Flatulence

By Dr. (Col) V K Gupta in Gastroenterology, Hepatology & Endoscopy

Mar 03 , 2020 | 3 min read

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 food digestion by the bacteria in the intestine.

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

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 a 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.

What causes Flatulence?

Normally app 200 ml of gas is present in the intestine at any given time. The main source of production is the digestive process taking place in the intestine and swallowing of air while eating or drinking. On average, a person passes flatus (passing gas per rectum) 14 times (normal range extends from 10-20 times).

The average daily excretion of gas is 750 ml with the 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

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

Alarm Symptoms of Flatulence

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

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 that 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 improve the sense of bloating are

Keep abdominal muscles properly toned up by regular physical exercises of the abdominal wall muscles.
Chew food properly.
Consume digestible fibres in the diet such as oatmeal, bran, multigrain foods and lentils.
Use of certain drugs like prokinetics, charcoal and simethicone preparations may be of great help in reducing the gases.

Some common Remedies

Use of Baking soda
Peppermint extracts
Saunf
Pudin Hara
Use of Isapgula husk for regular bowel movements

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.

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