Flatulence

What is Flatulence?

Flatulence is a medical term used to describe passing gas from the digestive tract out the anus. Passing gas is quite normal. Actually, the average adult passes gas about 10 times a day.

How does gas get into the digestive tract?

Gas normally enters your digestive tract when you swallow air during eating, and as a byproduct of normal digestion.

Food is primarily digested in your small intestine. The small intestine absorbs about 90% of the water that you consume. The large intestine absorbs any remaining water. It also absorbs electrolytes (like sodium and potassium) and vitamins, and forms your stool. Stool is made up of water, dead and living bacteria, undigested foods (like fiber), wastes, epithelial cells (or cells that line your digestive tract), fats, electrolytes, mucus, and other substances.

Over 700 different types of bacteria live in your large intestine.

These bacteria serve many functions. They help to absorb, excrete, and break down undigested foods. They produce vitamins like biotin (B7), B12, and vitamin K, which is important in blood clotting. They play a role in stimulating your immune system and controlling the growth of bad bacteria in your gut. They produce enzymes that help us break down fiber and undigested carbohydrates. AND, they release gas as a byproduct of their work.

When undigested carbohydrates reach the large intestine, bacteria ferment these undigested sugars and release a mixture of carbon dioxide, nitrogen, methane, hydrogen sulfide, and hydrogen gases. Bacteria in the large intestine consume some of these gases but the rest are expelled as flatus.

Normal, healthy gas is often passed without a noticeable odor. If food isn’t digested properly, sulfur or other gases are released leading to malodorous flatus.

What causes excess flatulence?

When gas gets trapped and builds up in your digestive tract you may start to feel uncomfortable and pass gas more frequently.

Any time undigested food reaches the large intestine, excess can gas can occur. A diet high in simple carbohydrates and foods that are not easily digested like high fiber foods and artificial sweeteners is often the cause. Artificial sweeteners can cause gas and bloating because they aren’t easily digested (or broken down).

Excessive flatulence can also be the result of an underlying medical condition like lactose intolerance, where you’re unable to fully digest the sugar (or lactose) in dairy products.

With lactose intolerance, lactose arrives in the large intestine undigested. Here, bacteria ferment these undigested sugars. The bacteria release gases as a byproduct of fermentation, and classic symptoms of diarrhea, gas, bloating, and excess flatus follow.

Other underlying GI disorders that can cause excess flatus include:

• Celiac Disease
• Small Intestinal Bacterial Overgrowth or SIBO
• Food intolerances (such as dairy, wheat, gluten, and egg)
• Constipation
• Diarrhea
• Irritable Bowel Syndrome (or IBS)
• Diverticulitis
• Intestinal parasites like Giardia and other GI infections
• Gastroenteritis
• Food poisoning
• GI Motility Disorders
• Pancreatic Insufficiency
• Gallbladder disease
• Hormonal fluctuations related to the menstrual cycle
• Pregnancy
• Cancerous polyps or tumors can block the intestinal tract causing gas to build up. The American Cancer Society’s updated 2018 guidelines for colorectal cancer screening recommend average-risk adults 45 years of age and older undergo regular colorectal cancer screening. The U.S. Preventative Task Force recommends screening begin at age 50. Those above average risk, with a family history of colorectal cancer or certain other cancers, with a personal history of cancer, with certain co-existing medical conditions, and of certain ethnicities are recommended to begin screenings sooner.
• Severe and persistent flatulence can be a symptom of a severe underlying condition. If you notice a sudden or worsening increase in your flatulence, or new flatulence, please be sure to schedule an appointment with our office for a comprehensive medical evaluation to avoid missed diagnosis, delayed care, and poor outcomes.

What are the symptoms of excess flatulence?

• Passing flatus greater than 10 times a day
• Noticeable malodorous flatus
• Abdominal pain, fullness, bloating, cramping, or knotting
• Pressure in your abdomen
• Abdominal distention or swelling

If you notice persistent abdominal pain, bloody stools or black tarry looking stools, a change in the consistency or caliber of your stools, thin stools or narrow stools, very hard or watery stools, a change in the frequency of your bowel movements, unintentional weight loss, back pain, pain that keeps you up at night, constipation or diarrhea, persistent or recurrent nausea or vomiting, fever, chills, sweats, or any other concerning symptoms, these could be alarm for concern and should be evaluated promptly and thoroughly by a trained medical professional to avoid missed diagnoses, delayed medical care, and poor outcomes.

What causes malodorous flatulence?

Causes may include:

• Food intolerances (like lactose, gluten, and fructose) where your body is unable to break down certain sugars or food components. Bacteria ferment undigested food and release malodorous gases.
• Consuming high fiber foods. High fiber foods are difficult to digest. If food isn’t digested properly, it decomposes and sulfur or other gases are released leading to malodorous flatus. Some foods that may cause odorous flatus include: vegetables in the cabbage family, broccoli, asparagus, garlic, and onions.
• An imbalance in your gut flora due to antibiotic use, infection, stress, small intestinal bacterial overgrowth (SIBO), or other causes.
• Constipation
• Diarrhea
• Infections (like viruses, parasites, bacteria, and C. diff)
• Colon cancer. Cancerous polyps or tumors can block your colon and cause gas to build up.

How can I minimize excess flatus?

For many people, simple lifestyle and dietary modifications may be enough to diminish or even fully alleviate your symptoms and manage your excess gas.

• Lose weight if you are overweight.
• Avoid overeating,
• Avoid swallowing air while you eat or drink,
• Eat slowly and mindfully
• Eat smaller meals
• Don’t use a straw
• Don’t talk excessively while eating
• Avoid chewing gum and mints
• Avoid carbonated beverages
• Stop smoking
• Avoid artificial sweeteners
• Modify your diet.
• Keep a food diary to help identify food triggers such as dairy.
• Avoid food triggers
• Avoid high carbohydrate foods and simple sugars that are hard to digest or go through the digestive tract undigested
• Stick to foods containing carbohydrates that are easier to digest like bananas and rice
• Choose beans and legumes that were fermented prior to cooking
• Ask us if Probiotics might help restore your gut flora.

What foods can trigger excess gas?

• High Fiber foods like dried beans, peas and lentils, certain fruits, vegetables, especially those in the cabbage family, asparagus, onions, and whole grains
• Beans that weren’t fermented prior to cooking
• Artificial sweeteners or sugar substitutes (check your food labels because these are often snuck into many of the foods we think are good for us like yogurts)
• High fructose corn syrup
• Lactose (in the case of lactose deficiency)
• High fructose corn syrup
• Carbonated beverages, such as soda and beer
• Chewing gum
• Mints
• Fiber supplements