I’m pretty sure that about nine out of ten patients I’ve ever seen have blamed their symptoms on gas, whether their symptoms have been in their head or their ankle. About one time out of a hundred, they’re right. It’s just one of those things that has been passed down through the decades.
The urge to pass gas from your intestine can come at the worst possible moment – during an important meeting, on the bus, or on a first date. Passing intestinal gas (flatus) usually isn’t serious, but can be seriously embarrassing.
Everyone passes gas, generally 12 or more times a day. But some people have excessive gas that bothers them most of the time. In some cases, gas you can’t expel can cause intense, intermittent pain.
The good news: although you can’t stop gas from forming, a few simple measures can go a long way toward reducing the amount of gas you produce and relieving your discomfort and embarrassment.
SIGNS AND SYMPTOMS
For most people, the signs and symptoms of excess gas and gas pain are all too obvious. They include:
• The voluntary or involuntary passing of gas, either as belching or as flatus.
• Sharp, jabbing pains or cramps in your abdomen. These pains may occur anywhere in your abdomen and can change locations quickly. Your stomach may feel “knotted.” The pain may be so bad sometimes that it feels like something is seriously wrong. When the pain occurs on the upper left side, gas pain may be mistaken for heart disease. When the pain occurs on the right side, it may be mistaken for appendicitis or gallstones.
• Abdominal bloating (distension)
Every time you eat or drink, you swallow air. It happens too when you’re nervous, or chew a lot of gum. Some of that air finds its way into your lower digestive tract (intestines). Most lower intestinal gas, however, is produced when bacteria there (your colon) ferment carbohydrates that aren’t digested in your small intestine. And we eat a lot of those in Dominica, don’t we?
Unfortunately, healthy foods – fruits, vegetables, and legumes (peas and beans) – are often the worst offenders. That’s because those foods are high in fiber. Fiber has many health benefits, like keeping your digestive tract in good working order and regulating blood sugar and cholesterol levels. But it can also lead to the formation of gas. Intestinal fiber supplements containing a substance called psyllium, such as Metamucil, may also cause such problems, especially if added to your diet too quickly.
Other causes of excess gas include:
• Another health condition such as diverticulitis, Crohn’s disease, or ulcerative colitis. These are all bowel conditions, by the way.
• Antibiotics. Antibiotics disrupt the normal bacterial flora that live in your bowel, allowing some bacteria to contribute to excess gas.
• Laxatives. Excessive use of these can cause the problem of excess gas.
• Food intolerances. If your gas and bloating occur mainly after eating dairy products, it could be because your body isn’t able to break down the lactose in dairy foods. Many people have this problem after age 6, and even infants are sometimes lactose intolerant. Other food intolerances, especially to gluten – a protein found in wheat and some other grains – also can result in excess gas, diarrhea and weight loss.
• Artificial additives. Some persons’ systems can’t tolerate the artificial sweeteners sorbitol and mannitol found in some sugar-free foods, gums and candies. Many healthy people get gas and diarrhea when they consume these sweeteners.
• Anything that causes intestinal gas or is associated with constipation or diarrhea can result in gas pain. These pains generally occur when gas builds up in your intestines and you’re not able to expel it. The pains are usually intense but brief. Once the gas goes, so does the pain. The gas you pass is a combination of oxygen, nitrogen, hydrogen, carbon dioxide and methane. Methane is the one that smells.
You’re more likely to have gas problems if you’re intolerant to lactose or gluten, eat a diet rich in fruits, vegetables, whole grains and legumes, or have a bowel condition such as those mentioned before, and irritable bowel syndrome.
WHEN TO SEEK MEDICAL ADVICE
Call the doctor if you have severe, prolonged or recurrent abdominal pain, especially if associated with nausea, vomiting bleeding, fever, or weight loss. Also, talk to your doctor if your gas or gas pains are so persistent or severe that they interfere with your ability to live a normal life. On most occasions, treatment can help reduce or alleviate the problems.
SCREENING AND DIAGNOSIS
Your doctor diagnoses your problem by listening to you and examining you, as always. Your abdomen will be tapped and listened to in order to determine if the sound of excess gas is present. Based on the findings further tests may be recommended to make sure more serious conditions aren’t present.
One or more of the following suggestions may help prevent excess gas.
• Try to identify and avoid the foods that affect you the most. Some of the worst offenders include beans, onions, broccoli, prunes, apples, sugar-free candies, whole-wheat bread, bran cereals, beer, sodas and other carbonated drinks, milk, cream, ice-cream, and ice milk. Obviously, some of these foods, if not most, are good for you, so do NOT stop eating all of them. Just to be aware of the possible consequence and know that you can only experience gas and gas pain within your gastrointestinal tract, not in your head, your back, your chest, your joints, and so on and so on.
• Try cutting back on fried and fatty foods. Bloating may result; fat delays stomach emptying and can increase the sensation of fullness.
• Temporarily curtail high-fiber foods. Add them back gradually over weeks. If you take fiber supplements, do so with at least 8 ounces of water and drink plenty of extra liquids throughout each day.
• Reduce your use of dairy products. Try using low-lactose dairy foods like yogurt, instead of milk. Consuming small quantities of milk products at a time, or consuming them with other foods may make them easier to digest. If you can get your hands on something like Lactaid, use it. Sometimes, unfortunately, you may need to eliminate dairy foods completely.
• Try smaller meals. You should be doing this anyway, not just to avoid gas; small meals and snacks, rather than two or three large meals.
• Eat slowly, chew your food thoroughly and don’t gulp.
• Avoid chewing gum and eating hard candies.
• Don’t eat when you’re anxious, upset or on the run. Your digestion can be disturbed.
• Don’t smoke. Smoking can increase the amount of air you swallow.
• Try a cup of peppermint tea. Peppermint oil contains menthol, which appears to be able to help relax your digestive tract, relieving gas pain. But, it may contribute to heartburn and acid reflux.
• Try using simethicone. Gas-X, Mylanta, Gelusil, and other over-the-counter preparations contain this. It helps to break up the bubbles in gas. Charcoal tablets may also help. You may not get this around here, but you can ask; natural food stores and many pharmacies have them.
See you next week.
Dr. Emanuel, based in the Commonwealth of Dominica, has been an educator of medical professionals, in training and the public, for over 20 years.