Flatulence: Description, causes and Risk Factors: Presence of an excessive amount of gas in the stomach and intestines. ICD-9-CM: 787.3. FlatulenceFlatulence is the state of having excessive stomach or intestinal gas. This can result in uncomfortable feelings of bloating, as well as increased belching (burping) or passing of gas from the rectum. Gas can be caused by a number of things. Gas in the digestive tract comes from two places: swallowed air and the breakdown of certain undigested foods, not broken down naturally. Foods that are difficult to digest and often cause flatulence are carbohydrates, for example sugars, starches and fiber. Undigested food passes from the small intestine into the large intestine. In the large intestine, harmless bacteria break down the food producing certain gases, like hydrogen and carbon dioxide, and in some people methane. These gases exit the body through the rectum. Those people who produce methane do not necessarily produce more gas, or have different symptoms related to gas. Food containing carbohydrates causes more gas, and foods with fat and protein cause less. The sugars that cause gas include raffinose, lactose and sorbitol. Raffinose, a complex sugar, is found in many vegetables including beans, cabbage, brussel sprouts, broccoli, asparagus and whole grains. Lactose, found in milk products, is the natural sugar found in milk. Lactose can also be found in some processed foods like bread, salad dressing and cereal. Research has shown that lactose intolerance is found more commonly among the African, Native American and Asian ethnicities. These people have lower levels of the enzyme, lactase, which develops in childhood. Fructose is found in onions, artichokes, pears and wheat. It is also used to sweeten fruit and soft drinks. Sorbitol, is a natural sugar found in some fruits including apples, pears, prunes and peaches. Sorbitol is also an ingredient used as artificial sweetener in “sugar free” candy and diet foods. Starches also cause gas. Starchy foods that can cause flatulence include corn, pasta, potatoes and wheat. These food items are not easily digested in the large intestine. Rice, however, does not cause gas. Lastly, fiber also can be a key cause of gas. There are two types of fiber: soluble and insoluble fiber. Water can easily break down soluble fibers, found in oat bran, beans, peas and most fruits. Soluble fibers are not broken down until the large intestine. The delay in digestion can cause gas. On the other hand, insoluble fiber produces little gas as it does not change in the digestion process through the intestines. This type of fiber can be found in wheat bran and some vegetables. Gas can also be caused by swallowing air while eating. Eating or drinking too fast, chewing gum and smoking are all ways to swallow more air. Certain foods and swallowing air are two common ways to have flatulence. However, some people experience gas because of other more serious concerns. Lactose intolerance, or the intolerance of dairy products, can cause one to have excessive gas. Persons with irritable bowl syndrome, or IBS, also suffer from excessive gas. IBS is a chronic stomach disorder, and can worsen with increased stress. IBS is a complex disorder of the intestinal tract that causes disruption in bowel habits often resulting in constipation and diarrhea. Another more serious cause of flatulence is malabsorption problems. This is caused by a body's inability to absorb or digest certain nutrients properly. Malabsorption is usually accompanied by diarrhea. To understand what causes flatulence odor, we must understand what causes flatulence in the first place. Flatulence is caused by the foods we eat going through the digestion process. Some foods cause more gas than others. Many people believe that red meats and proteins cause bad flatulence odors, but it is foods high in sugars that cause us to pass gas. Natural sugars such as lactose, fructose, sorbitol and raffinose found in milk and produce are the main offenders, when it comes to the really smelly stuff. While red meats can take a long time to digest and cause our feces to smell atrocious, proteins and fats cause little gas. Swallowing air when eating or drinking can increase the number of times we pass gas. The average person passes gas 14 to 23 times during a 24-hour period. Some of the food that causes flutulence include Beans, brans and whole grain cereals, eggs, fermented foods such as dosas, bread, and cakes, fried food, milk products, fruits like apple, banana, and grapes, potatoes, pulses like black gram and bengal gram, sauce and gravies. Diagnosis: Diagnostic tests for flatulance include
  • Abdominal CT scan.
  • Abdominal ultrasound.
  • Blood studies such as CBC or blood differential.
  • Barium enema x-ray.
  • Barium swallow x-ray.
  • Upper endoscopy (EGD).
  • Sigmoidoscopy.
Treatment Options: To avoid gas, keep these few remedies in mind. Eat slowly and chew your food thoroughly. Relax while eating. Avoid the foods that cause discomfort as mentioned earlier like beans and carbonated drinks. Also, try taking a walk after eating for 10 or 15 minutes to increase digestion. It also helps to drink a soothing tea like chamomile or peppermint after a meal to avoid gas. Changing your diet can be a key way to avoid gas as well. Over-the-counter medicines work well to cure excessive gas and prevent gas as well. Antacids and digestive enzymes are the most common nonprescription, over-the-counter remedies. Antacids contain simethicone, which combines with gas bubbles in the stomach to remove the gas. For those who have problems digesting lactose, the enzyme lactase, can help and is also available over-the-counter. Taking or chewing lactose tablets is recommended before meals to help digest those foods while eating. Lactose-free milk products are also available, and can be a good solution to avoid gas. Another recommended remedy is Beano, which contains an enzyme to help digest sugar found in vegetables and beans. Beano is taken before meals as well. If you are having more chronic problems, it could be attributed to a more serious problem, like IBS, and you should see a doctor. Prescription medicines are available to tackle the excessive gas sometimes caused by IBS. You should call your physician if you are having other symptoms in addition to flatulence, like heartburn, intense abdominal pain, nausea, vomiting, diarrhea and constipation. Flatulence is very common, and it is not life-threatening. While it may be unpleasant and embarrassing, there are ways to reduce the symptoms and prevent gas. Altering your diet is the best way to avoid gas. It is also helpful to use over-the-counter medicines that aid in digestion and reducing the amount of air swallowed. Also, a person's enzyme levels tend to decrease with age, so gas may be a more persistent problem as a person ages. But a close eye on diet choices can be successful in the prevention of flatulence. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.  


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