Feeling gassy — is it ever a cause for concern?

Everyone does it, but no one talks about it. No, not that topic — the fact that we pass gas every day. In fact, the average person produces between 1/2 and 1 liter of gas daily and passes gas about 10 to 20 times. Annoying? Well, sometimes. Embarrassing? Possibly. But is excess gas ever a cause for concern?

A healthy digestive system

Intestinal gas is a normal part of digestion. “While people may not like it when they do it, especially at inappropriate times, it’s just a sign of a regular, healthy digestive system at work,” says Dr. Kyle Staller, a gastroenterologist with Harvard-affiliated Massachusetts General Hospital.

Gas is produced when bacteria in the digestive system break down food. Intestinal gas contains mostly hydrogen and methane, with small amounts of other gases like hydrogen sulfide, which give gas a bad odor. Yet most components of intestinal gas are odor-free.

But can you ever be too gassy — and is frequent gas ever a problem?

Which foods you eat — and how you digest them — can increase gas production. For instance, as people age, they often have trouble digesting foods that contain short-chain carbohydrates called FODMAPs, a term that stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

“These foods are either not digested or incompletely digested, which causes increased fermentation by gut bacteria and ultimately creates more gas,” says Dr. Staller.

Foods with gas-producing FODMAPs

Common foods with gas-producing FODMAPs include broccoli, beans and lentils, wheat, garlic, onions, apples, and some fruit juices. But FODMAPs are also present in some surprising foods, like avocadoes and cherries.

People sometimes turn to sugar-free foods as a means to manage their weight, and many of those contain sorbitol or other sugar alcohols, FODMAPs that are also readily fermented in the gut. Lactose — the sugar in milk and dairy products — is a FODMAP as well, and gas is a common consequence of lactose intolerance.

“This range of foods is why someone distressed by excess gas might consider speaking with a nutritionist to help identify possible problem ones, and then design a strategy to either decrease the portion sizes or to completely eliminate them and replace them with other foods,” says Dr. Staller.

In many cases, a person may tolerate smaller amounts of a gas-producing food, but a heavy dose creates excessive gas. For instance, you may have trouble digesting a glass of milk or a bowl of ice cream, but be fine with cream in your coffee.

If you need extra help controlling excess gas, you can try an over-the-counter product like Beano or Gas-X before eating. These help reduce excess gas, pressure, and bloating. “There’s no harm in using them, but be mindful that they don’t work for everyone, and you should stop taking them if you don’t feel noticeably better after six weeks,” says Dr. Staller.

Does gas increase as we age?

While it may seem like you produce more gas with age, that is not true, says Dr. Staller. “Older people often just have an increased awareness of their gas, so it feels like they produce more.” He adds that it’s common for sphincter muscles to weaken with age, so people lose some ability to hold gas in, making it more noticeable, especially in social situations.

Is excess gas ever cause for concern?

While gas is normal, there are times when it could be a red flag for a serious health issue. If gas occurs more frequently than usual, or if it’s accompanied by other symptoms, like abdominal pain, weight loss, fever, or bloody stools, you should speak with your doctor.

“These symptoms could be signs of a digestive disorder, such as celiac disease, ulcerative colitis, or Crohn’s disease,” says Dr. Staller.

Otherwise, realize that gas is a small reminder that your digestion is working as it should.

Is It Gas Pain or Something More Serious?

Is It Just Intestinal Gas?

Keep in mind that some people pass gas more than 20 times a day, and that can be considered normal depending on the individual. Unless there are underlying problems or alarming symptoms, such as blood in the stool, weight loss, abdominal pain, family history of malignancy, or difficulty swallowing, it’s probably nothing to be concerned about, according to Dr. Shatnawei. So what you may think is excessive gas may be a rather ordinary amount. Keeping and reviewing a diet journal could easily help you identify the source of the problem as one of the many gas-producing foods. Here are some simple ways to tell if intestinal gas is behind your bloating and discomfort:

• You feel the urge to pass gas or to belch.
• You get relief from the bloating and pain when you pass gas.
• Your pain and bloating don’t persist or worsen.
• Excessive gas and bloating get better when you make certain changes to your diet, like eliminating dairy, cutting back on fiber, or limiting high-fat foods.
• Pain and bloating improve when you swallow less air, which is what happens when, for example, you chew gum or eat too quickly.

Although not usually a sign of serious illness, excessive gas can be a warning sign of an underlying medical issue. Excessive gas could be a sign of an abnormality with your digestive system, like gastroparesis, for example. Also, what you think are gas pains could actually be any one of a number of health problems.

Here are just a few possible causes of abdominal pain and bloating:

• Constipation
• Lactose intolerance or another food intolerance or allergy
• Gastroesophageal reflux disease (GERD) or indigestion
• Irritable bowel syndrome (IBS)
• Kidney stones, gallstones, or an inflamed gallbladder
• Crohn’s disease or ulcerative colitis (inflammatory bowel disease)
• An ulcer in the digestive tract
• Appendicitis
• An obstruction in the bowel
• A tumor in the abdomen

In most of these cases, you will notice symptoms other than just gas and bloating. For instance, in the case of appendicitis, there will most likely be changes to your abdomen, including stiffness and extreme tenderness. Gas pain doesn’t make your belly sensitive to the touch, so if you notice extreme pain, always seek medical advice.

If your pain, bloating, and excessive gas problems are persistent, take steps to find out the cause.

Diagnosing the Problem

A physical exam and diagnostic tests may be performed to help rule out other more serious medical conditions that could be mimicking excessive gas pain. If lactose intolerance is suspected, your doctor may schedule you for a breath test. Depending on the potential causes, other tests may include blood work, imaging — such as X-ray or computerized tomography (CT) — and endoscopy.

“Excessive gas that causes bloating and discomfort can be a challenging condition to treat,” says Shatnawei. “It often requires a change in lifestyle, which isn’t always easy. You may have to adjust your diet. For example, carbohydrates can make bloating worse. Sometimes avoiding carbonated beverages, chewing gum, legumes (like beans and lentils) or cruciferous vegetables (like cauliflower) may help.”

Sensitivity to gluten can also cause bloating. “But sensitivity to gluten does not necessarily imply celiac disease,” cautions Shatnawei. It’s best to seek medical advice before eliminating gluten from your diet.

Constipation can also contribute to bloating. Exercise can help.

If an imbalance in the gut bacteria in the small bowel is suspected, probiotics may help, Shatnawei says.

If you have persistent excessive gas, abdominal pain, or bloating, and can’t get relief, it’s a good idea to head to your doctor. If the problem is intestinal gas, he can recommend ways to provide relief. And if it’s a more serious problem, you can catch it early and get started on treatment.

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Bloating and gas formation: causes, treatment

Why can flatulence and bloating occur?

Mechanisms for the development of these symptoms are varied. Sometimes they can
occur for functional reasons, and sometimes they are caused
by certain diseases ³ .

The everyday reasons why the stomach can swell are quite obvious – first of all, this is the consumption of a large number of foods that can cause active gas formation ³ .

Pathological conditions leading to bloating and gas formation may be different. Among them, for example, a deficiency of
digestive enzymes and disorders of the circulation of bile acids.
In addition, other diseases of the digestive system
can be the cause: Crohn’s disease, irritable bowel syndrome (
we will talk about it a little later), pancreatitis. Also, the cause of a swollen abdomen can
be a violation of the peristalsis of the intestinal walls after surgery on the gastrointestinal tract,
for chronic diseases or acute infections ^1-3 .

Belching with a swollen abdomen and against the background of excessive accumulation of gases
can also be a sign of illness. So, for example, “feeling of
accumulation of gases” in the chest in adults can occur with severe
heart pathologies, such as myocardial ischemia. Bitter or sour eructations not associated with food
may be associated with hiatal hernia
, GERD (gastroesophageal
reflux disease), peptic ulcer, biliary tract,
pancreas. But belching with an unpleasant odor can often occur due to stenosis of the gastric outlet. Also, belching
can be a side effect when taking certain medications
^{2, 3} .

Irritable bowel syndrome (IBS)

Abdominal hypersensitivity is one of the main causes of symptoms in IBS. With this pathology, there may be an increase in pain sensitivity in response to stretching of the intestinal wall, in which the metabolic disorder of painkillers produced in the body plays a role ⁴ .

Characteristically, in IBS, there is often a diffuse nature of pain perception disorders throughout the intestine, and an increase in sensitivity occurs selectively to mechanical stimuli ⁴ . Therefore, throughout the day, patients may complain of a swollen abdomen, which may be accompanied by rumbling and transfusion in the intestines. Such complaints are not confirmed by objective methods ⁵ .

Dysbacteriosis

As a result of changes in composition and quantity
normal intestinal microflora may
move microorganisms from the colon to the small intestine
. For this reason,
fermentation and putrefactive processes begin
earlier, at the level of the small intestine, due to which
the stomach can swell and diarrhea occurs,
absorption of nutrients is disturbed ⁶ .
Intestinal distention
without diarrhoea, which is the predominant symptom, may be due to
overgrowth of bacteria that process
carbohydrates to short chain fatty acids
and gas ⁷ .

Flatulence and bloating

in women

In the luteal phase of the menstrual cycle and especially before the start and in the first days
of menstruation, women may experience
gas retention in the intestines and bloating.
This is due to an increase in the level of hormones
prolactin, vasopressin, which in turn
reduce the activity of prostaglandin
E. As a result, constipation may occur,
fluid retention, bloated abdomen,
and depression and irritability ⁸ .

Diagnosis

To find out the cause of bloating, you need to see a doctor. The main method confirming the accumulation of gases in the intestines is a survey radiography of the abdominal cavity. The study allows you to assess the amount of gas, its location, the presence or absence of intestinal obstruction ⁶ .

If, according to the results of the examination, the formation of gases with bloating and belching is not associated with diseases (functional disorder), the doctor can prescribe a diet and advise simple measures to help restore the normal functioning of the digestive organs ^{1, 3} .

How can you help yourself with excessive gas formation?

As a medical treatment for bloating, the doctor may
prescribe adsorbents that can absorb certain compounds and
defoamers that help break up small gas bubbles,
making them more comfortable to evacuate ³ .

Also, with symptoms of impaired digestion, which include
bloating,
enzyme preparations can help digest food. Their components are selected in such a way that
compensate for the deficiency of enzymes necessary for digestion in
various diseases, as well as to improve food digestion in

5 errors in nutrition, sedentary lifestyle

¹¹ . One of these
preparations is Festal® ^{11, 12} .

Festal® contains several active substances at once, which can
promote the digestion of food components. Pancreatin and its
enzymes facilitate the digestion of carbohydrates, fats and proteins, which
contributes to their more complete absorption in the small intestine.
Components of bile help to improve the absorption of fats.
Hemicellulase helps reduce gas formation by
breaking down fiber ^{11, 12} . The recommended dose of
Festal® is 1-2 tablets 3 times a day ¹² .

More about the drug

THERE ARE CONTRAINDICATIONS. IT IS NECESSARY TO CONSULT WITH A SPECIALIST.

Diet for flatulence and bloating

0005 to chew food thoroughly – the habit of eating on the run and prolonged use of chewing gum
can increase aerophagy, then
there is involuntary swallowing of air, in which the stomach can
swell. In addition, you should avoid
indigestible carbohydrates – legumes, cabbage, as well as fatty foods and products containing
artificial sweeteners. Carbonated drinks should also be excluded from the diet
, as they themselves are a source of
gas ^{1, 3, 13} .

It is worth eating 4-5 times a day – slowly, without talking,
chewing food thoroughly, without stuffing your mouth. Physical activity, including
walking and abdominal exercises ^{1, 3, 13} , is also worth using to normalize intestinal motility
.

proper nutrition and proper foods

Bloating is most often a symptom of constipation (in scientific terms, constipation or obstipation), that is, it is a symptom of slow intestinal transit, which may be associated with a decrease in the volume and weight of the stool, although not necessarily.
The main opponents of a flat stomach and the main causes of flatulence are diet, insufficient fluid intake, improper eating behavior, sedentary lifestyle, stress, environmental and lifestyle changes. Foods that are the enemy of a flat stomach are those foods that should be avoided for constipation and bloating.

Foods that are the enemy of a flat stomach

• Carbohydrate-rich foods that cause fermentation in the intestines, as well as animal fats.
• Sweets, sweetened and carbonated drinks that irritate the intestinal wall and cause gas.
• Sausages and fatty meats, which not only contribute to constipation, but are the enemy of intestinal well-being and overall health.
• Fried food – it is poorly absorbed by the stomach and irritates the intestines, causes stagnation and slows down the whole process of digestion.
• Bakery products and pastries made from white wheat flour of the highest grade.
• Alcohol, which not only irritates the intestinal walls, but also causes digestive disorders, preventing the proper absorption of nutrients, vitamins and mineral salts, useful for maintaining the perfect functioning of the body.

But you can not limit yourself to just eliminating these enemies of a flat stomach from the diet. Constipation and bloating are also based on bad eating habits: hasty eating, talking while eating, chewing gum, etc.

Useful life hacks:

Physical activity, such as fast walking or cycling, will have a great effect on the whole body.
Experts recommend physical activity for at least 3 hours a week (about half an hour a day).

Drinking plenty of fluids (not sugary) makes bowel movements easier, reducing bloating.
For optimal results, it is recommended to drink at least 2 liters of water per day and drink with meals.

It is also necessary to find time to go to the toilet after eating (better after breakfast in the morning or after lunch), ie. when a bowel movement is more likely due to increased bowel contractions caused by stomach filling (gastrocolic reflex).

What is constipation?

The term constipation/obstipation comes from the Greek word styphein (narrow) and indicates difficulty in emptying the bowel. This definition includes a number of symptoms now grouped under the more precise definition of Obstructive Defecation Syndrome (OSD), such as excessive effort to defecate, feeling of incomplete bowel movement, bloating, abuse of laxatives or the need to do frequent enemas, and so on.

• The normal frequency of bowel movements is highly individual and depends on several factors, such as gender.
• Men tend to have more regular bowel movements than women, usually once a day.
• In women, it is considered normal if the bowels are emptied 2-3 times a week. Generally, stools are passed without effort or discomfort and without undue abdominal tension

If no bowel movement occurs for more than three days, constipation is diagnosed. The urge to void should increase as the rectum fills with stool.
If a person does not feel this need even for several days, this means that his rectum is not full. In this case, it is likely that intestinal transit is slow (true constipation). However, if a person feels the urge but is unable to have a bowel movement, or there is partial/incomplete bowel movement, this means that their rectum is full of stool, but something is preventing proper emptying (constipation due to difficult bowel movements)

In addition to bloating, constipation can cause complications such as hemorrhoids or fissures.

Diet for bloating and constipation

An important factor influencing bowel function, bloating, and, consequently, the possibility of constipation, of course, is nutrition. An unbalanced diet is a high intake of foods rich in animal fats (such as meat, dairy products and eggs), sugar (such as cakes and various sweets) and a low intake of fiber (ie vegetables, fruits and whole grains). It should be noted that among all fibers, it is fiber that determines intestinal motility and contributes to its normal functioning, i.e. those contractions that are necessary to move the feces through the intestinal tract to its most final part, that is, the rectum, and, finally, ejection.

Research in this area has found that a diet high in fiber leads to an increase in fecal mass, which in turn increases the frequency of bowel movements. This means that minimal changes in diet (but also in lifestyle) can help solve the problem of constipation without going to the doctor or taking medication.

Eating more high fiber foods such as whole grains, fruits and vegetables can certainly improve bowel function. A balanced diet must include at least 25-30 grams of fiber per day. However, this recommendation is not valid if a person suffers from irritable bowel syndrome (diarrhea), a bowel disorder that can be exacerbated by a diet rich in fermentable fibers.

Reduce bloating: boiled or raw vegetables?

Foods that promote bowel movement, reduce bloating and create a flatter stomach include vegetables that can be eaten boiled or raw, depending on your preference.

Among the most suitable vegetables are spinach, broccoli, green beans, courgettes and artichokes, steamed and sauteed. Alternative ways to cook vegetables and retain moisture are purees or soups.

Say yes to grains like bran, wheat and legumes. These foods are rich in insoluble fiber, which facilitates intestinal transit.

Among fruits, give preference to kiwifruit (best eaten in the morning on an empty stomach), pears, plums, figs and apricots. The edible peel is better to eat than peel. Fruit can help even when cooked.

The addition of extra virgin olive oil to the dish helps the stool to remain soft even during long transit through the intestines, facilitating its natural emptying.

Eat yogurt or dairy products.

Lactobacilli play an important role in maintaining intestinal function and can also be introduced into the diet with the help of drugs and dietary supplements – for example, Lactoflorene Flat Stomach®.

Among the foods that should be eaten with moderation are those that are defined as astringents because they contain substances that are not absorbed and cause the colon wall to relax. This disrupts the normal intestinal peristalsis necessary to move the masses towards the rectum. This category of food includes potatoes, carrots, lemons, rice, bananas.

Other causes of bloating and constipation

In addition to foods that are enemies of a flat stomach, there may be other causes of bloating and constipation.

Irritable Bowel Syndrome

This syndrome is often accompanied by constipation and bloating. Excessive contractions or spasms of the muscles of the colon slow down the passage of feces inside the intestines, which also leads to an increase in water reabsorption, and this, in turn, causes more and more hard stools and, as a result, constipation.

Travel

Many people suffer from constipation while traveling. This is due to changes in the daily routine, diet, type of water and the difficulty in finding a suitable toilet.

Pregnancy

In this case, constipation is due to hormonal changes.

Fissures and hemorrhoids

In such situations, there is pain in the anal canal and spasm of the anal sphincter, which can prevent defecation.

Medicines

Many medicines cause constipation. In particular, opioid analgesics, antacids containing aluminum or calcium, antispasmodics, antidepressants, tranquilizers, iron, anticonvulsants for epilepsy, antiparkinsonian drugs, heart drugs, or calcium channel blockers for pressure.

Colon dysmotility

In these cases, the digestive tract digests food more slowly than usual. Therefore, it takes more time for the feces to form, move through the intestines, and then pass out.

Pelvic floor dysfunction

In these cases, the muscles responsible for defecation (pelvic floor muscles) do not work properly. They don’t relax enough for the stool to come out. In other cases, they may not be compressed enough to move feces through the large intestine.

Abuse of laxatives

People who usually take large amounts of stimulant laxatives become dependent on them and may need to gradually increase the dose until the bowel becomes unresponsive and stops working altogether.