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6 of the best vitamin C supplements: What to look for
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Most people can get adequate vitamin C in their diet by eating fruits and vegetables. However, some people take a vitamin C supplement due to dietary restrictions or a medical condition.
Vitamin C, or ascorbic acid, is a water soluble vitamin and antioxidant that is essential for health. It helps the immune system, skin, and bones function, and it combats damage from free radicals, which are molecules that can adversely affect the body.
This article looks at who may benefit from taking vitamin C, how much people need to consume per day, and some of the best vitamin C supplements available on the market.
According to the National Institutes of Health (NIH), vitamin C deficiency is rare in the United States.
However, although most people can get enough vitamin C from fruits and vegetables, others may have difficulty getting enough vitamin C from their diet.
People who may be at risk of vitamin C deficiency include:
- older adults
- people with alcohol use disorders
- people with eating disorders
- people who smoke, as cigarette smoke increases the damage that free radicals cause, resulting in a higher need for vitamin C
- people who eat restricted diets for medical reasons
- people with certain medical conditions, such as kidney disease that requires hemodialysis, conditions that cause malabsorption, and some types of cancer
- infants who drink boiled cow’s milk, because the heat destroys the small amount of vitamin C it contains
Anyone who is concerned that they have a deficiency can ask a doctor for blood tests to see which nutrients they need. Having a long-term deficiency in vitamin C can lead to scurvy.
In addition to those who have a vitamin C deficiency, some other people may also benefit from consuming more of this nutrient. For example, some evidence suggests that vitamin C can reduce the severity and duration of the common cold.
According to the NIH, there is no conclusive evidence that vitamin C has an impact on COVID-19, however.
According to the NIH, the recommended daily intake of vitamin C for most people is 75–90 milligrams (mg).
Typically, the small intestine absorbs up to 100 mg of vitamin C from food per day. Once the cells have become saturated with vitamin C, they cannot absorb any more.
However, some people believe that taking very large doses of vitamin C, or “mega-dosing,” is beneficial. This may stem from a 1976 paper that indicated that high-dose vitamin C could prolong the lives of people with terminal cancer.
However, more recent studies have not repeated this result.
Vitamin C doses of over 2,000 mg per day may cause side effects, such as:
People with particular health conditions and those who take certain medications may also need to avoid vitamin C supplements. These conditions include hemochromatosis, which causes the body to store too much iron, and kidney stones.
Vitamin C may also interact with chemotherapy treatment.
The Food and Drug Administration (FDA) does not regulate vitamin C products. For this reason, it is important to discuss taking any new supplement with a doctor.
There are several forms of vitamin C. In supplements, vitamin C usually comes in the form of ascorbic acid. However, some supplements contain other forms, such as sodium ascorbate, calcium ascorbate, or ascorbic acid with bioflavonoids.
According to the NIH, all forms of vitamin C are similarly beneficial.
There are various ways to take vitamin C, including:
- chewable gummies
- effervescent tablets
Some people may prefer the convenience of swallowing tablets, while others may prefer a powder that they can mix into drinks.
People who have problems absorbing nutrients may prefer a sublingual supplement, as the body absorbs these in the mouth rather than in the intestines.
There are many vitamin products on the market, and because they are not FDA-regulated, they may vary significantly in purity, ingredients, and dose.
People should always buy vitamin C from a reputable company and ensure that the products undergo third party testing.
The products listed below contain safe doses of vitamin C for adults and have undergone independent testing for quality.
Please note that the author of this article has not tried any of these products. All information presented here is purely research-based.
Care/of Vitamin C
Care/of is a vitamin subscription service that creates a personalized plan for individuals based on their health needs.
The brand’s vitamin C supplement undergoes multiple rounds of testing to ensure safety, and the brand also sources its ingredients from trusted suppliers.
The supplement is vegan, gluten-free, and genetically modified organism (GMO)-free, and it contains 250 mg of fermented vitamin C per serving.
Care/of Vitamin C is available for purchase online.
Ritual, another multivitamin subscription service, uses vitamin C as an ingredient in some of its products, including its postnatal multivitamin.
The tablet contains 25 mg of vitamin C and a number of other nutritional supplements, including choline, omega-3 fatty acids, vitamin D, and biotin.
Ritual claims that its ingredients are traceable and that customers can use the website to track the exact origin of the ingredients in the products.
Ritual Postnatal is available for purchase online.
Persona Vitamin C with Bioflavonoids
Persona is a subscription service that carries a vitamin C supplement containing bioflavonoids. The product is citrus flavored and can help boost antioxidant intake.
Each supplement contains 500 mg of vitamin C and has undergone quality testing at each stage to ensure safety.
Persona subscriptions also include consultations with nutritionists and personalized plans based on each individual’s health conditions.
Persona Vitamin C with Bioflavonoids is available for purchase online.
Pure Encapsulations Liposomal Vitamin C Liquid
The Pure Encapsulations Liposomal Vitamin C Liquid provides 1,000 mg of vitamin C in one teaspoon and comes in a pleasant citrus flavor.
According to the company, it contains non-GMO ingredients and is suitable for vegans and vegetarians.
This product contains liposomal vitamin C, which means that tiny bubbles of oil contain the vitamin C.
According to one 2020 study, the gut absorbs this form of vitamin C easier. However, the company likely factored this into the product’s price, which is higher than that of other products by other brands.
The company is National Sanitation Foundation (NSF) and Good Manufacturing Practice (GMP) certified, and it has its ingredients tested for contaminants.
Pure Encapsulations Liposomal Vitamin C Liquid is available for purchase online.
Life Extension Buffered Vitamin C Powder
Some people find that taking ascorbic acid irritates their stomach. Buffered vitamin C is a less acidic form of the nutrient, which may help reduce adverse effects.
One serving of this powder provides 4,000 mg of vitamin C. This dose is very high — twice that of the upper limit that the NIH recommends.
However, as this product comes in a powder, people can lower the dose to a more moderate level by using smaller amounts of powder.
Life Extension is also NSF and GMP certified and produces a Certificate of Analysis for every product it makes.
Life Extension Buffered Vitamin C Powder is available for purchase online.
NOW Supplements Orange Chewable Vitamin C-500
People who do not like swallowing tablets may prefer a chewable vitamin. This product delivers 500 mg of vitamin C per chewable tablet. A person can take one or two per day.
The product is free from common allergens and suitable for vegans. It does contain some sugar and natural sweeteners, though this only totals 1 gram per dose. The tablets have a natural orange flavor.
According to the website, NOW exceeds GMP standards and tests all raw ingredients for safety and purity.
NOW Supplements Orange Chewable Vitamin C-500 is available for purchase online.
Eating more fruits and vegetables is the best way for someone to increase their vitamin C intake naturally.
The NIH suggests:
- half a cup of raw sweet red pepper, which contains 95 mg of vitamin C
- three-quarters of a cup of orange juice, which contains 93 mg of vitamin C
- half a cup of broccoli and half a cup of strawberries, which totals 97 mg of vitamin C
- one medium orange and half a cup of cooked cabbage, which totals 98 mg of vitamin C
Some companies also fortify their breakfast cereals with added vitamin C.
High heat, water-based cooking methods, as well as prolonged storage, can destroy some foods’ vitamin C content.
For this reason, the NIH suggests lightly steaming or microwaving vegetables to retain more of their nutrients.
Vitamin C deficiency can be fatal without treatment. A person should contact a doctor if they have symptoms that may indicate a vitamin C deficiency.
These symptoms include:
- small red or purple spots on the skin
- inflamed, swollen, or bleeding gums
- wobbly teeth or tooth loss
- corkscrew shaped hairs
- joint pain
A person should also consult a doctor before taking vitamin C, particularly if they have a medical condition, are pregnant, or take any medications.
Most people get enough vitamin C by eating a varied diet that includes fruits and vegetables. However, some people may need to take a supplement.
All forms of vitamin C work in much the same way, but people should always buy from a reputable seller and consider the dose, quality, and price point before buying a product.
Consuming too much vitamin C may cause side effects.
Some people should not take vitamin C, so it is always best to consult a doctor before starting any supplement.
Best meals and foods for boosting iron
A diet plan for iron deficiency anemia needs to include a healthy balance of heme and non-heme iron-rich foods, such as meat and poultry, seafood, iron-rich vegetables, nuts and seeds, and beans. It is also crucial to include foods that can improve the body’s absorption of iron and avoid foods that may interfere with this process.
Iron deficiency anemia occurs when your body does not have enough iron to form healthy red blood cells.
Iron deficiency anemia has a number of causes, but is most commonly the result of inadequate dietary intake and/or blood loss.
A person with iron deficiency anemia will typically receive oral iron supplementation or intravenous (IV) iron treatment. People with iron deficiency anemia are also encouraged to increase their dietary intake of iron by prioritizing iron-rich foods.
Anemia can result from many factors, including a lack of iron in the diet and heavy menstruation.
Bleeding in the stomach and intestines can also cause iron deficiency anemia. This type of bleeding is sometimes a side effect of nonsteroidal anti-inflammatory drugs (NSAIDs). Or it may result from:
- swelling in the large intestine or esophagus
- certain cancers
Certain people are at greater risk for developing iron deficiency anemia. They include pregnant people, those with certain medical conditions such as Crohn’s disease, people who have undergone bariatric surgery, people with heavy menstrual periods, and those who follow a vegan diet.
In these cases, doctors usually advise people to take iron supplements.
The recommended daily allowance (RDA) of iron depends on a person’s age and sex. A baby younger than 6 months only requires 0.27 milligrams (mg) of iron a day, while a male aged 19–50 years requires 8 mg a day, and a female in the same age range needs 18 mg of iron a day.
During pregnancy, a person should increase their daily iron intake to 27 mg a day.
People with iron deficiency anemia need a significant boost and require 150–200 mg of iron a day, or 2–5 mg per kilogram of their body weight. However, dosage recommendations vary, as the body does not absorb high doses of iron supplements efficiently. A person should consult with their doctor to decide on a suitable dose of extra iron.
Adding iron-rich foods to the diet can help treat anemia. A healthcare professional can advise about the kinds of foods to choose from and other ways to increase iron absorption.
The best diet for a person with anemia includes plenty of foods rich in iron and other foods that help the body to absorb iron. A person should also be aware of foods that can inhibit iron absorption.
The plan below was developed to show the type of healthy meals a person with anemia might include:
Unsweetened oatmeal made with sprouted oats topped with raspberries, hemp seeds, and cacao nibs. Enjoy with a glass of iron-fortified orange juice.
Breakfast hash made with chickpeas, chicken sausage, mushrooms, sweet potatoes, and spinach.
Tea and coffee inhibit iron absorption, and people should not drink them with meals.
A bowl of beef chili, or a tuna burger, with a spinach salad.
A bagel with smoked salmon, cream cheese, and spinach.
Lamb chops with boiled potatoes, steamed broccoli, and curly kale.
A stew that includes kidney beans, chickpeas, black-eyed peas, tinned tomatoes, onions, red peppers, and garlic, topped with vegan or dairy-based cheese and a dollop of vegan or dairy-based yogurt.
Many foods contain high levels of iron. A person may find it easy to combine them and make tasty, nutritious meals that help to boost the intake of iron.
Fruits and vegetables
- curly kale and other varieties
- collard greens
- dandelion greens
- Swiss chard
- citrus fruits
- red and yellow peppers
However, some dark, leafy greens also contain oxalates, which can inhibit iron absorption. Rather than relying solely on vegetables, a person should aim to get iron from a variety of sources.
Nuts and seeds
- pumpkin seeds
- hemp seeds
- pine nuts
- sunflower seeds
Meat and fish
Beans and pulses
- kidney beans
- black-eyed peas
- pinto beans
- black beans
- lima beans
It may be a good idea to choose iron-fortified cereals, bread products, orange juice, rice, and pasta. Also, fermented and sprouted grains and legumes are a better choice for people with iron deficiency because sprouting and fermenting break down anti-nutrient compounds that negatively impact iron absorption.
The following foods can interfere with iron absorption:
- tea and coffee
- milk and some dairy products
- foods that contain tannins, such as grapes, corn, and sorghum
- foods that contain phytates or phytic acid, such as brown rice and whole-grain wheat products
- foods that contain oxalic acid, such as peanuts, parsley, and chocolate
Although adding foods rich in iron to your diet can help raise blood levels of iron, most people with iron deficiency need to take supplemental iron to achieve healthy iron status.
Some people do not absorb iron well and may need to have IV iron treatments. A person’s doctor will advise on the best treatment for their specific needs. However, the following strategies can maximize a person’s iron intake:
- Refrain from drinking tea or coffee with meals.
- Avoid eating foods rich in calcium with those rich in iron.
- Eat iron-rich foods alongside those rich in vitamin C.
- Cook with a cast-iron skillet.
- Cook foods for shorter periods.
If a person has tried changing their diet and their iron levels remain low, they should speak with a doctor or dietitian, who may recommend a supplement.
Healthcare professionals often recommend choosing a supplement containing ferrous salts such as ferrous fumarate, ferrous gluconate, or ferrous sulfate. Iron dosage recommendations vary. A person’s doctor will determine the most effective form and dose of iron based on their needs.
People with iron deficiency anemia can benefit from adding iron to their diet. The foods and strategies listed above can help a person to manage the condition.
Eating certain dark, leafy greens, meat, seafood, beans, nuts, and seeds can help a person to boost their iron intake.
It may also be a good idea to use a cast-iron skillet, and cook meals for shorter periods, when possible.
Iron supplements can benefit people who do not receive enough iron from their diets. It is essential to follow dosage instructions carefully.
How To Decrease Bloating | Natural Remedies for Gas and Bloating
Natalie Egan, MS, RD, LDN
Brigham and Women’s Hospital
Previously published on Intelihealth.com
We all have gas. Yet, we’re embarrassed to mention it to health-care providers and friends in social conversation. Ten percent to 20 percent of adults have the digestive complaints of belching or flatulence. Here’s the good news: bloating or gas doesn’t necessarily mean there is something wrong with digestion. But to minimize gas and its embarrassment, the first areas to focus on are diet and eating habits.
The Passing Of Gas
The three most common ways of expelling gas are burping, abdominal bloating, and flatus. Swallowed air, which may stay in the stomach for a period of time, is released by belching. Bloating typically occurs with air that is trapped in the colon or small bowel. Air passed through the bowel is typically passed as flatus. A normal individual emits flatus from 12 to 25 times per day, with more gas in the intestine later in the day than earlier.
Intestinal gas is made up of oxygen, nitrogen, carbon dioxide, hydrogen and methane. The composition varies depending on the type of intestinal gas. Gas is caused by various factors, the most common of which are eating behaviors and the bacterial fermentation of certain foods.
The colon is filled with bacteria, yeasts and fungi, which break down the foods not digested by the small intestine, mostly different forms of carbohydrates. These bacteria particularly enjoy undigested carbohydrates, and the fermentation leads to gas production, hydrogen and methane expelled as flatus. Lactose is one of the most common sources of gas-causing carbohydrate, affecting people who are “lactose intolerant,” meaning they do not have the enzyme lactase needed to digest the carbohydrate. Typically, lactose is found in dairy products. Beans are the second most common carbohydrate implicated in gas production. The indigestible carbohydrate in beans that typically causes flatus is raffinose.
Behaviors, Food Choices And Activity
Eating behaviors and other habits such as gum chewing, gulping foods and drinking with eating can cause us to swallow air. Bulky foods such as lettuce, cabbage, and dense breads not chewed into small enough pieces increase swallowed air.
Typically, swallowed air contains oxygen, nitrogen and carbon dioxide. It tends to not have a foul smell, but it does contribute to the discomfort associated with gas.
People vary widely in how sensitive they are to gas production. Keeping a food record to document incidences of gas in relation to foods eaten can shed light on whether food or behavior may be aggravating the situation.
Behaviors And Food Choices That Can Lead To Gas
- Talking while eating
- Eating when upset
- Smoking or chewing tobacco
- Using a straw or sports bottle
- Overloading your stomach
- Deep sighing
- Drinking very hot or cold beverages
- Chewing gum or eating hard candy
- Drinking from a water fountain
- Tight-fitting garments
- Long-term use of medications for relief of cold symptoms
- Carbonated beverages
- Spicy, fried or fatty foods
- Broccoli, cabbage, onions
- Apple or prune juice
- Dried fruits
- Anything containing sorbitol, mannitol or maltitol, found in many low-carb or sugar-free foods
Beat The Bloat
Bloating is a sensation that makes the abdomen feel larger than normal. The abdomen doesn’t get physically bigger until its volume increases by one quart, so the bloated feeling may occur, but the abdomen is not distended. Intestinal gas may cause the feeling of bloating.
Here are additional suggestions to decrease bloating:
- Eat slowly, and consume smaller, more frequent meals
- Chew your foods well
- Drink beverages at room temperature
- Have your dentures checked for a good fit
- Increase physical activity during the day
- Sit up straight after eating
- Take a stroll after eating
It is important not to completely omit foods from the diet that may cause gas. As we know, a high-fiber diet is important for bowel regularity and colon health, so it is well worth the patience it may take to slowly build up tolerance to these types of carbohydrates. Start by adding the offending high-fiber food in smaller quantities, such as a half cup or less. Be sure that fluid intake and activity levels are adequate, as they help to move foods through the digestive tract.
Natural And Other Remedies For Gas
Many advertisements tout medications or remedies that reduce gas and bloating. Some have been shown to be of value in clinical studies, others have not yet been proven scientifically but are anecdotally helpful. Before trying anything, you may want to consult with your physician.
Two products on the market can help with food-related gas and bloating. Both products are packaged forms of the enzymes needed to break down the problematic carbohydrates. Lactase, found in products such as Dairy Ease and Lactaid, can be taken with dairy foods to help break down lactose and lessen gas. Beano helps digest the indigestible carbohydrate in beans and other gas-producing vegetables.
Natural remedies for gas include:
- Peppermint tea
- Chamomile tea
Over-the-counter gas remedies include:
- Activated charcoal
- Lactase enzyme (Lactaid or Dairy Ease)
When To Be Concerned
In most situations, occasional gas and abdominal discomfort does not require medical attention. Over- the-counter products, or a self-assessment of habits and changes in eating behaviors can help remedy the situation. However, you should seek medical attention when there is an increase in frequency, location or severity of the symptoms, or if they are accompanied by weight loss, diarrhea, vomiting or heartburn.
Foods That Cause Gas | How to Get Rid of Gas Pains
Symptoms of Gas & Bloating
- Belching (Burping)
- Passing gas (flatus)
- Abdominal cramping
- A full feeling in the abdomen (bloating)
- Swollen abdomen from internal pressure (distention)
Burping is a normal part of digestion, especially after meals. Passing gas 15-20 times a day is also normal. Burping and passing gas may cause embarrassment, but rarely indicate a medical problem.
What Causes Gas & Bloating?
There are two main causes of gas in the digestive tract (esophagus, stomach, small intestine, large intestine).
- Digestion and fermentation of foods – Your digestive tract contains beneficial bacteria that break down food and nutrients. In your large intestine, gas is formed during the fermentation process of carbohydrates like fiber and sugar.
- Swallowing Air – Everyone swallows some air while eating and drinking. Drinking or eating quickly, smoking, chewing gum, or even loose dentures can cause some to swallow more air. The medical term for swallowing air is aerophagia.
Foods That Cause Gas
Most foods with carbohydrates can cause gas while protein and fats cause little gas.
Sugars such as lactose, fructose, raffinose, stachyose, verbascoce, and sorbitol can cause gas.
High Fiber Foods
- Beans (legumes)
- Whole grains
Even though high-fiber foods can increase gas, fiber is critical for a healthy digestive tract.
Other Dietary Considerations
Carbonated beverages, fiber supplements, and artificial sweeteners can also cause excess gas in the digestive system.
Medical Conditions that Cause Gas
Some medical conditions can increase intestinal gas, gas pains, or bloating including:
- Intestinal diseases – chronic intestinal diseases like Crohn’s disease, ulcerative colitis, and diverticulitis can cause excess gas.
- Overgrowth of bacteria – A change or increase in small intestine bacteria may cause excess gas, weight loss, or diarrhea.
- Food intolerance – some food intolerances can cause excess intestinal gas. This is caused by an inability to properly break down the sugar in dairy products (lactose intolerance) or gluten (celiac disease).
- Constipation – It may be difficult to pass gas when experiencing constipation.
Diagnosing Gas, Gas Pains, and Bloating
Even though gas and bloating are common, a medical evaluation may sometimes be necessary. If you experience blood in the stool, diarrhea, fevers, anemia, or weight loss, you should talk to a doctor.
Medical History & Physical Exam
First, your doctor will review your medical history and ask questions about your symptoms and dietary habits.
The doctor may also examine your abdomen for tenderness or anything that feels abnormal. A stethoscope may be used to help the doctor determine how well the digestive tract is working.
The results of these preliminary tests will help determine the next level of diagnosis if necessary.
Additional Tests for Gas, Gas Pains, and Bloating
- Breath tests – Breath tests can help determine problems of malabsorption or intestinal bacteria overgrowth.
- Colonoscopy – In patients 50 or older, or who have a family history of colorectal cancer, the possibility of colon cancer may be considered.
- Imaging – If chronic belching is a problem, x-rays may be used to inspect the small intestine, stomach, and esophagus. This is known as an upper GI series
Treatment for Gas, Gas Pains, and Bloating
If your gas and gas pains are caused by an underlying condition, treatment for that condition may provide relief. Usually, gas can be treated through lifestyle modifications, dietary changes, and over-the-counter medications.
Not everyone has the same reaction to all foods. Keeping a food diary can help you determine which foods cause increases in gas and bloating. Eliminating or reducing certain foods may be necessary to reduce your symptoms.
Foods that can cause gas due to high fiber include whole wheat, bran, prunes, peaches, apples, pears, asparagus, artichokes, cauliflower, cabbage, brussels sprouts, broccoli, onions, and beans. You may try avoiding high-fiber foods for a week or two and gradually start to eat them again. You should visit with a doctor or dietitian to make sure you’re getting enough fiber.
Some people do not easily digest lactose, the sugar found in dairy products. Reducing or eliminating dairy products could help you reduce symptoms of gas and bloating. There are often lactose-free options for some products like milk.
You may try eliminating sugar substitutes or trying a different type.
Fat in your digestive tract can slow-down digestion, allowing food to ferment longer and produce gas. Reducing fat in your diet may help lessen symptoms.
Soda, beer, sparkling water, or other carbonated drinks can increase the amount of gas in your digestive tract.
Some fiber supplements could cause an increase in gas and bloating. Visit with your doctor about what types of fiber supplements might be right for you.
Drink more water throughout the day and with meals. This will reduce the chances of constipation.
Over-The-Counter Medications for Gas
Beano, BeanAssist – these alpha-galactosidase medications aid in the digestion of carbohydrates often found in vegetables and beans. These supplements are taken right before you eat.
Lactaid, Digest Dairy Plus – Lactase supplements aid the digestive process of lactose, the sugar in dairy products. They will help reduce symptoms in people who are lactose intolerant. If you are breastfeeding or pregnant, talk to your doctor before using lactase supplements.
Gas-X, Mylanta Gas Minis – Simethicone can break down gas bubbles making it easier for gas to pass through the digestive tract. However, there is minimal evidence showing it reduces symptoms.
Actidose-Aqua, CharoCaps – Activated charcoal, taken before and after a meal, may reduce symptoms. Research has not proven these claims. Activated charcoal could also interfere with the absorption of medications. It can also stain your clothing and the inside of your mouth.
Prescription Medications for Gas
For those with more serious, underlying conditions like irritable bowel syndrome, your doctor may prescribe prescription medications.
Lifestyle Changes to Reduce Gas
Some lifestyle adjustments can help reduce gas, gas pains, and bloating.
- Eat smaller portions – Many healthy foods can also cause gas. Eating smaller portions may help reduce excess gas.
- Chew completely and slow down – If you eat too fast, it could cause gas. Tip: put down your fork between each bite.
- drinking through straws
- chewing gum
- sucking on hard candies
- Secure dentures properly – If dentures are loose, they can cause you to swallow excess air when eating and drinking.
- Don’t smoke – Smoking can increase the amount of air you swallow.
- Get regular exercise – exercising most days will help reduce the risk of constipation, which blocks gas from exiting your colon.
Slow-moving or trapped gas can cause pain, known as gas pains. Some foods are more likely to produce gas in the digestive system. Eating these foods less often can help reduce gas.
Some digestive conditions like celiac disease and irritable bowel syndrome can also cause an increase in gas or gas pains.”,
“name”: “Digestive Tract, Bowel, Intestine”
“name”: “Digestion and fermentation of foods – Your digestive tract contains beneficial bacteria that break down food and nutrients. In your large intestine, gas is formed during the fermentation process of carbohydrates like fiber and sugar.”
“name”: “Swallowing Air – Everyone swallows some air while eating and drinking. Drinking or eating quickly, smoking, chewing gum, or even loose dentures can cause some to swallow more air. The medical term for swallowing air is aerophagia.”
“name”: “Medical History & Physical Exam”
“name”: “Breath tests”
“name”: “Foods that can cause gas due to high fiber include whole wheat, bran, prunes, peaches, apples, pears, asparagus, artichokes, cauliflower, cabbage, brussels sprouts, broccoli, onions, and beans. You may try avoiding high-fiber foods for a week or two and gradually start to eat them again. You should visit with a doctor or dietitian to make sure you’re getting enough fiber.”
“name”: “Some people do not easily digest lactose, the sugar found in dairy products. Reducing or eliminating dairy products could help you reduce symptoms of gas and bloating. There are often lactose-free options for some products like milk.”
“name”: “Artificial Sweeteners- You may try eliminating sugar substitutes or trying a different type.”
“name”: “Fatty/Fried Food – Fat in your digestive tract can slow-down digestion, allowing food to ferment longer and produce gas. Reducing fat in your diet may help lessen symptoms.”
“name”: “Over-The-Counter Medications for Gas
Beano, BeanAssist – these alpha-galactosidase medications aid in the digestion of carbohydrates often found in vegetables and beans. These supplements are taken right before you eat.
Lactaid, Digest Dairy Plus – Lactase supplements aid the digestive process of lactose, the sugar in dairy products. They will help reduce symptoms in people who are lactose intolerant. If you are breastfeeding or pregnant, talk to your doctor before using lactase supplements.
Gas-X, Mylanta Gas Minis – Simethicone can break down gas bubbles making it easier for gas to pass through the digestive tract. However, there is minimal evidence showing it reduces symptoms.
Actidose-Aqua, CharoCaps – Activated charcoal, taken before and after a meal, may reduce symptoms. Research has not proven these claims. Activated charcoal could also interfere with the absorption of medications. It can also stain your clothing and the inside of your mouth.”
“name”: “Belching (Burping)”
“name”: “Passing gas (flatus)”
“name”: “Abdominal cramping”
“name”: “A full feeling in the abdomen (bloating)”
“name”: “Swollen abdomen from internal pressure (distention)”
Gas in the Digestive Tract
Everyone has gas and eliminates it by burping or passing it through the rectum. However, many people think they have too much gas when they really have normal amounts. Most people produce about 1 to 3 pints a day and pass gas about 14 times a day.
Gas is made primarily of odorless vapors – carbon dioxide, oxygen, nitrogen, hydrogen, and sometimes methane. The unpleasant odor of flatulence comes from bacteria in the large intestine that release small amounts of gases that contain sulfur.
Although having gas is common, it can be uncomfortable and embarrassing. Understanding causes, ways to reduce symptoms and treatment will help most people find relief.
What causes gas?
Gas in the digestive tract (that is, the esophagus, stomach, small intestine, and large intestine) comes from two sources:
- swallowed air.
- normal breakdown of certain undigested foods by harmless bacteria naturally present in the large intestine (colon).
Air swallowing (aerophagia) is a common cause of gas in the stomach. Everyone swallows small amounts of air when eating and drinking. However, eating or drinking rapidly, chewing gum, smoking, or wearing loose dentures can cause some people to take in more air.
Burping, or belching, is the way most swallowed air – which contains nitrogen, oxygen, and carbon dioxide – leaves the stomach. The remaining gas moves into the small intestine, where it is partially absorbed. A small amount travels into the large intestine for release through the rectum. (The stomach also releases carbon dioxide when stomach acid and bicarbonate mix, but most of this gas is absorbed into the bloodstream and does not enter the large intestine.)
Breakdown of Undigested Foods
The body does not digest and absorb some carbohydrates (the sugar, starches, and fiber found in many foods) in the small intestine because of a shortage or absence of certain enzymes.
This undigested food then passes from the small intestine into the large intestine, where normal, harmless bacteria break down the food, producing hydrogen, carbon dioxide, and, in about one-third of all people, methane. Eventually these gases exit through the rectum.
People who make methane do not necessarily pass more gas or have unique symptoms. A person who produces methane will have stools that consistently float in water. Research has not shown why some people produce methane and others do not.
Foods that produce gas in one person may not cause gas in another. Some common bacteria in the large intestine can destroy the hydrogen that other bacteria produce. The balance of the two types of bacteria may explain why some people have more gas than others.
Which foods cause gas?
Most foods that contain carbohydrates can cause gas. By contrast, fats and proteins cause little gas.
The sugars that cause gas are raffinose, lactose, fructose, and sorbitol.
Raffinose. Beans contain large amounts of this complex sugar. Smaller amounts are found in cabbage, brussels sprouts, broccoli, asparagus, other vegetables, and whole grains.
Lactose is the natural sugar in milk. It is also found in milk products, such as cheese and ice cream, and processed foods, such as bread, cereal, and salad dressing. Many people, particularly those of African, Native American, or Asian background, normally have low levels of the enzyme lactase needed to digest lactose after childhood. Also, as people age, their enzyme levels decrease. As a result, over time people may experience increasing amounts of gas after eating food containing lactose.
Fructose is naturally present in onions, artichokes, pears, and wheat. It is also used as a sweetener in some soft drinks and fruit drinks.
Sorbitol is a sugar found naturally in fruits, including apples, pears, peaches, and prunes. It is also used as an artificial sweetener in many dietetic foods and sugarfree candies and gums.
Most starches, including potatoes, corn, noodles, and wheat, produce gas as they are broken down in the large intestine. Rice is the only starch that does not cause gas.
Many foods contain soluble and insoluble fiber. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Found in oat bran, beans, peas, and most fruits, soluble fiber is not broken down until it reaches the large intestine, where digestion causes gas.
Insoluble fiber, on the other hand, passes essentially unchanged through the intestines and produces little gas. Wheat bran and some vegetables contain this kind of fiber.
What are some symptoms and problems of gas?
The most common symptoms of gas are flatulence, abdominal bloating, abdominal pain, and belching. However, not everyone experiences these symptoms. The determining factors probably are how much gas the body produces, how many fatty acids the body absorbs, and a person’s sensitivity to gas in the large intestine.
An occasional belch during or after meals is normal and releases gas when the stomach is full of food. However, people who belch frequently may be swallowing too much air and releasing it before the air enters the stomach.
Sometimes a person with chronic belching may have an upper GI disorder, such as peptic ulcer disease, gastroesophageal reflux disease (GERD), or gastroparesis.
Occasionally, some people believe that swallowing air and releasing it will relieve the discomfort of these disorders, and this person may intentionally or unintentionally develop a habit of belching to relieve discomfort.
Gas-bloat syndrome may occur after fundoplication surgery to correct GERD. The surgery creates a one-way valve between the esophagus and stomach that allows food and gas to enter the stomach but often prevents normal belching and the ability to vomit. It occurs in about 10 percent of people who have this surgery but may improve with time.
Another common complaint is passage of too much gas through the rectum (flatulence). However, most people do not realize that passing gas 14 to 23 times a day is normal. Too much gas may be the result of carbohydrate malabsorption.
Many people believe that too much gas causes abdominal bloating. However, people who complain of bloating from gas often have normal amounts and distribution of gas. They actually may be unusually aware of gas in the digestive tract.
Doctors believe that bloating is usually the result of an intestinal disorder, such as irritable bowel syndrome (IBS). The cause of IBS is unknown, but may involve abnormal movements and contractions of intestinal muscles and increased pain sensitivity in the intestine. These disorders may give a sensation of bloating because of increased sensitivity to gas.
Any disease that causes intestinal inflammation or obstruction, such as Crohn’s disease or colon cancer, may also cause abdominal bloating. In addition, people who have had many operations, adhesions (scar tissue), or internal hernias may experience bloating or pain. Finally, eating a lot of fatty food can delay stomach emptying and cause bloating and discomfort, but not necessarily too much gas.
Abdominal Pain and Discomfort
Some people have pain when gas is present in the intestine. When pain is on the left side of the colon, it can be confused with heart disease. When the pain is on the right side of the colon, it may mimic gallstones or appendicitis.
What diagnostic tests are used?
Because gas symptoms may be caused by a serious disorder, those causes should be ruled out. The doctor usually begins with a review of dietary habits and symptoms. The doctor may ask the patient to keep a diary of foods and beverages consumed for a specific time period.
If lactase deficiency is the suspected cause of gas, the doctor may suggest avoiding milk products for a period of time. A blood or breath test may be used to diagnose lactose intolerance.
In addition, to determine if someone produces too much gas in the colon or is unusually sensitive to the passage of normal gas volumes, the doctor may ask patients to count the number of times they pass gas during the day and include this information in a diary.
Careful review of diet and the amount of gas passed may help relate specific foods to symptoms and determine the severity of the problem.
Because the symptoms that people may have are so variable, the physician may order other types of diagnostic tests in addition to a physical exam, depending on the patient’s symptoms and other factors.
How is gas treated?
Experience has shown that the most common ways to reduce the discomfort of gas are changing diet, taking medicines, and reducing the amount of air swallowed.
Doctors may tell people to eat fewer foods that cause gas. However, for some people this may mean cutting out healthy foods, such as fruits and vegetables, whole grains, and milk products.
Doctors may also suggest limiting high-fat foods to reduce bloating and discomfort. This helps the stomach empty faster, allowing gases to move into the small intestine.
Unfortunately, the amount of gas caused by certain foods varies from person to person. Effective dietary changes depend on learning through trial and error how much of the offending foods one can handle.
Many nonprescription, over-the-counter medicines are available to help reduce symptoms, including antacids with simethicone. Digestive enzymes, such as lactase supplements, actually help digest carbohydrates and may allow people to eat foods that normally cause gas.
Antacids, such as Mylanta II, Maalox II, and Di-Gel, contain simethicone, a foaming agent that joins gas bubbles in the stomach so that gas is more easily belched away. However, these medicines have no effect on intestinal gas. Dosage varies depending on the form of medication and the patient’s age.
Activated charcoal tablets (Charcocaps) may provide relief from gas in the colon. Studies have shown that when these tablets are taken before and after a meal, intestinal gas is greatly reduced. The usual dose is 2 to 4 tablets taken just before eating and 1 hour after meals.
The enzyme lactase, which aids with lactose digestion, is available in liquid and tablet form without a prescription (Lactaid, Lactrase, and Dairy Ease). Adding a few drops of liquid lactase to milk before drinking it or chewing lactase tablets just before eating helps digest foods that contain lactose. Also, lactose-reduced milk and other products are available at many grocery stores (Lactaid and Dairy Ease).
Beano, a newer over-the-counter digestive aid, contains the sugar-digesting enzyme that the body lacks to digest the sugar in beans and many vegetables. The enzyme comes in liquid form. Three to 10 drops are added per serving just before eating to break down the gas-producing sugars. Beano has no effect on gas caused by lactose or fiber.
Doctors may prescribe medicines to help reduce symptoms, especially for people with a disorder such as IBS.
Reducing Swallowed Air
For those who have chronic belching, doctors may suggest ways to reduce the amount of air swallowed. Recommendations are to avoid chewing gum and to avoid eating hard candy. Eating at a slow pace and checking with a dentist to make sure dentures fit properly should also help.
Although gas may be uncomfortable and embarrassing, it is not life-threatening. Understanding causes, ways to reduce symptoms and treatment will help most people find some relief.
Points to remember
- Everyone has gas in the digestive tract.
- People often believe normal passage of gas to be excessive.
- Gas comes from two main sources: swallowed air and normal breakdown of certain foods by harmless bacteria naturally present in the large intestine.
- Many foods with carbohydrates can cause gas. Fats and proteins cause little gas.
- Foods that may cause gas include
- vegetables, such as broccoli, cabbage, brussels sprouts, onions, artichokes, and asparagus
- fruits, such as pears, apples, and peaches
- whole grains, such as whole wheat and bran
- soft drinks and fruit drinks
- milk and milk products, such as cheese and ice cream, and packaged foods prepared with lactose, such as bread, cereal, and salad dressing
- foods containing sorbitol, such as dietetic foods and sugarfree candies and gums
- The most common symptoms of gas are belching, flatulence, bloating, and abdominal pain. However, some of these symptoms are often caused by an intestinal disorder, such as irritable bowel syndrome, rather than too much gas.
- The most common ways to reduce the discomfort of gas are changing diet, taking nonprescription medicines, and reducing the amount of air swallowed.
- Digestive enzymes, such as lactase supplements, actually help digest carbohydrates and may allow people to eat foods that normally cause gas.
For More Information
To learn more about this topic, visit:
Belching, Bloating, and Flatulence – American College of Gastroenterology
Intestinal gas is a topic that people often find difficult to discuss, but we all have gas in our intestinal tract. Gas can contribute to a sense of bloating (fullness), belching, abdominal cramps, and flatulence (gas). These symptoms are usually brief and resolve once gas is released by belching or flatulence. Some people can be more sensitive to even normal amounts of gas and develop the above symptoms.
Belching is a normal process and results from swallowed air accumulating in the stomach. The air can either be belched back or can be passed out of the stomach into the small intestine and be subsequently passed as rectal gas (flatus).
Bloating refers to a sense of fullness in the upper abdomen. This can be influenced by gas and/or food accumulation in the stomach. Some patients experience the symptom with normal amounts of gastric gas.
Flatulence refers to the passage of rectal gas. The gas is generally a combination of swallowed air and gas produced by the action of colon bacteria on undigested carbohydrates.
Gas which accumulates in the right upper portion of the colon can lead to pain which could seem like gallbladder pain. Gas which accumulates in the left upper portion of the colon can radiate up to the chest and seem like cardiac pain.
We all swallow air during the process of eating. Individuals can have excess swallowing due to sucking on hard candies or chewing gum. Drinking carbonated beverages such as soda or beer can also generate excess gastric air. In addition, individuals who experience anxiety may swallow air excessively. Poorly fitting dentures and chronic postnasal “drip” can also cause excess air swallowing. As a result, significant amounts of gas can enter the stomach and small bowel in 24 hours which can lead to belching, bloating or flatulence.
Some carbohydrates cannot be digested by the enzymes in the small intestine and reach the colon where bacteria metabolize them to hydrogen and carbon dioxide gasses. Examples of such food are bran, cabbage, cauliflower, broccoli, and beans. This can result in excess flatulence in some patients. Many patients experience abdominal cramps, bloating and flatulence when they ingest milk, certain cheeses or ice cream because they lack the enzyme (lactase) which is required to digest milk sugars (lactose). This condition, called lactose intolerance, is less common in people of northern European origin.
Another cause of bloating and abdominal distension is termed bacterial overgrowth. This is not an infection, but occurs when there is an excess amount of normal bacteria in the small intestine. This results in increased production of intestinal gas contributing to the above symptoms. Finally, underlying constipation may also contribute to bloating and a sense of abdominal distention.
As mentioned above, excessive air swallowing, and certain foods and carbonated beverages are significant contributors to belching and flatulence. Some patients with Irritable Bowel Syndrome (IBS) appear to be uniquely sensitive to normal or only slightly increased volumes of intestinal gas and may develop abdominal cramps as a result. Patients with altered anatomy due to surgery or those with certain rheumatologic diseases may be at an increased risk of bacterial overgrowth in the small intestine which can lead to belching, bloating or flatulence.
Some patients, particularly women who have had one or more pregnancies, experience abdominal distension when standing erect. This is often assumed to be gas accumulation. However, if the distension is not present when the patient is lying “flat”, then the likely explanation is weak abdominal muscles (which extend from the lower rib cage to the pelvis on both sides of the umbilicus) due to the stretching and loss of muscle tone which occurs during pregnancy.
There are individuals who have heartburn and stomach disorders that may swallow air for relief. The diagnosis of esophageal reflux or gastric inflammation should be excluded by x-rays or endoscopy (examining the esophagus and stomach with a flexible tube while the patient is sedated). Abdominal distension when erect but not when recumbent is an indication of weak abdominal muscles. If lactose intolerance is suspected, milk can be withdrawn from the diet and symptoms observed. However, lactose can be administered orally and the hydrogen gas which is generated in susceptible people can be measured in the breath. Postnasal discharge from sinus problems can cause air swallowing and should be considered. If bacterial overgrowth is suspected, your physician may administer a hydrogen breath test.
Blood tests are not usually helpful for gaseous problems but testing for celiac disease may prove useful since failure to absorb wheat, barley, and rye can lead to excess flatulence.
Patients complaining of excessive gas passages may benefit from keeping a “flatus” diary for three days. The time of each gas passage and food for each meal can be noted. The gas passages can be compared to published “normal” flatus frequency.
Patients should eliminate carbonated beverages such as soda and beer. Foods such as cauliflower, broccoli, cabbage, beans, and bran should be avoided. Milk and other dairy foods should be avoided. Lactaid milk or non-dairy milk such as soy or almond milk can be used. Chewing gum and sucking on hard candies should be avoided. Sugar free gum and hard candies should be avoided as they may have mannitol or sorbitol as sweeteners which can cause flatulence. To ensure that only potentially symptom causing foods are eliminated without resulting in marked dietary restrictions, patients should eliminate food items one by one and keep a symptom diary.
Simethicone products have been promoted as treatment for gaseousness but their efficacy has not been convincing. Charcoal tablets have also been used to reduce flatulence without convincing benefit. Bismuth subsalicylate has been used to reduce the noxious odor of some sulfa-containing rectal gasses. Alpha-d-galactosidase, an over the counter product, has been used to help in the digestion of complex carbohydrates. Some patients may benefit from this strategy.
Individuals with IBS may benefit from symptomatic therapy for “gas pains” by using antispasmodic therapy such as dicyclomine or hyoscyamine under the tongue.
Some patients with bacterial overgrowth may see improvement from the occasional use of antibiotics to reduce the number of bacteria in the small bowel, thereby reducing gas production.
If weak abdominal muscles are suspected as a cause for abdominal distension, abdominal-tensing exercises may be helpful, although very difficult to achieve when patients are middle aged and older.
If symptoms fail to respond to the dietary strategies noted above, medical help should be sought to be confident that no other underlying abnormalities are present.
- Belching and flatulence are normal body processes.
- Swallowed air is “gas” in the body and contributes significantly to symptoms.
- Unabsorbed dietary carbohydrates can cause gas production by colon bacteria.
- Carbonated beverages, sucking on hard candy, and chewing gum should be avoided.
- Abdominal distension when erect but not recumbent may be due to weak abdominal muscles.
- Increasing frequency or severity of symptoms should prompt medical attention.
Author(s) and Publication Date(s)
Ronak Modi, MD, and Harris R. Clearfield, MD, MACG, Drexel University College of Medicine, Philadelphia, PA – Updated July 2013.
Michael Levitt, MD, Veteran Affairs Medical Center, Minneapolis, MN, and Larry Szarka, MD, Mayo Graduate School of Medicine, Rochester, MN – Published June 2004.
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Treatment for Gas in the Digestive Tract
How can I reduce or prevent excess gas?
To reduce or prevent excess gas and gas symptoms, your doctor may suggest the following:
Swallow less air
Your doctor may suggest that you take steps to swallow less air. For example, eat more slowly, avoid gum and hard candies, and don’t use a straw. If you wear dentures, check with your dentist to make sure they fit correctly. Swallowing less air may help ease gas symptoms, especially if you burp a lot.
If you smoke, quit smoking. Your doctor can help you find ways to quit smoking. Studies show that people who get help quitting have a better chance of succeeding.
If you smoke, quit.
Change your diet
To reduce gas, your doctor may suggest you eat smaller, more frequent meals and eat less of the foods that give you gas. Learn more about changing your diet to reduce gas.
Some over-the-counter medicines may reduce gas or gas symptoms:
- Alpha-galactosidase (Beano, Gas-Zyme 3x) contains the enzyme the body lacks to digest sugars in beans, grains, and many vegetables. You can take this enzyme just before eating to break down gas-producing sugars. Doctors recommend the enzyme for adults and for children ages 12 and older.
- Simethicone (Gas-X, Mylanta Gas) can relieve gas-related bloating and pain or discomfort in your abdomen by helping gas pass through your digestive tract. Doctors may recommend simethicone for infants and children.
- Lactase tablets and drops are available for people with lactose intolerance. The lactase enzyme digests the lactose in the food or drink and reduces the chances of developing symptoms such as bloating, gas, or diarrhea. Lactose-free and lactose-reduced milk and milk products are available at most supermarkets and are identical nutritionally to regular milk and milk products. Check with your doctor before using lactase products. Some people, such as children younger than age 3 and pregnant and breastfeeding women, may not be able to take these products.
For safety reasons, talk with your doctor before using supplements or any complementary or alternative medicines or medical practices.
Your doctor may prescribe medicines to help reduce gas or gas symptoms, especially if you have small intestinal bacterial overgrowth or irritable bowel syndrome.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
90,000 correct nutrition and correct products
Bloating is most often a symptom of constipation (scientifically speaking, constipation or constipation), that is, it is a symptom of slowed intestinal transit, which may be associated with a decrease in stool volume and weight, although not necessarily.
The main opponents of a flat stomach and the main causes of flatulence are diet, inadequate fluid intake, inappropriate eating behavior, a sedentary lifestyle, stress, environmental and lifestyle changes.Enemy foods for a flat stomach are foods that should be avoided for constipation and bloating.
Enemy products of a flat stomach
- Foods rich in carbohydrates that cause intestinal fermentation, as well as animal fats.
- Sweets, sweetened and carbonated drinks that irritate the intestinal walls and cause gas.
- Sausages and fatty meats, which not only contribute to constipation, but are also enemies of intestinal well-being and overall health.
- Fried food – it is poorly absorbed by the stomach and irritates the intestines, causes congestion and slows down the entire process of digestion.
- Bakery products and pastries made from premium white wheat flour.
- Alcohol, which not only irritates the intestinal walls, but also causes digestive disorders, preventing the proper absorption of nutrients, vitamins and mineral salts, which are beneficial for maintaining the perfect functioning of the body.
But you cannot limit yourself to just excluding a flat stomach from the diet of these enemies.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 brisk walking or cycling, will have a great effect on the whole body.
Experts recommend that you devote at least 3 hours a week to physical activity (about half an hour a day).
Drinking plenty of fluids (not sweet) facilitates bowel movement by 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 a meal (preferably after breakfast in the morning or after lunch), i.e. when bowel movements are more likely due to increased bowel contractions caused by filling of the stomach (gastrocolic reflex).
What is constipation?
The term constipation / constipation comes from the Greek word styphein (narrow) and indicates difficulty in emptying the bowels.This definition includes a number of symptoms currently grouped under the more precise definition of Obstructive Defecation Syndrome (ODS), such as excessive effort to defecate, a feeling of incomplete bowel movement, bloating, overuse 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 a more regular bowel movement than women – usually once a day.
- In women, it is considered normal if the bowel is empty 2-3 times a week. As a rule, stools come out without effort or discomfort and without undue stress on the abdomen
If bowel movements do not occur for more than three days, constipation is diagnosed. The urge to evacuate should increase as the rectum fills with feces.
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 slowed down (true constipation). However, if a person feels the urge, but cannot defecate, or there is a partial / incomplete bowel movement, this means that his rectum is filled with feces, but something is preventing proper emptying (constipation due to difficult bowel movements)
In addition to bloating, constipation can cause complications such as hemorrhoids or cracks.
Diet for bloating and constipation
Diet is undoubtedly an important factor influencing bowel function, bloating, and, consequently, the possibility of constipation.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 (that is, 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 stool through the intestinal tract to its very final part, that is, the rectum, and, finally, ejection.
Research in this area has found that a high-fiber diet leads to an increase in stool mass, which in turn increases the frequency of bowel movements. This means that minimal changes in diet (but also in lifestyle) can help resolve constipation without going to a doctor or taking medication.
Consuming 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 does not apply if the person is suffering from irritable bowel syndrome (diarrhea), an intestinal disorder that can be aggravated by a diet rich in fiber that tends to ferment.
Reduce Bloating: Cooked or Raw Vegetables?
Foods that can help empty your bowels, reduce bloating and create a flatter stomach include vegetables that can be eaten boiled or raw, depending on your preference.
Among vegetables, spinach, broccoli, green beans, steamed and sautéed zucchini and artichokes are the most suitable. Alternative methods for cooking vegetables and retaining moisture are purees or soups.
Say yes to grains such as bran, wheat, and legumes. These foods are rich in insoluble fiber to facilitate intestinal transit.
Among fruits, give preference to kiwi (it is better to eat in the morning on an empty stomach), pears, plums, figs and apricots.The edible peel is better consumed than peeled off. Fruit can help even when cooked.
Adding extra virgin olive oil to the dish helps the stool stay soft even during prolonged transit through the intestines, facilitating its natural emptying.
Consume yogurt or fermented milk products.
Lactobacilli play an important role in maintaining intestinal functions and can also be introduced into the diet with the help of drugs and dietary supplements – for example, Lactoflorene Flat stomach.
Foods that should be treated in moderation include those defined as astringents because they contain substances that are not absorbed and cause relaxation of the colon walls. This disrupts the normal intestinal motility necessary for the movement of the masses to the rectum. This food category 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 colon muscles slow down the passage of feces inside the intestines, which also leads to an increase in water reabsorption, which, in turn, causes increasingly hard stools and, as a result, constipation.
Many people suffer from constipation while traveling. This is due to changes in daily routine, diet, type of water, and difficulty finding the right toilet.
In this case, constipation is due to hormonal changes.
Cracks and hemorrhoids
In such situations, pain occurs in the anal canal and spasm of the anal sphincter occurs, which can interfere with defecation.
Many medicines cause constipation. In particular, opioid analgesics, antacids containing aluminum or calcium, antispasmodics, antidepressants, tranquilizers, iron, anticonvulsants for epilepsy, antiparkinsonian medications, heart medications, or calcium channel blockers from pressure.
Colon motility disorders
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 exit.
Pelvic floor dysfunction
In these cases, the muscles responsible for defecation (pelvic floor muscles) are not working properly. They do not relax enough to allow stool to escape. In other cases, they may not be compressed enough to move the stool through the large intestine.
People who usually take large amounts of stimulant laxatives become dependent on them and may need to gradually increase the dose until the intestines become numb and stop working altogether.
Constipation can cause abnormalities in the thyroid gland.
Scleroderma, lupus, multiple sclerosis, Parkinson’s disease and stroke can cause constipation.
Loss of salts by the body
Dehydration with loss of salts, such as vomiting or diarrhea, can cause subsequent constipation.
Postoperative cicatricial stenosis, chronic inflammation of diverticula, tumors and cancer can cause intestinal compression and, consequently, constipation.
Injury or swelling of the spine can cause constipation due to damage to the nerves that control the muscles responsible for defecation.
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90,000 Top 7 Gas and Bloating Foods
The release of gases in a healthy person occurs on average 5-15 times a day. But it happens that the number of such episodes increases or the gases acquire a pungent unpleasant odor.
During social distancing and wearing medical masks, this may not be as noticeable, but it still causes discomfort to many people, especially if accompanied by bloating and painful sensations.
Excessive gassing is most often associated with food.
Knowledge of products that cause such an effect helps to correct the situation. When undigested particles of some of them enter the intestines, bacteria try to break them down and release gases in the process.When the gas accumulates, it is released.
Foods high in dietary fiber, such as vegetables and legumes, feed good gut bacteria. In turn, these microorganisms process fibers into useful substances – vitamins and butyric acid. However, some bacteria release gases as a side effect.
Gastrointestinal diseases and some conditions can also be the cause of increased gas production. Among them are lactose and gluten intolerance, irritable bowel syndrome (IBS).
This article is published for educational and informational purposes only, and should not be used for diagnosis or treatment, or to replace professional advice.
Photo by Shelley Pauls / Unsplash
Beans, lentils, chickpeas, peas and other legumes contain galactooligosaccharides (GOS) and fructans, dietary fiber that the human body cannot break down on its own. But the intestinal bacteria do an excellent job with this task and are very fond of these products, but in the process of their splitting they release gases.
People with irritable bowel syndrome (IBS) are more susceptible to gas discomfort, so some nutritionists recommend a diet low in GOS and fructans, including legumes.
If legumes are scarce in your diet, introduce them gradually. For starters, you can add some lentils or a few beans to a salad, or spread some hummus on a sandwich. This way you can avoid excessive gassing.
Photo by Christophe Dion / Unsplash
Cruciferous vegetables like broccoli and cauliflower are common foods that are associated with bloating and gas. During cooking and chewing, these plants release glucosinolates, sulfur-containing organic compounds.
Studies show that many bacteria in the intestine convert glucosinolates into sulfates and ferrous ions during the fermentation process. In the future, these substances can turn into hydrogen sulfide, due to which the gases acquire an unpleasant odor.
On the one hand, glucosinolates feed probiotic bacteria that naturally inhabit the human intestine. These bacteria include Lactobacillus and Bifidobacterium. On the other hand, gut with too many sulfate-reducing bacteria like Desulfovibrio can increase the production of hydrogen sulfide, which causes a particularly unpleasant odor.
With the Atlas Microbiota Test, you can find out if there are too many bacteria Desulfovibrio that are responsible for the production of hydrogen sulfide living in your gut.
Milk and dairy products
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With lactose intolerance, milk and dairy products produce gas and an unpleasant odor. Lactose is a sugar found in milk, and the enzyme lactase is responsible for its breakdown.
When the body does not produce enough lactase, dairy products can cause diarrhea, abdominal pain, and severe flatulence within 30 minutes to two hours after consumption.
Flatulence – bloating due to the accumulation of gas.
Probiotic intestinal bacteria like Lactobacillus are able to process and absorb lactose. Their high content in the microbiota can reduce the symptoms of intolerance, especially in people who have a lot of galactooligosaccharides (GOS) in their diets.
Photo by Angelo Pantazis / Unsplash
Wheat, barley, rye and their products contain gluten. It is a protein that causes gas to build up in people with celiac disease, a gluten intolerance.Gluten ingestion of a person with celiac disease causes an autoimmune reaction, which is accompanied by bloating and abdominal pain, as well as diarrhea.
The only way to reduce the immune system’s response to foods with gluten is to eliminate them from your diet. But despite the popularity of gluten-free diets, you should be very careful with them. Symptoms of celiac disease are similar to symptoms of other diseases and inflammations of the gastrointestinal tract, therefore, whole food groups can be excluded from the diet only as directed by a doctor and under his supervision.
Avoiding grains can lead to nutrient deficiencies and microbiota imbalances. And this can even exacerbate the problem of increased gassing. Always check with your doctor or dietitian before making major changes to your diet.
Genetic Test Atlas will help you find out if you have a predisposition to lactose and gluten intolerance.
High protein diets
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High protein diets such as keto and meat diets are dominated by beef, eggs, pork, fish and poultry.These foods contain a lot of sulfur, which, as a result of fermentation by bacteria, turns into hydrogen sulfide.
Protein Supplements – Protein powders and bars may also contain ingredients that cause excessive gas and bloating. For example, many protein shakes are made with whey from milk – in people with lactose intolerance, this can cause an unpleasant gastrointestinal reaction.
Protein bars and shakes also typically contain low-calorie sweeteners such as sorbitol, mannitol, lactitol, xylitol, and food additives that cause flatulence.Also, many protein bars use inulin as a fiber source, which ferments the bacteria in a lot of gases.
Products containing inulin
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Inulin, an indigestible plant fiber, is one of the favorite treats of good gut bacteria. But, as we wrote earlier, the joy of bacteria is often accompanied by the release of a large number of gases.
Inulin is a prebiotic that increases the abundance of good bacteria like Lactobacillus and Bifidobacteria.Gut bacteria then convert it into butyrate, a fatty acid that maintains the health of the intestinal mucosa.
Inulin improves the absorption of magnesium and calcium, trace elements that support bone health, nerve and muscle function.
Research shows that it also lowers blood sugar and helps control appetite. However, when inulin is fermented, microorganisms also release gases, which can cause bloating and cramping, especially if you eat too much of this fiber.According to research, the daily intake of inulin for healthy people is 10 grams.
Abrupt addition of large amounts of fiber, including inulin, is likely to cause bloating and gas. Therefore, any dietary fiber should be introduced into the diet gradually, and over time, the side effects in the form of bloating and gas will decrease.
Products containing inulin:
|Product (100 g)||Inulin content (g)|
Remember to drink fiber with plenty of water to avoid constipation.
Photo by Glen Carrie / Unsplash
Many processed foods, especially low calorie and low carbohydrate foods, can cause bloating and gassing if they contain vegetable polyols:
|sorbitol||chewing gums, some sweets, desserts, ice cream, diabetic products|
|lactitol||bakery products, chocolate, confectionery, desserts, chewing gum|
|mannitol||sweets, jams and jellies, puddings and powdered beverage mixes, chewing gum|
|xylitol||chewable multivitamins, lozenges, sugar-free gum and certain pharmaceuticals (cough syrups)|
Polyols are sugar alcohols that cannot be absorbed by the human body.Instead, they are fermented by bacteria in the large intestine, releasing gases in the process.
If from time to time you experience bloating or increased gas production, there is nothing to worry about and, most likely, this is due to what you ate. However, you should consult your doctor if you experience the following symptoms:
- frequent gas with a strong odor;
- Constant bloating and abdominal pain;
- Recurrent episodes of diarrhea or constipation;
- fecal incontinence;
- blood in the stool;
- fever, nausea, chills, muscle and joint pain.
Microbiota Test The Atlas will help you assess the level of bacterial diversity in your gut and the ability of microorganisms to break down dietary fiber. Low potential for fiber breakdown can be one of the reasons for the increased gas production and bloating when eating fiber-rich foods.
- Dr. David R. Linden, Hydrogen Sulfide Signaling in the Gastrointestinal Tract, 2014
- Umberto Volta et al., Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness, 2013
- NHS, Flatulence
- Nielson T Baxter et al., Dynamics of Human Gut Microbiota and Short-Chain Fatty Acids in Response to Dietary Interventions with Three Fermentable Fibers, 2019
- Charles Coudray et al., Dietary inulin intake and age can significantly affect intestinal absorption of calcium and magnesium in rats: a stable isotope approach, 2005
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- Dr Jaci Barrett & Lyndal McNamara, FODMAP blog, Polyols, 2016
- Harvard Medical School, Relief from intestinal gas, 2013
- Nielson T. Baxter et al., Dynamics of Human Gut Microbiota and Short-Chain Fatty Acids in Response to Dietary Interventions with Three Fermentable Fibers, 2019
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Tactics for correcting gas formation in young children | L.P.
The article is devoted to the possibilities of diagnostics and treatment of gas formation in young children. The possibilities of using various drugs, including simethicone, are being considered.
Functional disorders (FN) of the gastrointestinal tract (GIT) still occupy one of the leading places in the structure of diseases of the digestive system . Anatomical and functional features of the structure of the digestive system in children can lead to increased gas production , which is accompanied by pain, prolonged crying, children become restless.The task of any practicing physician is to identify the cause of this condition, to determine whether it is physiological or a manifestation of any disease. According to statistics, organic causes are found in 10-12% of cases, which indicates the need to first of all exclude the functional causes of disorders.
Causes of increased gas formation
In children of the first year, functional disorders of the gastrointestinal tract include conditions caused by imperfection of the motor (physiological gastroesophageal reflux, violation of gastric motility, dyskinesia of the small and large intestines) and secretory (lack of the amount and activity of digestive enzymes) functions, which can cause symptoms of regurgitation, intestinal colic, flatulence, etc.. Enhanced gas formation can disrupt the work of other internal organs.
Air swallowing by an infant, leading to the development of gastroesophageal reflux, occurs when the baby is not properly attached to the breast, crying, too fast milk flow from the breast, etc. In an adult, air can get from the environment into the stomach, and then into the intestines with food, drinking, talking and even deep breathing. This is the main volume of intestinal gases. Part of the air trapped from the outside comes out with a belch, the remaining gas enters the intestines, reaching the rectum.
Gas in the body is also formed due to the vital activity of bacteria that make up the normal intestinal microflora. In the process of their vital activity, these bacteria emit gases: nitrogen, carbon dioxide, oxygen, hydrogen, methane, ammonia, phenol, skatole, indole and some other gases in small volumes, including toxic gases. Depending on the ratio of gases in the intestine, the smell of the released intestinal gas also changes. Gases in the intestines are not in the form of air cavities, but in the form of small bubbles in the mucus.
The removal of gases from the intestine occurs in several ways: through the rectum, by absorption into the blood and then excretion during breathing through the lungs, and also through the esophagus in the form of regurgitation of air. Gases are partially consumed by some bacteria that make up the intestinal microflora – for them gases are a nutrient medium.
Thus, excessive accumulation of gases in the intestines is noted during food intake, excessive work of bacteria that produce gas, due to fermentation and putrefaction, during which a large number of various gases are released in the intestine.
When complex carbohydrates (polysaccharides – fiber, cellulose, starch) are digested, fermentation occurs in the colon, and when proteins (amino acids) are broken down, putrefaction. These processes are physiological. It is the consumption of a sufficient amount of complex carbohydrates and the fermentation process that contribute to the formation of a sufficient mass of feces and stimulation of intestinal motility. Fermentation and putrefaction are interrelated physiological processes.
So, during fermentation, acids and simple carbohydrates are released, on which the vital activity of putrefactive bacteria depends, and a balance is maintained between these processes.If the nutrition is correct and balanced, then the decay processes are moderately expressed, as a result of exposure to gastric and pancreatic juice, bile, the vital activity of certain types of bacteria. In case of malnutrition and digestion, protein and carbohydrate food in the small intestine is not completely digested (there are not enough enzymes and intestinal juice), but stagnates, ferments and decays. As a result of such phenomena, nutrients undigested in the small intestine are broken down, and feces are formed.
Possible causes of excessive fermentation and putrefaction in the intestines can be malnutrition, especially overeating, deficiency of digestive enzymes in children of the first year of life, or diseases of the stomach, liver, pancreas, intestinal motility disorders, imbalance of intestinal microflora, including in case of intestinal diseases, infections, etc. In the case of intense fermentative and putrefactive processes, an excess amount of intestinal gases is produced. There are many reasons for increased gas production, and this process can be associated with all stages of digestion, starting with food intake (Fig.one).
Food products that lead to increased gas production, as well as the amount of food consumed, can aggravate the violation of physiological processes in the body. It is known that the use of the following products leads to increased gas formation: all varieties of cabbage (white cabbage, red cabbage, broccoli, Brussels sprouts, colored), all types of legumes (peas, beans, soybeans, lentils, beans), rutabagas, raw onions, turnips, artichokes, milk and dairy products, including fermented milk.To a lesser extent, the use of carbonated drinks, apples, pears, bananas, peaches, watermelons, carrots, raisins, celery, bread, mushrooms, whole grains, wheat, bran, starchy foods (pasta, fresh bread, potatoes, corn) leads to increased gas production , since excess starch is difficult to digest. Once in the large intestine, unbroken starch swells, and excess gas is formed with the help of bacteria.
Despite the fact that there are many products on this list, they should not be discarded, because.because they are all necessary for our body, contain essential nutrients, vitamins, minerals and trace elements, amino acids. These foods must be properly combined and processed. So, for example, all fried, pickled and smoked dishes, regardless of their usefulness, will increase the amount of gases, and boiled, steamed and baked ones will contribute to increased gas formation to a lesser extent. Eating fresh fruits and vegetables stimulates the formation of a large amount of gas, but this phenomenon persists for the first 3-4 days, then fresh vegetables and fruits are well tolerated and do not contribute to increased gas production.The time of eating certain foods also affects the process of gas formation – most foods that lead to increased gas formation are best consumed in the morning. Physical activity plays an important role, which improves intestinal motility and helps to remove gases from the intestines.
Clinical picture of increased gas production
With normal intestinal motility, gases are excreted without hindrance, even with their increased formation. With excessive gas formation, abdominal pain and / or intestinal colic occur, which are paroxysmal and even cutting in nature.This symptom is associated with stretching of the intestinal loops with excessive volumes of gas. The pain is relieved by the removal of gases from the intestines. Intestinal colic is more common in children of the first year of life.
It is worth separating two concepts – bloating and increased gas production. Bloating is a feeling of heaviness, a feeling of fullness in the abdomen, the abdomen may increase in size, but the amount of gas may be normal. Bloating occurs when gas accumulates in the intestines due to a violation of their excretion.Increased gas production is not always accompanied by bloating if the elimination of gases occurs unhindered through the rectum.
Gas and diarrhea or constipation are mostly symptoms that appear in parallel and have common causes. According to the classification of Rome IV criteria (2016), they refer to functional disorders of the interaction of the gastrointestinal tract and the central nervous system (Table 1). For the first time, the Rome IV criteria officially approved the term “syndrome of functional disorders overlap” – a synchronous course of several functional states or a transition from one to another .
During bowel movements, both diarrhea and constipation produce a large amount of gas, which leads to relief of the condition and elimination of symptoms of bloating and intestinal colic.
Unfortunately, patients do not always go to a doctor – mainly when physiological problems are transformed into organic ones due to a long course. Many parents are of the opinion that a child should always have colic and do not require correction. The task of the doctor at the reception is, first of all, to determine the presence of a problem, to conduct a diagnostic search for its causes.Thorough questioning allows you to identify problems such as violation of the rules of attachment to the breast, the mother’s diet, the rules and timing of the introduction of complementary foods. By addressing these problems, the doctor will reduce the risk of developing other chronic disorders.
Diagnostics and methods of correction of increased gas production
As already noted, the most common causes of increased gas production in the intestines are unhealthy diet, impaired intestinal motility in young children and a sedentary lifestyle in both children and adults.Consequently, it is possible to get rid of a large amount of gas by normalizing the regimen and diet of a nursing mother, correcting the technique of attachment and breastfeeding, adhering to the rules of complementary feeding, increasing the child’s physical activity (if necessary, give him a massage of the abdomen and gymnastics).
But if, after the correction of nutrition and physical activity, increased gas production, intestinal colic and / or there are other symptoms of disturbance from the digestive system, then it is necessary to continue the diagnostic search.In this case, gas formation may be just one of the symptoms of more serious pathologies. An additional thorough examination will help establish the true cause of the excess gas production.
As an initial diagnostic minimum of examinations, it is necessary to conduct a thorough examination with an assessment of the child’s anthropometric indicators and their age-appropriateness; laboratory examinations: general blood and urine analysis, coprogram, if necessary – sowing feces for intestinal flora; ultrasound examination of the abdominal organs, kidneys and urinary tract (to exclude pathology).Important diagnostic tests are a biochemical blood test, liver tests. In the presence of indications, it is necessary to carry out fibroesophagogastroduodenoscopy, sigmoidoscopy and colonoscopy, etc., radiography, computed tomography and magnetic resonance imaging. If necessary, use other research methods [5, 6].
Depending on the research results obtained, the doctor prescribes appropriate treatment.
enzyme deficiency (according to the coprogram) – corresponding enzyme preparations;
intestinal dysbiosis – pre- and probiotics;
intestinal infections – etiotropic drugs taking into account sensitivity, intestinal antiseptics, bacteriophages;
helminthic invasions – anthelmintic drugs;
liver diseases – phospholipids, hepatoprotectors, antioxidants;
colitis – antispasmodics, anti-inflammatory drugs;
disturbances of peristalsis associated with neurological disorders, appropriate drugs are prescribed by a neurologist.
After determining the diagnosis and prescribing adequate therapy for the underlying disease, subject to an appropriate diet, the problem of gas formation is gradually stopped.
Simultaneously with the diagnostic search, it is necessary to carry out symptomatic therapy, which the doctor prescribes at the stage of diet correction.
Symptomatic drugs for the treatment of increased gas production
Enterosorbents – preparations of this group absorb toxins and gases, safely remove them from the intestines.However, the side effects of these drugs do not allow their use for a long time: when used for more than 2 weeks. there is a violation of the absorption of trace elements, vitamins, hormones and nutrients. Concomitant use with other drugs reduces their effectiveness.
Antacids help to remove toxins, gases and microorganisms throughout the digestive tract, normalize the passage of contents through the intestines. However, when using them, the risk of constipation is high.
Defoamers , in particular simethicone , is the preparation Bobotic (Medana Pharma, Poland). Simethicone does not cause malabsorption of nutrients, vitamins, trace elements and drugs, does not lead to constipation and / or diarrhea. The drug has surface-active properties, being an antifoam agent: it reduces the surface tension of gas bubbles (defoaming activity) in the gastrointestinal tract, leading to their rupture; The gases released during the disintegration of bubbles are absorbed by the intestinal walls or excreted due to peristalsis, reduces the content of gases in the intestine.Simethicone is chemically inert, not absorbed from the gastrointestinal tract, does not affect the motor-evacuation function of the stomach and intestines, which allows it to be excreted unchanged . The drug is used in the presence of symptoms of increased gas formation, by mouth, after meals. Bobotik is recommended for children from 28 days of age to 2 years, 8 drops (20 mg of simethicone) 4 times a day, from 2 to 6 years – 14 drops each (35 mg of simethicone) 4 times a day, children over 6 years old and adults – 16 drops (40 mg of simethicone) 4 r. / Day. After the disappearance of symptoms, the drug should be discontinued .
In addition, taking into account the chemical characteristics of simethicone, such as inertness, uniform distribution over the intestinal mucosa, the drug is used before esophagogastroduodenoscopy, colonoscopy as a preparatory agent, and also in combination with contrast agents for uniform distribution throughout the intestine. It was noted that the drug does not have a negative effect on expensive endoscopic equipment .
Also, for spasms (intestinal colic), antispasmodics are used.The drugs act on the nerve receptors of the intestinal wall, relieve spasm, and facilitate the removal of gases through the rectum. Their long-term use is possible.
In cases of motility disorders, drugs that enhance intestinal motility are used. They act on the central nervous system and block dopamine receptors in the intestine, increasing peristalsis. Due to this, the removal of excess gases from the intestines is accelerated, eliminating the symptoms of increased gas formation. The drugs are best used 15-30 minutes before meals.
The remaining groups of drugs are prescribed by a doctor based on research results.
Sometimes diseases are detected that do not allow to eliminate the cause of increased gas production, for example, intestinal abnormalities, genetic diseases. It is also difficult to get rid of excess gas in young children and the elderly. With genetic syndromes associated with enzyme deficiency (celiac disease, phenylketonuria, lactase deficiency, etc.), a complete rejection of foods that are not absorbed in the intestine is necessary.In such cases, in addition to diet, regular symptomatic treatment of flatulence will help.
Thus, in pediatric practice, in the presence of symptoms of increased gas production, bloating, intestinal colic during the diagnostic search and at the first stage of treatment, one of the primary remedies will be the drug Bobotik, which acts on the gas bubbles in the intestinal mucus, facilitating their removal from the intestine through the rectum. reducing the incidence of intestinal colic.
Espumisan – get rid of flatulence!
One of the universal laws of nature says that “nothing arises out of nowhere and disappears into nowhere”, and is applicable even to the processes of life of the human body. Judge for yourself: first food, and then, excuse me, gases. At the same time, we are ready to talk about food almost endlessly, discussing its preparation and taste. About the same, with which the digestion process ends in the end, we are bashfully silent. Of course, until the results begin to “declare” themselves …
Want to talk about this?
Gas formation in the intestine is not only very common, but also a completely normal physiological phenomenon, the same as breathing or sweating, and is observed not only in humans, but also in many other mammals.
Thanks to one of the studies in which 11 Americans participated, it was possible to record how and in which parts of the intestine the formation of gas occurs. So, in the process of fermentation in the right (ascending) section of the large intestine, hydrogen and carbon dioxide are formed, and in the process of decay in the left (descending) section, hydrogen sulfide and methane “mature”. The role in the formation of the latter was relatively recently established for the bacterium Methanobrevibacter smithii , which lives in our intestines.Its main task is the absorption of hydrogen, an increase in the concentration of which in the intestine reduces the efficiency of microbial fermentation, and conversion into methane. Further, all these gases are mixed with nitrogen and oxygen, which are part of the air that enters our stomach (and then into the intestines) during the meal.
Thus, during the absorption and digestion of an average dinner, about 15 liters of gases are formed. However, only a small part of them directly goes “free” – a greater amount of gases still penetrates through the intestinal walls into the blood, after which they are released with exhaled air through the lungs.
The frequency of discharge of gases, as well as their composition, are individual. In many flatulence (this is how the release of intestinal gases is called) occurs only a couple of times a day, in others – up to several dozen; however, the average frequency is up to 15 times a day. The volume of intestinal gases is no less individual – it ranges from 0.1 to 2.1 liters per day.
If the distribution of gases in the intestine occurs evenly, their pressure is so insignificant that flatulence occurs completely silently.However, even a slight skew in the distribution of gases (for example, eating foods rich in polysaccharides – beans, lentils, dairy products, onions and garlic, radishes, cashews, cabbage, etc.) in the intestines leads to pressure, under the influence of which they come out with a sharp sound (the so-called sphincter resonance).
For many years, it was also believed that the unpleasant odor of flue gases is provided by skatole and indole, formed as a result of the decomposition of protein products.However, a study in 1984 showed that odor was determined by the presence of sulfur-containing compounds such as methanethiol, hydrogen sulfide and dimethyl sulfide.
Joking aside, or Let’s Talk About Serious
It is likely that the problem of flatulence for many years would have remained a topic, if not a taboo, then certainly not beyond the scope of indecent humor, if the formation of intestinal gas in most remained quite normal and did not cause the appearance of many disturbing symptoms.However, in recent years, both doctors and pharmacists more and more often, when consulting patients, have to deal with complaints of excessive gas production and accompanying unpleasant symptoms and pain, which significantly reduce the quality of life.
Flatulence – this is the name of a problem about which we are silent until it “talks” about itself or forces us to talk about it. So, often, tormenting us with abdominal pain and bloating, flatulence leads to the doctor’s office or to the pharmacy, forcing us to overcome embarrassment and start a conversation on this awkward topic.But if we are stubborn enough or hardy enough to continue to ignore this problem, she begins to “talk” about herself: loud rumbling and gas emission, and in the most unexpected and inappropriate situations. For example, in the confined space of an elevator full of employees, when in despair you don’t shout “Stop, I’ll get off!”, In the evening silence of a cinema or during a working meeting.
What are the causes of flatulence? There are several of them. For example, and limentary flatulence occurs when drinking carbonated drinks or products that cause fermentation processes (lamb meat, black bread, raisins, kvass), as well as containing polysaccharides (beans, radishes, cabbage).The latter are difficult to digest, which increases the production of gas in the intestines.
Digestive flatulence is a consequence of a violation of the digestive processes due to enzymatic insufficiency (for example, in patients with chronic pancreatitis) or malabsorption, which leads to the formation of a significant amount of undegraded products, which are decomposed by the intestinal microflora with the formation of gases.
Dysbiotic flatulence develops when the composition of the intestinal microflora changes: its excess in the small intestine leads to the splitting of products with the release of a large amount of gases, while in the lower parts of the digestive system, the processes of decay and fermentation are significantly activated, which are also accompanied by increased gas emission.In addition, under normal conditions, a large amount of gases are absorbed by bacteria, however, with dysbiosis, the balance between gas-producing and gas-absorbing microorganisms is disturbed.
Dynamic flatulence occurs as a result of impaired bowel movement. At the same time, there may not be an obvious increase in the amount of gas and a changed gas composition, but its transit through the intestine is slowed down. This option is possible with intestinal paresis in the postoperative period, with intoxication, peritonitis, after vagotomy, as well as with irritable bowel syndrome, accompanied by impaired motility and coordination of the activity of various parts of the intestine.Nervous disorders and emotional overload can also lead to flatulence due to spasm of intestinal smooth muscles and slowing of peristalsis.
As you can see, flatulence is a fairly common symptom in a wide variety of diseases of the digestive tract, therefore it may well indicate the presence of a disease in the patient (which requires appropriate diagnosis) or accompany some other already diagnosed diseases (thus requiring appropriate correction against the background of treatment of the underlying disease).
Diagnostics will help us. And what will help the diagnosis?
However, how to diagnose diseases of the abdominal organs, if the accumulation of a large number of gases, often accompanying them, makes such an effective, affordable, simple and safe method as ultrasound examination (ultrasound) completely uninformative, and the usual preparation of the patient, including an examination on an empty stomach with nutritional restriction (even in the absence of excessive gas formation) does it not always provide satisfactory visualization?
Actually, the same applies to such a method of examination as endoscopy – a foamy secret obtained as a result of gas formation in the intestine and its interaction with mucus, creates conditions under which it sometimes becomes simply impossible to conduct an endoscopic examination.Attempts to remove such a secret (for example, by suction or “blowing”) often takes a lot of time and does not allow to achieve complete removal of foam, and often leads to the opposite result – in response to the introduction of air into the intestinal lumen, the amount of foam increases, which practically nullifies all previous efforts.
Obviously, in all these cases, a means or method of preparation is needed that would allow the maximum evacuation of gases, but at the same time were convenient and safe.Fortunately, in the arsenal of endoscopists today there is a tool that meets these requirements and allows you to effectively and quickly get rid of the foamy secretion, which means that you can get clear visualization. On the other hand, such a drug is completely safe, since it is not able to penetrate into the bloodstream, which means it has a systemic effect or cause side effects, somehow affect the digestion or absorption of drugs.
Many, perhaps, have already understood that we are talking about an antifoam agent simethicone, which is known on the Ukrainian pharmaceutical market under the trade name ESPUMIZAN ® thanks to the Berlin-Chemie company.As a surfactant, simethicone reduces the surface tension of small gas bubbles in the foam. This leads to the fact that small air bubbles, dissolved in the mucus and forming a foam, burst and merge into larger ones. Thus, the foam, as it were, settles, and the formed free gas is able to evacuate along with the intestinal contents in a natural way.
How effective is this method of preparing for a diagnostic examination? Numerous studies of both foreign and domestic specialists (including meta-analyzes and reviews) indicate its high efficiency in preparing patients for ultrasound or endoscopic examinations (Shcherbakov P.L. et al., 2007; Ahsan M. et al., 2011; Wu L. et al., 2011).
So, for example, in a comparative study of the quality of visualization of the pancreas, gallbladder and liver parenchyma, common bile duct and portal vein using activated charcoal and ESPUMISAN, the quality of diagnosis was comparatively better in the group using the latter. For example, against the background of the use of simethicone, the number of cases with good quality visualization of the gallbladder increased to 47–64% (Mitkov V.IN 2007).
We have already mentioned above that flatulence can accompany certain diseases. One of them, for example, chronic pancreatitis . It is natural that enzymatic deficiency is the cause of flatulence: particles of unsplit products, passing through the intestines, under the influence of the intestinal flora undergo decomposition with the formation of gaseous products, which eventually accumulate in the intestines and lead to the development of the already mentioned symptoms.That is why, along with substitution therapy, patients with chronic pancreatitis should also be treated with flatulence, which ESPUMISAN ® also allows to cope with.
So, in a study conducted at the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine, with the participation of patients with residual symptoms after full treatment of pancreatitis, manifested in the form of flatulence, the planned appointment of this drug made it possible to stop the accumulation of gas and bloating in 97.5% of cases, rumbling in the abdomen – in 96% of the subjects (Gladkova R.M. et al., 2005).
The results of another study, also conducted with the participation of patients with chronic pancreatitis, demonstrated that ESPUMISAN ® not only helps to cope with accumulated gases, but also helps to normalize cavity and parietal digestion. At the same time, the researchers note that the drug is not absorbed in the digestive tract, is excreted unchanged, does not affect the biochemical processes of digestion, which allowed them ultimately to recommend ESPUMIZAN ® for long-term therapy (Poluektova E.A., 2009).
However, even if after the diagnostics we did not reveal any diseases of the digestive system, this is not at all a reason to ignore flatulence. Moreover, even flatulence itself is quite painful for the patient, since the accumulating gases lead to bloating or bouts of cramping pain like colic. It is also often accompanied by dyspeptic disorders: nausea, belching, loss of appetite, constipation or diarrhea, bad breath and rumbling in the abdomen, as well as urge to defecate, which simply cannot be contained, and uncontrolled release of gas.
Agree that with such a “set” it is difficult to lead any active lifestyle, implying a full working day, including the need to move by public transport, be 8 hours in a row at the workplace among colleagues, travel on business trips, attend many hours of meetings or attend negotiations. Not to mention free time and personal life – after all, at home, with your family, you want to relax in every sense. However, the results of such relaxation are unlikely to be perceived with understanding by others …
What then turns out – to endure at work and at home, and during breaks specially go out to the open balcony? Or rely on the patience of loved ones and hope that the expression “they were blown away like the wind” is not about you?
ESPUMISAN ® allows you to live fully and relax when you want, without consequences for relationships in the family and team, while not becoming an object for ridicule and the owner of the nickname “Thunder in Pants”.Effective and safe.
Why effective? We talked about this in detail a little higher. Why is it safe? Because it is inert and is not fermented by microorganisms, is not absorbed in the digestive tract and is excreted unchanged, and also does not enter the systemic circulation and does not cause side reactions.
In addition, ESPUMIZAN ® , unlike enterosorbents, does not absorb food components and drugs, does not affect the biochemical processes of digestion and absorption: it does not in any way affect the metabolism of proteins, fats or carbohydrates, does not interfere with the absorption of vitamins, minerals and microelements.At the same time, due to the defoaming effect and a decrease in the gas content in the intestine, ESPUMISAN ® indirectly influences the normalization of digestive functions.
ESPUMIZAN ® is safe, available without a prescription and can be used not only in adults and children over the age of 6 years, but even in very young children from 1 year old. For this, two forms of the drug have been developed: in the first case, ESPUMISAN ® in capsules is suitable for patients, in the second – ESPUMIZAN ® L in the form of a suspension.
ESPUMISAN ® : get rid of flatulence without any “second thoughts”!
Flatulence in culture
In many cultures, flatulence in public places is seen as an embarrassing situation, however, depending on the context, it can sometimes be perceived with humor. In modern Western society, most often people make an effort in order to be in a public place, to contain intestinal gases, as well as to hide the sound and smell emitted at the same time.In other cultures, flatulence is no more awkward than coughing.
Today, the social acceptability of flatulence as one of the elements of humor in the entertainment industry and in the media is undergoing shifts. At the same time, this is not at all a sign of discouragement: in historical sources there are references to the existence in ancient and medieval culture of meteorists (flatulists), who entertained the audience by emitting gases in a musical manner. Actually, enlightened France did not stay away from such entertainments – in the 19th century.in the Moulin Rouge, an entertainer named Le Pétomane became famous for precisely this kind of talent. In the XXI century. the successor of his traditions was a British meteorist working under the pseudonym Mr. Methane and even looking for luck in 2009 at the Britain’s Got Talent contest (which is analogous to the show “Ukraine Got Talent”).
In 2002, the movie “ Thunderpants ” was released, the plot of which revolves around a character – a boy named Patrick Smash, who suffers from increased gas production, but dreams of becoming an astronaut.In the end, he overcame the challenges and even made his dream come true.
In January 2011, Malawi’s Southern African Minister of Justice, George Chaponda, attempted to outlaw the emission of gases in public with the Air Fouling Legislation. A little later, the minister withdrew his initiative.
Information for you:
90,000 Do’s and Don’ts, Nutrition Principles
In this article, we will talk about flatulence, a symptom of irritable bowel, and whether proper nutrition can help get rid of it.You will learn:
Flatulence, or bloating, is a condition in which:
Most people associate this condition with discomfort (the abdomen feels as if “inflated”, visually enlarged) and pain in the lower abdomen, may be accompanied by shortness of breath and palpitations caused by an increase in intestinal volume and an elevation of the diaphragm 2 .
Gas formation and accumulation of gases in the gastrointestinal tract (GIT) is a natural process.During the day, more than 20 liters of gas are formed in the digestive tract 1 , 70% of which enters the stomach and intestines when food or liquid is swallowed 2 .
Gas in the gastrointestinal tract can also be formed when it is released from the blood, as a result of the vital processes of bacteria 1 . However, normally, about 200 ml of gas 1 can be contained in the digestive system at a time.
Flatulence often occurs as an independent phenomenon (it is occasionally observed in almost all people 1 ).However, it can also be a symptom of a functional disorder of the intestine, such as irritable bowel. According to some reports, flatulence accompanies the course of gastroenterological diseases in 85% of cases 1 .
The following types of flatulence are emitted by depending on the causes of excess gas production or problems with the elimination of gas from the intestines:
Another common cause of bloating is excessive air flow into the stomach when swallowing food and swallowing saliva 2 .The volume of air swallowed increases with a hasty meal, talking while eating, using chewing gum, carbonated drinks 1 . Excessive salivation caused by a state of mental stress and neurosis can also lead to this condition. 1 .
From what products can the stomach “swell”?
Methods for relieving discomfort caused by bloating depend on the type of flatulence. However, in each case, treatment involves avoiding foods that cause flatulence and adhering to a diet that is determined based on the cause of the bloating.
Food flatulence is closely related to the diet.
It is caused by the use of:
- fermentation products, e.g. brown bread containing yeast 2
- carbonated drinks, such as: kvass, beer, koumiss 2
Foods that cause gas and bloating also include: legumes, corn and oat products, wheat baked goods, some vegetables and fruits (cabbage, potatoes, cucumbers, apples, peaches, pears), dairy products ( soft cheeses, milk, ice cream) 1 .
The basis of the treatment of food flatulence is adherence to a diet consisting in the exclusion of the above products from the diet. When revising the diet, it is recommended to increase the consumption of foods with a low gas generating potential: bananas, white rice, protein-containing foods (beef, chicken, turkey, egg white) 2 .
In case of flatulence of a digestive origin, foods should be excluded from the diet, the digestion of which is complicated by a deficiency of essential enzymes.So, for example, with a deficiency of lactase in the intestine, the use of dairy products should be limited 2 .
Studies have shown that in irritable bowel the composition and volume of intestinal gas does not change, however, the passage of gas through the intestine is almost 2 times slower 1 .
The influence of the diet on the manifestation and exacerbation of symptoms of irritable bowel cannot be denied. This connection is clearly confirmed by the fact that with prolonged fasting, there is a weakening of the entire complex of symptoms of discomfort in the intestines, including flatulence 3 .In this case, bloating is usually mild in the morning. After eating, the feeling of discomfort increases 4 .
Although there is a clear link between flatulence and food intake, identifying specific foods that cause bloating is not an easy task. After all, the diet of healthy people and those who suffer from chronic feelings of discomfort in the intestines is practically the same 5 .
The reaction to specific food products is caused by the increased sensitivity of the nerve endings in case of irritated intestines.Nutrients contained in food, entering the digestive tract, stimulate nerve endings in the stomach and intestines 6 .
If the stimulus is weak and the intestines do not undergo significant deformation, the signal does not reach the brain.
A stronger stimulus associated with the feeling of intestinal distension is transmitted from the nerve endings of the intestine to the brain and causes painful sensations 6 .
When irritable bowel is hypersensitive, even a weak stimulus can feel painful and affect bowel motility 6 .
Based on the mechanism of increased sensitivity of the irritable bowel to external stimuli, scientists have experimentally identified a number of nutrients that influence the manifestation of symptoms of intestinal dysfunction: fermentable oligo-, di- and monosaccharides and polyols (FODMAPs) 6 . Researchers have shown that increased intake of these nutrients causes unpleasant symptoms not only in irritable bowel, but also in healthy people 6 . By identifying the food sources of these nutrients, you can understand which foods are causing gas and bloating.
Flatulent nutrients contain 6 :
- fruits: apples, cherries, pears, peaches, apricots, plums
- vegetables: asparagus, artichokes, beets, onions, garlic, peas, mushrooms, cauliflower
- cereals: wheat, rye, barley
- milk and dairy products: yoghurt, ice cream, soft cheeses
Why do you need a special diet for flatulence?
Bloating can be caused by various reasons: from intolerance to specific foods to complex disorders in the digestive tract with irritable bowel.Despite such a wide range of reasons, the list of products that provoke increased gas production and, as a result, flatulence, is unchanged. Does this mean that you need to eliminate these foods from your diet to relieve irritable bowel discomfort?
Indeed, many diets recommended for flatulence and functional bowel disorders imply a restriction or complete rejection of a certain food group. There are gluten-free and low-carb diets, nutrient-restricted FODMAP diets.However, all of them not only imply the lack of important nutrients 7 , but may not suit you personally. Therefore, it is important to listen to your body and to wisely limit the consumption of those foods that cause discomfort in your gut.
A change in diet will undoubtedly be beneficial, but if flatulence occurs constantly, this may indicate a bowel disorder. In this case, complex therapy will be needed so that the treatment helps to normalize the bowel function and really brings relief, and not limited to the elimination of abdominal pain and flatulence.
Duspatalin ® 135 mg will help relieve discomfort accompanying flatulence, such as bloating, cramps and pain.
- Duspatalin ® 135 mg after 15 minutes 9 begins to act, relieving pain and spasm.
- Spasm relief allows the intestines to “relax”, relieving pain, as well as the passage and elimination of gas and eliminating the very cause of flatulence and bloating.
- Clinical trials have shown that the use of the drug Duspatalin ® 135 mg in the treatment of irritable bowel significantly reduces the degree of manifestation of all accompanying symptoms: more than 6 times reduces pain and helps to eliminate manifestations of flatulence 8 .
- With a course of 28 days or more Duspatalin ® 135 mg normalizes bowel function, eliminating a complex of symptoms: pain, stool disorders (diarrhea or constipation), flatulence, bloating 10 .
- The drug has a high safety profile: unlike most other antispasmodics,
it does not have a systemic effect *, and its effect lasts for 6 months.
With Duspatalin ® , your intestines are unperturbed.
90,000 what to do if the intestines are working against you 9,0001
Flatulence is a serious problem for many people. The gases in the intestines seriously impair the quality of life and cause a lot of inconvenience to those who have a predisposition to flatulence.However, everyone can independently reduce the amount of gas released by the intestines if they monitor their diet.
So, what you can eat, what you can’t, and most importantly, as it is, if you suffer from flatulence. First of all, doctors categorically prohibit drinking all carbonated drinks: mineral water, lemonade, champagne. A number of products cause increased gassing. You can’t eat :
– cabbage in all its types: boiled, sauerkraut, steamed;
– black bread;
– all legumes;
– Fresh fruits, especially grapes;
– starchy vegetables;
– muffins, pastries.
At the same time, with flatulence , you can eat :
– boiled prunes;
– some types of cheese;
– baked apples.
“In order for the food lump that you put in the mouth and begin to chew, it is well processed with saliva, begins to be well digested in the stomach and comes ready-made into the intestine, it is necessary that it turns into a mushy mass, which will be easy to move along the gastrointestinal tract, – notes K.MD, professor, physician Leonid Lazebnik. – To do this, you need to make at least 30 chewing movements. In the process of chewing, it is not necessary to swallow air, as this causes increased gas formation. ”
The main cause of bloating is the malfunctioning of the gastrointestinal tract. The right foods can help the body. Among these products are ginger, dairy products and spices: fennel, cumin, marjoram, mint. The “secret of success” mint is menthol, which is included in its composition.This substance relieves spasms, and also soothes the nervous system. Mint leaves can easily improve digestion and restore appetite. And to avoid chewing on bare mint leaves, keep the mint smoothie recipe, which has a beneficial effect on the digestive process. The drink is based on kefir, it is he who, thanks to its beneficial bacteria, eliminates gases from the intestines.
To make a smoothie, put in a blender 500 grams of kefir, chopped banana and a bunch of fresh mint. Mix for 1-2 minutes. Everything – a smoothie that will help get rid of the “revolution” in the stomach, ready.Drink it so that bowel problems never bother you.
90,000 Bloating: causes and treatment with folk remedies
The causes of bloating can vary. This insidious disease cannot be ignored due to unpleasant heavy sensations and bursting pain.The disease is called flatulence and occurs due to the formation of a large amount of gas in the stomach and intestines. How can this be avoided and what home treatment will help? Read about everything in the article.
Causes of bloating
Flatulence cannot be called a terrible or dangerous disease. Increased gas production is more an unpleasant manifestation of malfunctions in the gastrointestinal tract.
The formation and release of gases are natural processes for the human body.Even an absolutely healthy person has almost 1 liter of gases in the stomach and intestines. They are necessary for the normal functioning of the body, as well as increasing intestinal tone and peristalsis.
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Bloating and gas more than 20 times a day indicate intestinal problems.
Based on practical experience, they can say that with flatulence, the following symptoms are observed:
- rumbling in the stomach;
- Frequent belching
- pressing pain in the abdomen.
These unpleasant sensations often provoke the reaction of other organs, causing headache, weakness, intense shortness of breath and chest pain. Sometimes stomach pain resembles an attack of appendicitis, my colleagues at WebMD say. If you notice such symptoms, so as not to harm your health, I recommend consulting a doctor, as medication may be required.
Frequent flatulence is sometimes a manifestation of such diseases: neurosis, constipation, colitis, peritonitis, cirrhosis, dysbiosis, enteritis, helminthiasis, pancreatitis and acute intestinal infections.
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The most common causes of flatulence are:
- Air intake during meals.
Most often, aerophagia occurs when a person is in a hurry to swallow food. At the same time, he swallows air. Once in the stomach, the air is extremely uncomfortable.
- Enzymatic deficiency.
In this case, the stomach hurts after taking milk, the article says.This is an indicator that the body is lacking in lactose, which facilitates the processing of dairy products. As a result, they begin to ferment in the intestines.
- Bloating during pregnancy.
Often occurs due to impaired blood flow, as well as intestinal motor activity.
- Violation of intestinal microflora.
This happens due to improper diet, as well as while taking antibiotics.
The bad habit also stimulates the excessive flow of air into the stomach.
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Bloating occurs spontaneously even in a healthy person after eating certain foods that stimulate fermentation processes. These include any legumes, beer, apples, mushrooms, cabbage, radishes, rye bread, carbonated drinks. Do not be surprised that your stomach puffs up if you ate several foods from this list at once.
What to do with bloating?
To effectively reduce gas production, I strongly recommend that my patients stop eating fatty and fried foods.To avoid the unpleasant phenomenon, stick to an appropriate diet. Meals should be fractional, and portions should be small, notes WebMD.
A bloating diet excludes vegetables, bread and other foods that contain starch. I also recommend using porridge, rice is especially useful in this case. Diet vegetables are eaten only baked or steamed.
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Remove pork, lard and offal from the menu.Instead, replace them with dietary rabbit, turkey, or quail. Once a week, it is advisable to arrange fasting days, during which you drink only kefir with zero fat content. Boiled rice will also help restore normal bowel function, which will cleanse the body of accumulated toxins.
To minimize the possibility of flatulence, be sure to chew food thoroughly. The enzymes in the saliva must have time to process the product well in the mouth. It promotes good digestion.
Traditional medicine suggests drinking herbal infusions against bloating. Here are the effective options:
- One of the universal compounds for flatulence – is a mixture of mint, chamomile, yarrow and St. John’s wort in equal proportions.
- An effective folk remedy is considered to be an infusion of dill seed, filtered through a fine sieve. Dill can be replaced with fennel seeds.
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Please note that the information provided is for informational purposes only.In order to correctly select the necessary methods for getting rid of flatulence, I recommend going to an appointment with a doctor.
If the cause of flatulence – is impaired blood circulation, then special physiotherapy exercises will allow you to get rid of its manifestations.
In case of enzyme deficiency, reduce the amount of milk in the diet. At the same time, you can safely eat natural yoghurts without additives and cheeses.
When bloating is accompanied by spasms and sharp pain, you need to lie down and relax with a warm heating pad on your stomach.
Strong tea, cocoa, coffee have a negative effect on the intestines, stimulating the gastrointestinal tract.
With simple recommendations, you will forget about the problem of bloating and its consequences. Watch your health, love yourself, so that such problems remain in the past for you.
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Attention! The material is for informational purposes only. You should not resort to the methods described in it without first consulting your doctor.
- Carol DerSarkissian. The Truth About Gas // WebMD. – 2016 .– 6 October. – Access mode: https://www.webmd.com/digestive-disorders/features/truth-about-gas#1
- Minesh Khatri. What are symptoms of gas? // WebMD. – 2020 .– 15 February. – Access mode: https://www.webmd.com/heartburn-gerd/qa/what-are-symptoms-of-gas
- Minesh Khatri. What other tips can help manage irritable bowel syndrome and gas? // WebMD. – 2020.- 25 January. – Access mode: https://www.webmd.com/ibs/qa/what-other-tips-can-help-manage-irritable-bowel-syndrome-and-gas
Author: MD Anna Ivanovna Tikhomirova
Reviewer: Candidate of Medical Sciences, Professor Ivan Georgievich Maksakov
Original article: https://www.nur.kz/family/beauty/1774033-vzdutie-zivota-priciny-i-lecenie-narodnymi-sredstvami/