Flatulence

Symptoms commonly attributed to “too much gas” such as bloating, distension and abdominal discomfort, are the most commonly encountered gastrointestinal complaints especially in the OPDs. What is said as excessive gas is merely an enhanced sensitivity of the gastrointestinal tract to the normally produced gases during the process of the food digestion by the bacteria in the intestine.

Almost half of the Indian population faces this problem of the flatulence at one or the other time in the lifetime.

As per news daily from London in Feb 2009, Adolf Hitler’s table manners have been highlighted as an abstract reported by his staff officer

The Nazi leader gorged on cake in his bunker and suffered from flatulence.

The secret intelligence report discovered during a house clearance outlines Hitler’s terrible table manners, “uncouth behaviour”, cake-scoffing and flatulence problem.

The entries say: “Hitler eats rapidly, mechanically, for him food is merely an indispensable means of subsistence…

 “At the table and in his speech he shows many facets of rather uncouth behaviour. He abstractedly bites his fingernails… and his table manners are little short of shocking.”

One entry reveals that Hitler “ate prodigious amounts of cake” which caused “a slight digestive disorder”.

Hence the main cause of flatulence is inappropriate eating habits. Before we go on to the management of this disorder, it will be pertinent to know certain facts about the problem of gas. This understanding will help us to a great extent in easy management of the problem.

1. What causes Flatulence?

Normally app 200 ml of gas is present in the intestine at any given time. Main source of production is digestive process taking place in the intestine and swallowing of air while eating or drinking. On an average a person passes flatus (passing gas per rectum) 14 times (normal range extends from 10-20 times). Average daily excretion of gas is 750 ml with range being 475 – 1500 ml. The quantity of the gases expelled is more or less unchanged in an individual. It is the unusual perception of the gases which gives rise to the sense of bloating.

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 (Accompanied by severe pain abdomen)
• 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

Food products that contribute to gas production

2. Alarm Symptoms

            Recent onset change in bowel habits with bloating

            Loss of appetite

            Weight loss

            Blood in stools

            Severe pain abdomen associated with abdominal distension

            Unexplained fever

            Lethargy with cold intolerance

            All these features necessitate immediate attention of the physician

3. Treatment of Flatulence

            It is evident from the above that the problem of excessive gas is basically due to inappropriate sensitivity of the intestine to the normal stretch sensation. There may be certain food products which may be leading to overproduction of gas than in normal circumstances. So one should avoid such foods mentioned above in the table.

            Other than this a few things that can help improving the sense of bloating are

            i)          Keep abdominal muscles properly toned up by regular physical exercises of the abdominal wall muscles.

            ii)         Chew food properly.

            iii)        Consume digestible fibres in the diet such as oatmeal, bran, multigrain foods and lentils.

            iv)        Use of certain drugs like prokinetics, charcoal and simethicone preparations may be of great help in reducing the gases.

4. Some common Remedies

            Use of Baking soda

            Peppermint extracts

            Saunf

            Pudin Hara

            Use of Isapgula husk for regular bowel movements

5. How can it be prevented?      

            i      Avoid pipes, cigarettes and cigars; chewing gum, sipping through straws and bottles with narrow mouths.

            ii     Avoid carbonated beverages

            iii     Eat slowly. Gulping food and beverages allows large amounts of air to enter the stomach.

            iv    Do not deliberately swallow air to force a belch.

            v     Avoid foods that may cause gas.