What causes excessive intestinal gas. How to identify foods that trigger gas production. Which lifestyle changes can reduce gas and bloating. When to seek medical attention for persistent gas issues. How to manage embarrassing gas symptoms in social situations. Which natural remedies may provide gas relief. How to distinguish normal gas from problematic flatulence.

Understanding the Root Causes of Excessive Intestinal Gas

Intestinal gas is a normal byproduct of digestion, but excessive gas can lead to discomfort and embarrassment. The primary causes of stomach gas include swallowed air during eating or drinking, which is typically released as a burp. Flatulence, on the other hand, occurs when the body struggles to absorb or digest certain carbohydrates in the small intestine. As undigested food moves to the large intestine, bacteria break it down, producing hydrogen, carbon dioxide, and sometimes methane.

Common Culprits Behind Excessive Gas Production

• High-fiber foods (beans, legumes, fruits, vegetables, whole grains)
• Carbonated beverages
• Chewing gum
• Eating too quickly or talking while chewing
• Drinking through a straw
• Consuming artificial sweeteners
• Chronic intestinal diseases (e.g., celiac disease)
• Food intolerances (e.g., lactose intolerance)
• Bacterial overgrowth in the small bowel

Is excessive gas always a cause for concern? According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), passing gas up to 25 times a day is considered normal. However, if you’re experiencing painful gas or chronic, foul-smelling flatulence, it’s time to investigate the underlying causes.

Identifying and Avoiding FODMAP Foods to Reduce Gas

One effective strategy for managing excessive gas is to reduce consumption of foods high in FODMAPs. But what exactly are FODMAPs? FODMAPs, which stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, are short-chain carbohydrates that the small intestine often struggles to absorb.

Dr. Rabia de Latour, a gastroenterologist and assistant professor of medicine at NYU Grossman School of Medicine, explains, “These carbohydrates, when left undigested, become fuel for gut bacteria in the colon. The breakdown process can produce hydrogen gas, leading to symptoms such as bloating, diarrhea, constipation, abdominal pain, and flatulence in FODMAP-sensitive individuals.”

Common High-FODMAP Foods to Watch Out For

• Fruits: apples, pears
• Vegetables: broccoli, Brussels sprouts, onions
• Whole grains: bran
• Dairy products: milk, cheese, ice cream
• Legumes: beans

Can a low-FODMAP diet really help with gas issues? Scientific evidence suggests it can. A research review published in the European Journal of Nutrition in February 2021 found that a low-FODMAP diet significantly reduced digestive symptoms compared to a control diet.

Dr. de Latour advises, “When attempting a low-FODMAP diet, be prepared for some restrictions. To identify your trigger foods, keep a food diary and eliminate foods one by one, tracking which eliminations provide the most benefit.” For a more structured approach, consider working with a dietitian who can guide you through the elimination and reintroduction process safely and effectively.

The Role of Artificial Sweeteners in Gas Production

Artificial sweeteners, particularly sugar alcohols like sorbitol, can contribute significantly to gas production. Dr. Stephen Bickston, a professor of internal medicine and medical director of the inflammatory bowel disease program at VCU Health, notes, “Sorbitol is often the first ingredient in many sugar-free gum brands. Consuming just one or two sticks can have an effect similar to eating a prune.”

Are all artificial sweeteners equally problematic for gas production? Not necessarily. The sweeteners commonly found in coffee shops or soft drinks, such as sucralose (yellow packets), saccharine (pink packets), and aspartame (blue packets), are not typically associated with gas or laxative effects.

Lifestyle Modifications to Reduce Gas and Bloating

Simple changes in eating habits and daily routines can significantly reduce gas production and discomfort. Here are some practical strategies:

Eat and Drink Slowly

Rapid eating or drinking can lead to swallowing excess air, which contributes to gas. Dr. Bickston advises slowing down during meals to minimize air intake. For those with dentures, ensuring a proper fit can prevent gasping air while eating.

Avoid Air-Inducing Habits

Several common habits can increase the amount of air you swallow, leading to excess gas. Consider reducing or eliminating the following:

• Smoking
• Chewing gum
• Drinking through a straw

Natural Remedies and Herbal Solutions for Gas Relief

For those seeking natural alternatives to manage gas, certain herbs have shown promise in scientific studies. Can herbs really provide effective gas relief? Research suggests they might.

A review published in 2019 in BMC Complementary Medicine and Therapies found that peppermint oil significantly improved symptoms of irritable bowel syndrome (IBS), including abdominal pain and bloating. This suggests that peppermint oil could be a beneficial natural remedy for those experiencing excessive gas due to IBS.

Other Herbs with Potential Gas-Relieving Properties

• Ginger
• Fennel
• Chamomile
• Caraway

While these herbs show promise, it’s important to consult with a healthcare provider before incorporating them into your regimen, especially if you have existing health conditions or are taking medications.

When to Seek Medical Attention for Gas Issues

While occasional gas is normal, persistent or severe gas symptoms may warrant medical attention. When should you consult a doctor about your gas issues?

• If gas is accompanied by persistent abdominal pain
• If you experience unexplained weight loss
• If gas is associated with changes in bowel habits
• If you notice blood in your stool
• If gas symptoms interfere significantly with your daily life

A healthcare provider can help determine if your gas symptoms are related to an underlying condition such as irritable bowel syndrome, inflammatory bowel disease, or small intestinal bacterial overgrowth (SIBO).

Managing Gas in Social Situations: Tips and Tricks

Dealing with gas in social settings can be embarrassing, but there are strategies to manage these situations discreetly:

1. Excuse yourself to the restroom if you feel the need to pass gas
2. Wear clothing that doesn’t constrict your abdomen
3. Practice relaxation techniques to reduce stress-induced gas
4. Consider over-the-counter gas relief products for temporary relief
5. Plan ahead by avoiding trigger foods before social events

Remember, everyone experiences gas, and most people are understanding if an occasional slip occurs. Maintaining a sense of humor about the situation can often help diffuse any awkwardness.

The Impact of Exercise on Digestive Health and Gas Reduction

Physical activity can play a significant role in promoting healthy digestion and reducing gas. How does exercise help with gas issues? Regular movement stimulates the digestive system, helping food move through more efficiently and potentially reducing the time for gas-producing bacteria to act on undigested food.

Beneficial Exercises for Digestive Health

• Walking after meals
• Yoga poses that target the abdominal area
• Light aerobic exercises
• Core-strengthening exercises

Aim for at least 30 minutes of moderate exercise most days of the week. Not only can this help with gas issues, but it also provides numerous other health benefits.

The Role of Probiotics in Managing Excessive Gas

Probiotics, the beneficial bacteria that support gut health, may help alleviate excessive gas in some individuals. These microorganisms can aid in digestion and potentially reduce the production of gas-causing bacteria in the intestines.

Do all probiotics work equally well for gas relief? Not necessarily. Different strains of probiotics may have varying effects on digestive symptoms. Some strains that have shown promise in reducing gas and bloating include:

• Lactobacillus acidophilus
• Bifidobacterium lactis
• Streptococcus thermophilus

When considering probiotic supplements, it’s advisable to consult with a healthcare provider to determine the most appropriate strain and dosage for your specific needs. Additionally, incorporating probiotic-rich foods into your diet, such as yogurt, kefir, sauerkraut, and kimchi, may provide similar benefits.

Tracking Your Symptoms: The Importance of a Food and Gas Diary

Keeping a detailed food and gas diary can be an invaluable tool in identifying your personal gas triggers. How should you approach this tracking process?

1. Record everything you eat and drink, including portion sizes and times
2. Note any gas symptoms, their severity, and when they occur
3. Track your stress levels and sleep patterns
4. Document any medications or supplements you take
5. Keep the diary for at least two weeks to identify patterns

By analyzing this information, you may be able to pinpoint specific foods or habits that contribute to your gas issues. This data can also be helpful when consulting with a healthcare provider or dietitian.

Understanding the Connection Between Stress and Digestive Issues

The link between stress and digestive health is well-established, and excessive stress can exacerbate gas and bloating. How does stress impact digestion? Stress can alter gut motility, increase inflammation, and disrupt the balance of gut bacteria, all of which can contribute to gas production.

Stress-Reduction Techniques for Better Digestive Health

• Mindfulness meditation
• Deep breathing exercises
• Progressive muscle relaxation
• Regular exercise
• Adequate sleep

Incorporating stress-management techniques into your daily routine may help reduce the frequency and severity of gas symptoms. If stress is a significant factor in your digestive issues, consider seeking support from a mental health professional who can provide additional coping strategies.

The Potential Benefits of Digestive Enzymes for Gas Relief

Digestive enzymes are substances that help break down food in the digestive tract. For some individuals, supplementing with digestive enzymes may help reduce gas and bloating, particularly if these symptoms are due to difficulty digesting certain foods.

Which digestive enzymes are most beneficial for gas relief? The most appropriate enzyme supplement depends on the specific foods causing issues:

• Lactase: for lactose intolerance
• Alpha-galactosidase: for beans and other complex carbohydrates
• Lipase: for fats
• Amylase: for starches

While over-the-counter enzyme supplements are available, it’s best to consult with a healthcare provider before starting any new supplement regimen. They can help determine if enzyme supplementation is appropriate for your situation and recommend the most suitable products.

Differentiating Between Normal Gas and Potential Health Issues

While some degree of gas is normal and even healthy, excessive or chronic gas can sometimes indicate underlying health issues. How can you tell if your gas is within normal limits or a cause for concern?

Signs That Your Gas Might Be More Than Normal

• Persistent, severe abdominal pain
• Significant changes in bowel habits
• Unexplained weight loss
• Blood in the stool
• Fever accompanying gas symptoms
• Nausea or vomiting

If you experience any of these symptoms along with excessive gas, it’s important to consult with a healthcare provider. They can help rule out more serious conditions such as inflammatory bowel disease, celiac disease, or gastrointestinal infections.

Remember, while gas can be uncomfortable and embarrassing, it’s a normal bodily function. By implementing dietary changes, lifestyle modifications, and seeking medical advice when necessary, most people can effectively manage their gas symptoms and improve their overall digestive health.

Are You Farting Too Much?

A sudden burp on the phone with your colleague. Breaking wind while getting into downward-facing dog–we’ve all been there (some, more than others). Whether you call it burping, belching, or tooting, there are ways to manage excessive gas.

Gas in the stomach is primarily caused by air a person swallows while eating or drinking, and it’s released from the mouth as a burp. Gas that is passed by flatulence is caused by the body’s inability to absorb or digest some carbohydrates in the small intestine. Once this undigested food passes into the small intestine, bacteria break it down, producing hydrogen, carbon dioxide, and sometimes methane.

Here are some of the main culprits when it comes to gas:

• High-fiber foods like beans, legumes, fruits, vegetables, and whole grains
• Carbonated beverages
• Chewing gum
• Eating too quickly or talking while chewing, which results in swallowing more air
• Drinking through a straw
• Consuming artificial sweeteners
• Chronic intestinal diseases like celiac disease and food intolerances, such as lactose intolerance
• Bacterial overgrowth in the small bowel

It’s common to experience some gas after eating — and to release it through belching or flatulence. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), passing gas up to 25 times a day is normal.

But if you’re experiencing painful gas and the embarrassment of chronic and foul-smelling flatulence, you can play detective and eliminate the cause with the following steps.

1. Avoid Foods Known to Cause Gas

One way to manage farting and belching is to eat fewer of the well-known gassy foods that are high in FODMAPs. FODMAPs stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

“These are short-chain sugars, or carbohydrates, found in many foods that the small intestine (where the majority of digestion occurs) has a hard time absorbing,” explains Rabia de Latour, MD, a gastroenterologist and an assistant professor of medicine at NYU Grossman School of Medicine in New York City. “This then leaves them untouched for some of the gut bacteria in your colon to break down.”

In people who are sensitive to FODMAPs, the by-products of this breakdown (hydrogen gas) can cause symptoms, such as bloating, diarrhea, constipation, abdominal pain, and flatulence.

Common foods containing FODMAPs include:

• Fruits like apples and pears
• Vegetables such as broccoli, Brussels sprouts, and onions
• Whole grains like bran
• Dairy products, including milk, cheese, and ice cream
• Beans

Some scientific evidence suggests a low-FODMAP diet can improve painful GI symptoms, including excessive gas. For example, a research review published in February 2021 in the European Journal of Nutrition determined that a low-FODMAP diet decreased digestive symptoms by a “moderate to large extent” compared with a control diet.

“When attempting a low-FODMAP diet, know what you are getting into,” Dr. de Latour advises. “It can be very restricting. To find your trigger foods, I recommend keeping a food diary and eliminating foods one by one to keep track of which food eliminations provide the most benefit.”

To make the process easier, consider working with a dietitian, who can help identify problem foods, suggest alternatives, and safely reintroduce foods to your diet you had previously eliminated.

2. Avoid Artificial Sweeteners

Sorbitol and related sugar alcohols are FODMAPs that are used in many sugar-free versions of foods. “Sorbitol is often the first ingredient in any brand of sugar-free gum I’ve found at local grocery stores,” says Stephen Bickston, MD, a professor of internal medicine and the medical director of the inflammatory bowel disease program at the Center for Digestive Health at VCU Health in Richmond, Virginia. “One to two sticks [of gum] is akin to eating a prune.” But the sugar substitutes that are found at a typical coffee stand or in popular soft drinks are not the kind that cause gas. The various packet sweeteners — yellow (sucralose), pink (saccharine), and blue (aspartame) — are not associated with gas or laxative effects.

3. Eat and Drink Slowly

When you eat or drink fast, you can swallow a lot of air, which can cause gas, says Dr. Bickston. The simple solution? Slow down when you eat. If you have dentures, check with your dentist to be sure they fit properly so you’re not gasping air while eating.

4. Don’t Fill Up on Air

Consider reducing or eliminating habits that cause your stomach to fill with air and lead to gas, like:

• Smoking
• Chewing gum
• Drinking through a straw

5. Try Herbs for Gas Relief

Some research suggests that herbs may help relieve excess gas. For example, a review published in 2019 in BMC Complementary Medicine and Therapies found that peppermint oil significantly improved symptoms of irritable bowel syndrome (IBS), including abdominal pain and bloating.

A review published in November 2018 in the journal Nutrients found that ginger helped speed digestion. If the stomach empties faster, gas can move more quickly to the small intestine to relieve bloating and discomfort.

Chamomile is thought to aid in a number of digestive issues, including upset stomach, bloating, and intestinal gas, by relaxing GI muscles and improving digestion, according to a research review.

When Gas Is a Symptom of an Underlying Problem

If excessive gas is persistent or severe, consult your doctor — it could be a sign of a more serious digestive condition, such as:

• Lactose intolerance This is the inability to digest lactose, the sugar found in milk and milk products. “I test with a milk challenge,” says Bickston. “The patient drinks a pint or two of milk — it can be any percent fat. What follows tells the patients whether they should limit their milk intake.” If avoiding milk reduces your symptoms you may be lactose intolerant.
• Irritable bowel syndrome (IBS) “Patients who meet the diagnostic checklist for irritable bowel syndrome suffer more pain at the lower levels of the abdominal cavity,” he says. You can get relief from IBS symptoms by trying a low-FODMAP diet to identify trigger foods, which a dietitian can help you with.
• Colon cancer “Excess gas is rarely the main symptom of patients with colon cancer,” Bickston notes. “But it does trigger my reflex to remind patients to get screened for colorectal cancer.”
• Upper gastrointestinal disorders Occasional belching is normal, but frequent belching may be a sign of an upper gastrointestinal disorder. These include peptic ulcers, gastroesophageal reflux disease (GERD), or gastroparesis, also called delayed gastric emptying.
• Small intestinal bacterial overgrowth (SIBO) This is when there’s higher than normal amounts of bacteria in the small intestine, particularly those that are not typically found here. The excess bacteria can lead to GI symptoms like gas, diarrhea, and loss of appetite. SIBO is a common complication of abdominal surgery and certain medical conditions like Crohn’s disease, diabetes, and celiac disease.

Also, warns Bickston, if you’ve had abdominal surgery, a hernia, or significant weight loss or weight gain, never dismiss your gas-like symptoms as normal. Get them checked out.

As annoying as it might be, some gas is a natural by-product of the body’s digestive system. But if your gas is excessive, painful, or chronic, talk to your doctor about possible causes and remedies.

Additional reporting by Ashley Welch.

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What Is Celiac Disease?

By Lindsey KonkelMedically Reviewed by Laura J Martin, MD

Reviewed: June 7, 2022

Medically Reviewed

Celiac disease is an autoimmune condition that prevents proper nutrient absorption and the digestion of gluten.

When people diagnosed with the condition are exposed to gluten — a binding protein common in grains but also in makeup products — the immune system malfunctions and attacks the walls of the small intestine, which is responsible for absorbing nutrients from food, according to the Celiac Disease Foundation.

 People with celiac disease have a swollen and irritated small intestine, which can interfere with this absorption, leading to nutrient deficiencies.

The condition requires avoiding gluten to manage symptoms.

Signs and Symptoms of Celiac Disease

Signs and symptoms of celiac disease vary widely from person to person. Indeed, some people with the condition are asymptomatic. Generally speaking, though, there are some telltale signs you should know.

First, digestive problems can occur in anyone with celiac disease, but they may be more common in children with the disease than adults. Here are some of the digestive symptoms that may occur, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

• Abdominal pain, bloating, or gas
• Chronic diarrhea (may be constant, or on and off for several weeks)
• Constipation
• Pale, foul-smelling, or oily stool
• Nausea and vomiting
• Unexplained weight loss

Celiac disease can cause problems in other parts of the body, too. And some of these symptoms are more common in adults than in children.

Nondigestive symptoms may include:

• Anemia (low red blood cell count)
• Fatigue (extreme tiredness that doesn’t go away with sleep)
• Infertility or miscarriages
• Missed menstrual periods
• Depression or anxiety
• Seizures
• Canker sores or ulcers inside the mouth
• Bone or joint pain
• Osteoporosis (weak, porous bones that break more easily)
• Itchy, blistery skin rashes
• Hair loss
• Tingling or numbness in hands or feet
• Headaches

Causes and Risk Factors of Celiac Disease

Unfortunately, researchers haven’t yet been able to identify exactly what causes celiac disease. Currently they think it has something to do with genetics combined with environmental factors.

If you have a family member with celiac disease, you’re at higher risk for the condition, research shows. For example, someone with a first-degree relative has a 10 to 15 percent risk of also having the condition.

Indeed, there’s a so-called “celiac gene.” Among those with celiac disease, 95 percent have the HLA-DQ2 gene, and most of the rest of that remaining 5 percent have the HLA-DQ8 gene.

People with a genetic disorder, such as Down syndrome

 or Turner syndrome,

 are also more likely to develop the disease.

If you have another autoimmune disorder, you’re also more likely to develop celiac disease. Those conditions include:

• Rheumatoid arthritis
• Lupus
• Thyroid disease
• Sjögren’s syndrome
• Type 1 diabetes
• Addison’s disease
• Autoimmune hepatitis
• Multiple sclerosis

How Is Celiac Disease Diagnosed?

A number of tests can help your doctor figure out whether you have celiac disease or another digestive condition.

Per the Mayo Clinic, your doctor may recommend:

• Blood tests Your blood sample will be checked for special proteins called antibodies. Certain antibodies tend to be elevated in people with celiac disease. Before your blood test, you should continue to eat foods containing gluten. Cutting out gluten before testing is complete could delay your diagnosis.
• Endoscopy Your doctor may ask a gastroenterologist to perform an endoscopy to confirm your diagnosis if a blood test shows you may have celiac disease. You’ll swallow a small, flexible tube containing a tiny camera. Through this tube, your doctor will perform a biopsy, removing a tiny piece of tissue from the wall of your small intestine. A specialist (usually a pathologist) will view this tissue under a microscope to see whether it has been damaged by celiac disease.
• Genetic testing Your doctor may order a genetic test to rule out a celiac disease diagnosis. Most people with celiac disease carry a certain variant of the HLA-DQ2 or HLA-DQ8 genes. But many people without celiac disease also have these variants, so celiac disease can’t be diagnosed by genetic testing alone.
• Capsule endoscopy Your doctor may order this test, in which you swallow a tiny camera inside a small capsule that travels through your digestive tract. The camera takes thousands of photos that are transmitted and recorded.

Duration of Celiac Disease

Celiac disease is a lifelong disease and not something individuals can outgrow. People with the condition must stop eating gluten for the rest of their lives.

In general, once individuals with celiac disease stop eating gluten, their symptoms will ease within a few days. The small intestine should heal completely in several months, though it may take up to two years for the body to heal completely in older individuals, per Johns Hopkins Medicine.

Treatment and Medication Options for Celiac Disease

Adhering to a gluten-free diet and avoiding medicines and products that contain gluten is the best way to keep symptoms of celiac disease under control, according to some research.

You can ask your pharmacist if gluten is an ingredient in certain medicines, herbal supplements, vitamins, or minerals.

Other types of products may have hidden sources of gluten, including:

• Cosmetics
• Skin and hair products
• Toothpaste and mouthwash
• Play-Doh
• Communion wafers
• Glue on envelopes and stamps

You can never be too careful. Read ingredient labels carefully when you’re out shopping and advise family and friends to do the same when shopping for you.

At first, the news of a celiac disease diagnosis may be tough to hear. For some, it might mean completely overhauling their diet.

But a dietitian can help you transition to a gluten-free diet in which you still eat healthy and nutritious foods. You’ll be instructed how to:

• Use food and product labels to identify ingredients that contain gluten
• Understand which foods are naturally gluten-free
• Find and eliminate hidden sources of gluten from the diet
• Make healthy food choices
• Design meal plans
• After starting on a gluten-free diet, individuals with celiac disease will continue to see a doctor for periodic checkups to make sure the condition is improving. Many doctors recommend a follow-up visit four to six weeks after you start the diet, notes Coeliac UK.

Are There Supplements That Are Good for People With Celiac Disease?

People with celiac disease are at risk of nutritional deficiencies because the disease can limit the small intestine’s ability to absorb nutrients from food, per the Celiac Disease Foundation.

 Your doctor can test for nutritional deficiencies with blood tests.

People with celiac disease often have low levels of:

• Iron
• Calcium
• Vitamin B12
• Vitamin B6
• Folate
• Vitamin A
• Vitamin E
• Vitamin D
• Vitamin K
• Zinc
• Copper

A multivitamin or nutritional supplement can help you rebuild your levels of essential nutrients.

But keep in mind that some vitamins, minerals, and herbal supplements may contain gluten. Talk to your doctor or pharmacist before taking any nutritional supplement to make sure it doesn’t contain gluten.

Gluten-free diets are sometimes low in fiber, which can lead to constipation. A fiber supplement with psyllium seed husks can also help, as can fiber-rich foods, like fruits and veggies.

Can Medication Help Manage Celiac Disease?

A small percentage of people with celiac disease find that their symptoms don’t improve, even with a strict gluten-free diet.

Symptoms may go away initially but then return, even in the absence of gluten. It’s unclear why this happens. If there is substantial inflammation in the small bowel, your doctor may prescribe a steroid medication.

Steroids are typically taken for a short period of time to suppress the immune system and stop the body’s harmful immune response.

How to Develop a Gluten-Free Diet to Control Celiac Disease

Gluten is found in many commonly loved foods, including traditional pizza crust, several types of sandwich breads, pasta, tortillas, cake, cookies, and even soy sauce.

 But for people with celiac disease, knowing the foods and products gluten lurks in — and then avoiding them — is key for keeping symptoms controlled and preventing an attack.

Foods to Avoid if You Have Celiac Disease

Foods that contain gluten include:

• Wheat
• Barley
• Rye
• Bulgur
• Durum wheat
• Farina
• Malt
• Semolina
• Spelt
• Graham
• Triticale

That means that people with celiac disease shouldn’t eat most breakfast cereal, bread, pasta, and processed foods.

Some processed foods that may contain gluten include:

• Bouillon cubes
• Brown rice syrup
• Candy
• Chewing gum
• Chips, including seasoned tortilla and potato chips
• Cold cuts, hot dogs, salami, and sausage
• Communion wafers
• French fries
• Gravy
• Imitation fish
• Rice mixes
• Soy sauce
• Beer and malt beverages

Soups and sauces are common sources of hidden gluten, as wheat flour is often used as a thickener. Pay special attention to sauces or soups that are cream-based. The Celiac Disease Foundation website has an extensive list of foods that may contain gluten.

Gluten-Free Foods

Cutting gluten out of your diet may seem like a difficult task, but many foods, including the following, are naturally gluten-free:

• Fruits
• Vegetables
• Fresh cuts of meat and poultry
• Fish and seafood
• Dairy
• Beans, legumes, and nuts

Beware, though, that prepared or processed versions of any of the above foods, such as sausage or ice cream, may contain gluten.

Many gluten-free grains and starches can be substituted for wheat and other gluten-containing grains:

• Rice
• Corn
• Potato (but not potato chips)
• Tapioca
• Sorghum
• Soy
• Quinoa
• Millet
• Arrowroot
• Amaranth
• Teff
• Flax
• Chia
• Gluten-free oats
• Buckwheat
• Nut flours
• Bean flours

Tips for Dining Out on a Gluten-Free Diet

The following strategies may help you stick to your gluten-free diet when eating out:

• Choose a restaurant with gluten-free options.  This means a place that serves naturally gluten-free foods or has a special gluten-free menu.
• Inform your waiter. Let them know you have celiac disease and may get sick if you eat anything containing gluten, including flour, bread crumbs, or soy sauce. Also ask them to inform the chef or cook. This way, you’ll have more confidence that nothing on your plate has touched gluten.
• Ask questions. Don’t assume anything is gluten-free. Omelets, for instance, may have pancake batter added to the egg mixture to make them fluffier, and baked potatoes can be coated with flour to make the skins brown and crispy.

Prevention of Celiac Disease

At this time, there is no proven way to prevent celiac disease. The best way to keep symptoms of celiac disease under control is to maintain a gluten-free diet.

Complications of Celiac Disease

Treatment for the disease and new lifestyle habits, such as following a gluten-free diet, can help prevent long-term complications.

• Malnutrition
• Anemia (low red blood cell count)
• Osteoporosis (weak bones caused by loss of bone density)
• Infertility or miscarriage
• Seizures
• Peripheral neuropathy
• Liver problems
• Heart problems
• Certain cancers (intestinal lymphoma, small bowel cancer)
• Lactose intolerance
• Dermatitis herpetiformis (an itchy rash of bumps and blisters) or other skin conditions

Research and Statistics: How Many People Have Celiac Disease?

Regardless of age or other factors, the symptoms of celiac disease can manifest differently depending on who you are.

 For example, some people with the disease have digestive problems, especially diarrhea, while others experience problems in other parts of the body, such as anemia, fatigue, headaches, and joint pain.

But best estimates put the prevalence of the condition around 1 in 100 people, or about one-half of 1 percent of the U.S. population, per the Celiac Disease Foundation.

Related Conditions and Causes of Celiac Disease

Unfortunately, celiac disease can be tough to diagnose in many people because its symptoms are often confused with those of other conditions. But it’s important to know that celiac is distinct from those conditions, including gluten intolerance and a wheat allergy, because it’s an autoimmune disease in which the immune system attacks the small intestine, leading to malabsorption.

Could Your Symptoms Be the Result of a Wheat Allergy?

If you’ve been tested for celiac and the results were negative, there’s a chance you simply have an allergy to wheat.

Wheat allergies affect millions of Americans, according to the American College of Allergy, Asthma & Immunology, and symptoms include:

• Headaches
• Stuffy or runny nose
• Hives or a skin rash
• Nausea and gastrointestinal symptoms, including diarrhea or vomiting
• Asthma
• Anaphylaxis (though this is uncommon)

These symptoms may appear after you eat foods with wheat, including bread, cereal, or granola. Because these foods also contain gluten, a wheat allergy is commonly called a “gluten allergy,” though there’s actually no such thing.

Your doctor can do a blood test or skin-prick test to diagnose you with a wheat allergy.

Treatment includes avoiding foods with wheat and using either corticosteroids or antihistamines. You should also have epinephrine on hand in case of an allergic attack.

Could You Have Intolerance to Gluten (Nonceliac Gluten-Sensitivity)?

Gluten intolerance, also called nonceliac gluten sensitivity (NCGS), is a possibility if you’ve tested negative for both celiac disease and a wheat allergy. But unfortunately, there isn’t a good test to diagnose this condition.

If your doctor suspects you have gluten intolerance, he or she may suggest a blood test and then a biopsy. If the biopsy is normal, your physician may suspect NCGS.

The main treatment for NCGS is a gluten-free diet, but as with celiac, be sure to work with your healthcare team to make sure you’re properly nourishing your body.

Celiac Disease and COVID-19

To date, there is no evidence or reports to suggest that individuals with celiac disease are at a greater risk of severe illness from COVID-19 than those without the condition.

The Celiac Disease Foundation is collecting physician and patient-reported data on people with celiac disease who have been diagnosed with COVID-19.

 This data will help show the true impact of COVID-19 on people with celiac disease.

Resources We Love

To properly control celiac disease, you need more than just resources for recipes. By visiting websites such as UpToDate, the National Institute of Arthritis and Musculoskeletal and Skin Diseases National Resource Center, and the U.S. Food and Drug Administration (FDA), you can find the resources you need to thrive with this autoimmune condition.

Additional reporting by Ashley Welch and Jane Okoji.

Editorial Sources and Fact-Checking

• Sources of Gluten.  Celiac Disease Foundation.
• Symptoms and Causes of Celiac Disease. National Institute of Diabetes and Digestive and Kidney Diseases. June 2016.
• Rubin JE, Crowe SE. Celiac Disease. Annals of Internal Medicine. December 1, 2020.
• Celiac Disease: Who Is at Risk? Beyond Celiac.
• Celiac Disease. Family Doctor. November 13, 2019.
• Autoimmune Disorders. Celiac Disease Foundation.
• Celiac Disease: Diagnosis and Treatment. Mayo Clinic. August 10, 2021.
• Celiac Disease. Johns Hopkins Medicine.
• Aljada B, Zohni A, El-Matary W. The Gluten-Free Diet for Celiac Disease and Beyond. Nutrients. November 9, 2021.
• Treatment for Celiac Disease. National Institute of Diabetes and Digestive and Kidney Diseases. October 2020.
• Once Diagnosed. Coeliac UK.
• Gluten in Medicine: Vitamins and Supplements. Celiac Disease Foundation.
• Nutritional Deficiencies in Celiac Disease. Beth Israel Deaconess Medical Center.
• Hidden Gluten: 4 Places and 1 Resource to Watch. Celiac Central. May 1, 2012.
• Journal Article Sheds Light on Gluten in Cosmetics. Beyond Celiac. August 31, 2012.
• Long-Term Health Conditions. Celiac Disease Foundation.
• Ciacci EJ, Lewis SK, Biviano AB, Iyer V, Garan H, Green PH. Cardiovascular Involvement in Celiac Disease. World Journal of Cardiology. August 26, 2017.
• Rubio-Tapia A, Murray JA. The Liver and Celiac Disease. Clinics in Liver Disease. March 1, 2019.
• Ianiro G, Bibbo S, Bruno G, et al. Prior Misdiagnosis of Celiac Disease Is Common Among Patients Referred to a Tertiary Care Center: A Prospective Cohort Study. Clinical and Translational Gastroenterology. January 7, 2016.
• Global Prevalence of Celiac Disease. Celiac Disease Foundation.
• Wheat & Gluten Allergy: Symptoms and Treatment. American College of Allergy, Asthma & Immunology.
• Celiac Disease and COVID-19. Celiac Disease Foundation.

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Flatulence

Hemorrhoids

Esophageal hernia

Gastroesophageal reflux

Irritable bowel syndrome

Diverticulitis

139February 26

Flatulence – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Excessive gas formation in the gastrointestinal tract leads to severe discomfort, especially if it is impossible to hold gases. Gaseous substances that fill the lumen of the stomach and intestines include hydrogen, methane, hydrogen sulfide and carbon dioxide. Together with food, air can enter the stomach, but mostly gases are a waste product of microorganisms, and also arise as a result of the interaction of hydrochloric acid of the stomach with bicarbonate coming from the pancreas. Increased gas formation is accompanied by bloating, a feeling of fullness and pain. This phenomenon is called flatulence.

In some cases, spastic conditions of the gastrointestinal tract interfere with the passage of gases, and sometimes a person cannot control this process even with a slight content of gases in the intestines.

Varieties of flatulence

Flatulence occurs with increased processes of gas formation and deterioration of intestinal motility.

Excess gas is removed from the stomach by eructations , from the intestines – through the rectum . In addition, gases can enter the bloodstream and be released with exhaled air. Gases formed in the intestines are absorbed only in the small intestine, where their bubbles are mixed with liquid contents. In the large intestine, gases are not absorbed into the blood due to the high density of feces, so the only way out for them is through the rectum, which occurs on average 15-20 times a day. Participating in the regulation of the intestines, gases affect its function in different ways: methane slows down the passage of feces and contributes to the development of constipation, hydrogen reduces the motility of the ileum, but promotes the movement of contents in the final sections of the colon.

Possible causes of increased gas production and incontinence

The reasons for the development of flatulence may be associated with: 1) dietary habits; 2) indigestion; 3) imbalance in the composition of the intestinal microflora; 4) impaired intestinal motility. Gastric overflow leads to eructation, which often disturbs patients with incomplete closure of the cardiac sphincter in hiatal hernia, gastroesophageal reflux disease .

In addition, impaired motility of the gastrointestinal tract in gastric ulcer, biliary dyskinesia, and some intestinal diseases is also accompanied by rapid belching, sometimes even with regurgitation. With the development of putrefactive processes in the stomach with gastroparesis belching may have an unpleasant odor.

However, often belching is not a symptom of the disease, but an indicator of malnutrition.

For example, when eating food hastily, a person can swallow a large amount of air. Also, excess gas in the stomach occurs after drinking carbonated drinks.

If gases fill the intestines, there is a feeling of bloating.

It can occur due to excessive content of gaseous substances, and be subjective due to the increased sensitivity of the intestinal mucosa.

Often this symptom occurs in functional disorders: irritable bowel syndrome, diseases of the pancreas accompanied by enzymatic deficiency, reproduction of pathological microflora. An increased formation of gases occurs when a large amount of legumes, cabbage, onions, carrots, raisins, bananas, apples, grapes, yeast dough products are consumed. Evidence of functional disorders is the appearance of swelling some time after eating. In the morning, before breakfast, this sensation is absent.

An unpleasant symptom is gas incontinence, which is possible even with their slight accumulation in the intestine. Such a problem may occur in patients with cracks and fistulas in the anus.

Gas incontinence is also a concern for patients with anal sphincter insufficiency. As a rule, this condition accompanies other types of pathology – hemorrhoids, prolapse of the rectum. Sometimes insufficiency of the internal anal sphincter can be the result of neurological disorders, surgical interventions or injuries, accompanied by the formation of scars and strictures.

The sphincter muscles weaken with age, which is why the problem of gas incontinence is more common in older people.

With intestinal diverticula – saccular protrusions of the mucous membrane and submucosa of the intestine – bloating and profuse discharge of gases are almost always observed.

In addition, there are feelings of fullness and heaviness in the abdomen, pain in the left iliac region and irregular, spastic stools (“sheep”). Often there is rumbling in the abdomen and rapid discharge of gases with an unpleasant odor.

In women, uncontrolled gas discharge develops in the last months of pregnancy, after childbirth due to pelvic floor dysfunction. The same problem occurs in a third of patients with prolapse and prolapse of the uterus and in a small percentage of cases with pathological lengthening of the cervix.

Gas incontinence occurs with lesions of the central nervous system due to injuries of the spine and head, and in this case it is accompanied by uncontrolled fecal and urination. With an epileptic seizure in the relaxation phase, urine, gases and feces can also occur. Gas control is lost at mental disorders (manic-depressive syndrome, dementia) and psycho-emotional stress.

Which doctors should I contact?

The problem of increased gas formation and uncontrolled discharge of gases can occur under different conditions of the body. In any case, you should visit
primary care physician. If the symptoms of flatulence bother a woman during pregnancy, after childbirth, or flatulence is accompanied by other symptoms, you should consult a
gynecologist. If bowel diverticula, anal sphincter insufficiency, or gastrointestinal dyskinesia are suspected, referral should be made to
gastroenterologist.

Diagnostics and examinations

If uncontrolled gas discharge occurs during pregnancy, after childbirth, as a rule, additional examination is not required. When complaining of a constant discharge of gases without symptoms of bloating, it is necessary to check the condition of the anal sphincter and intestines. For this, sigmoidoscopy and colonoscopy are performed.

If gas incontinence is accompanied by bloating, pain, a feeling of fullness, an examination of the entire gastrointestinal tract is required to exclude the pathology of the biliary tract, pancreas and intestines. To rule out diverticula, your doctor may order a barium X-ray contrast study, a colonoscopy, a helical CT scan, and a comprehensive abdominal ultrasound examination.

Biliary dyskinesia can be detected using an ultrasound of the gallbladder, and an ultrasound of the pancreas.

If the doctor suspects impaired intestinal motility as the cause of flatulence, he may prescribe electrogastroenterography and manometry.

Be sure to conduct laboratory tests to assess enzymatic deficiency and intestinal microflora.

In these cases, informative general;

complex biochemical blood test with determination of total protein and albumin,

bilirubin and its fractions,

as well as a coprogram.

Treatment

Bloating and increased gas can be both a sign of a disease and a consequence of an improper diet and lifestyle. You can cope with these symptoms only by establishing their cause.

In any case, it is necessary to normalize the diet and exclude gas-forming products from the diet.

Functional disorders involve correction of the motility of the gastrointestinal tract, microflora and elimination of enzymatic deficiency. It is also necessary to eliminate the causes of psycho-emotional stress. To reduce the pressure of gases in the intestine, adsorbents (activated carbon, etc.), carminatives, enzymatic preparations are used.

If the cause of uncontrolled gas passage is an insufficiency of the anal sphincter due to hemorrhoids, fissure or fistula, surgical treatment is necessary. At intestinal diverticula non-drug treatment is possible, which involves changes in lifestyle and diet. Patients are not recommended cleansing enemas and the use of laxatives. Nutrition should include fiber-rich foods. Antispasmodics, phosphodiesterase inhibitors, non-selective calcium channel antagonists, and water-soluble fiber preparations are used as drug therapy.

What should be done in case of flatulence?

With increased gas formation and bloating, it is desirable to identify those foods that cause flatulence, and refuse them or reduce their number.

After the digestion processes are normalized, these products should be introduced into the diet gradually, helping the intestines with enzyme preparations. The improvement of peristalsis is facilitated by the consumption of a sufficient amount of liquid – up to 2-2.5 liters per day.

It is advisable not to eat foods containing a large amount of fat, and sweet dishes. Fermentation in the intestines is also facilitated by fruits and foods containing yeast. Before cooking legumes (which contribute to the occurrence of flatulence), you should first soak them in water.

It is very important to eat properly to prevent swallowing air while eating.

Eating should be done slowly, avoiding lying down. An active lifestyle and moderate physical activity contribute to the reduction of flatulence.

Sources:

1. Clinical guidelines “Irritable bowel syndrome”. Developed by: Russian Gastroenterological Association, Association of Coloproctologists of Russia. – 2021.
2. Clinical guidelines “Diverticular disease”. Developed by: Russian Gastroenterological Association, Association of Coloproctologists of Russia. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Why flatulence occurs and what to do about it

Likbez

Health

September 10, 2020

You may be talking too much while eating, or it may be a symptom of a serious illness.

Flatulence (from the Greek for “lifting up”, “bloating”) is a medical term for excessive accumulation of gases in the intestines. It is often confused with bloating. These states are really similar, but there is an important nuance.

Bloating is just a symptom of flatulence. Very common, but far from the only one and not even always mandatory.

What are the symptoms of flatulence

In addition to bloating, excess gas in the intestines can manifest itself in other signs:

• belching;
• frequent need to pass gases – more than 10 times a day;
• a loud gasping sound that is sometimes impossible to control;
• bad smell;
• uncontrollable grumbling, “overflow” in the stomach;
• fast saturation.

Why flatulence is dangerous

In itself, this condition is not dangerous, except that it slightly reduces the quality of life. It’s embarrassing when, at an important meeting, you suddenly make yourself felt not with a sensible sentence, but with a loud rumbling in your stomach or even a fart.

However, in some cases flatulence may indicate a serious illness. And it’s important not to miss it.

What are the causes of flatulence

Excess gases in the intestines can appear in two ways:

• exogenous, when gases come from outside, for example, if we swallow excess air while eating or drinking;
• endogenous, when excess gases form inside the intestines as a side effect of food digestion or the inability of the body to absorb a particular product.

Here are the most common causes of flatulence.

External (exogenous)

1. You accidentally swallowed a lot of air

A small amount of it enters the intestines every time we eat or drink. The key word here is “small”. Such a volume of air inside the gastrointestinal tract does not affect well-being in any way.

But in some cases we swallow much more air than usual. It increases the pressure inside the intestines and leads to flatulence. This happens when you:

• chew gum;
• sucking on a lollipop;
• suck or bite on foreign objects, such as chewing on the cap of a pen or biting your nails;
• smoke;
• drink through a straw;
• chatting actively while eating.

2. You are very hungry and eat in large chunks

This eating behavior in itself makes you swallow more air. In addition, large pieces expand the esophagus – and air enters the digestive tract in impressive volumes.

3. You have eaten a food that increases gas formation

Foods high in fiber are most often caused by increased gas formation in the intestines:

• legumes, in particular beans and peas;
• hard fruits such as apples or pears;
• vegetables, especially different types of cabbage: white cabbage, cauliflower, Brussels sprouts, broccoli;
• whole grain products: cereals, bread, bran.

4. You drank soda

First, the bubbles that you swallow increase the amount of gas in the intestines. Secondly, carbonated drinks, especially diet ones, contain sweeteners – sorbitol or xylitol, which increase gas formation.

Internal (endogenous)

1. You have constipation

Normally, intestinal gases, if they become too much, pass easily and imperceptibly through the anus. But when constipated, it is difficult for them to break out. The pressure in the intestines rises.

When the stool moves, excess air moves under high pressure to the anus. So there is a grumbling in the stomach, and when the gases are released, this is accompanied by a specific loud sound.

2. Your intestinal microflora is disturbed

A change in the number or composition of bacteria in the small intestine leads to the fact that food is digested more slowly and worse, begins to ferment. This is how excess gases are formed. This condition can be caused, for example, by taking antibiotics.

3. You have a food intolerance

This means that the intestines cannot break down and assimilate certain foods, such as milk lactose or the gluten protein found in grain foods (cereals, bread, pasta). Fermentation begins, foul-smelling gases are released.

4. You have diabetes mellitus

Diabetes seriously impairs the digestive function: it impairs intestinal motility, changes its bacterial composition, and makes absorption of foods difficult. Flatulence is only one of the consequences of these disturbances.

5. You may be developing a disease of the gastrointestinal tract

Here are a few diseases that can be symptomatic of flatulence (and sometimes, in the early stages, the only one):

• gastroenteritis and other intestinal infections;
• irritable bowel syndrome;
• stomach ulcer;
• duodenal ulcer;
• gastroparesis – a condition in which the muscles of the walls of the stomach weaken;
• autoimmune pancreatitis;
• gallstones;
• cholecystitis;
• diverticular disease.

What to do if you have flatulence

Flatulence caused by external causes is usually harmless and resolves on its own rather quickly. Therefore, if you suffer from gases only from time to time and you can associate this with, for example, drinking carbonated drinks or chatting while eating, there is nothing to worry about.

But if flatulence began to haunt you regularly – every day or several times a week, contact a gastroenterologist.

Your doctor will ask you about your symptoms, ask about your lifestyle and eating habits, perform an examination, and listen to your abdomen with a stethoscope. Perhaps he will offer to undergo an additional examination – to take blood and urine tests, to do an ultrasound of the abdominal organs.

If the results of the tests show that the causes of increased gas production are internal, associated with diseases of the gastrointestinal tract, it will be necessary to treat or correct the specific disease. When therapy is completed, problems with intestinal gases will disappear.

However, most often flatulence is the result of an unhealthy lifestyle, irregular or unhealthy diet. Your doctor will advise you on how to overcome this.

Here are some general tips:

• Eat slowly, chewing your food thoroughly. It is important not to swallow air with large pieces.
• Avoid chewing gum and hard candies.
• Drink less carbonated drinks.
• Consider avoiding diet foods and drinks with sweeteners and monitor your condition. Perhaps flatulence in your case is caused precisely by artificial sweeteners.
• Divide food into small portions. Many foods that cause gas are an important part of a healthy diet. In order not to deprive yourself of, for example, fiber, try eating it in small portions. Perhaps this will solve the problem.
• Stop smoking or do it as little as possible.
• If you wear dentures, see your dentist to see if they fit well. Poorly fitting ones can lead to swallowing excess air while eating or drinking.