes gas. Insoluble
fibre always passes unchanged through the intestines and produces
little gas. Wheat bran and some vegetables contain this kind of
fibre.
Pulses Most beans, especially dried beans and peas, baked beans,
and soya beans
Milk and milk products Milk, Cheese, icecream
Vegetables Cabbage, radishes, onions, broccoli, cauliflower,
cucumber, potatoes, turnips
Fruits Apples, apricots, apples, raisins, bananas
Cereals and breads All foods containing wheat and wheat products
including cereals, breads, etc.
Fatty foods Deep fried foods, fatty meats, rich cream sauces and
gravies, pastries
Drinks Carbonated beverages, soft drinks and processed fruit
juices
What are the symptoms?
The most common symptoms of gas are belching, flatulence,
abdominal bloating and abdominal pain.
Belching is emitting wind noisily from the stomach through the
mouth. An occasional belch during or after meals is normal and
releases gas when the stomach is full of food. However, in people
who belch frequently, the problem may be because of swallowing too
much air and releasing it before it enters the stomach. Sometimes
a person with chronic belching may have a digestive tract
disorder, such as peptic ulcer, gastro-oesophageal reflux disease
(GERD) or gastritis.
Flatulence is passage of gas through the anus. Passing gas this
way 10-20 times a day is normal, but more often may be
embarrassing.
Abdominal bloating is usually the result of an intestinal motility
disorder, such as irritable bowel syndrome (IBS). This condition
is characterised by abnormal movements and contractions of
intestinal muscles and may give a feeling of bloating because of
increased sensitivity to gas. Other diseases such as Crohn’s
disease and colon cancer may also cause abdominal bloating.
Abdominal pain and discomfort may be present when there is excess
gas in the intestines.
How is it treated?
The most common treatments to reduce the discomfort of gas are
changing dietary habits, taking medication and reducing the amount
of air swallowed. Medicines such as antacids with simethicone and
activated charcoal and reduce the symptoms. Simethicone which is a
foaming agent that joins gas bubbles in the stomach so that gas is
more easily belched away. Digestive enzymes, such as lactase
supplements, also help by digesting carbohydrates and may allow
people to eat foods that normally cause gas. Activated charcoal
tablets may provide relief from gas in large intestines.
The doctor may also prescribe medicines to help reduce symptoms,
especially in case of motility disorders such as IBS. Drugs such
as metoclopramide may move gas through the digestive tract.
Restricting the foods that cause gas such as fruits, vegetables,
whole grains and milk products helps. Limiting high-fat foods also
may help reducing bloating and discomfort. This helps the stomach
empty faster, allowing the gases to move into the small
intestines.
How can it be prevented?
Avoid pipes, cigarettes and cigars; chewing gum, sipping through
straws and bottles with narrow mouths.
Avoid carbonated beverages
Eat slowly. Gulping food and beverages allows large amounts of air
to enter the stomach.
Do not deliberately swallow air to force a belch.
Avoid foods that may cause gas.
Intestinal gas
Certain foods are
causes flatulence
Flatulence treatment
using plain water
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