The National Institute of Digestive Diseases describes gas in the digestive tract as air that leaves your body through your mouth when you burp or through your anus when you pass gas. For this blog I’ll be focusing on air that leaves our body through the anus. The actual intestinal gas that leaves through the anus is called flatus, also known as farting, and flatulence is the “flatus or gas” that is expelled through the anus.  In some instances, flatus contains a small amount of sulfur and it’s the sulfur that gives it the odor.

A certain amount of gas production is normal in everybody.  Even though she may not admit it, even your wife passes gas.  Some people produce more gas than others and some people are more symptomatic from gas production than others.  The amount of gas someone produces can change day to day based on many variables, and its these that we will discuss today.  Although we can’t get rid of all our gas production, usually by working through the many causes, we can decrease it and make it more tolerable.

What Causes Intestinal Gas?

When we eat food, our body starts the digestion process which begins with food particles passing from the stomach to the small intestine. A majority of the food absorption will take place in the small intestine and then the remaining undigested food particles will pass into the colon, where bacteria break the rest of it down. It’s this process where bacteria in the colon break down carbohydrates, sugars and fibers that produces the most intestinal gas. While eating a lot of vegetables is very good for you, it can make you gassier than a high protein diet. In addition to certain types of foods and your body’s ability to fully break them down and digest them, a disruption in the bacteria found in the colon can produce excess gas as well.

Other causes of intestinal gas primarily relate to swallowing air and digestive disorders like celiac disease, Crohn’s disease, GERD, IBD, SIBO and ulcers. These disorders are commonly associated with producing excessive intestinal gas, but you should work with your doctor to get an accurate assessment of your specific conditions. Swallowing too much air may happen when you drink through a straw, eat or drink too quickly, use CPAP for sleep apnea or frequently chew gum. I think it’s interesting to point out that approximately 50 percent of gas that leads to flatulence can come from swallowing air, not from food.

Flatulence – What’s Considered Normal?

Most people produce up to 4 pints of gas a day (yes, even your wife), so we all have plenty of ammo to let out more than a few toots each day. Most healthy people release gas throughout the day with the average range being between 14-23 times.

Excessive gas and bloating is very different than just flatulence and should be evaluated by a doctor, which I’ll cover in the next section in addition to other symptoms that should be examined.

When to See a Doctor for Excessive Gas?

If you feel like you make more gas than others or more gas than you used to, it’s time to get checked out.  Again, usually the diet is to blame, but there are also may other reasons that could be the cause.  Also, if your gas causes pain or abdominal distention, it’s time to get it evaluated.  Typically, your physician will review your diet and medications, as well as over the counter supplements as all of these can play into gas production.  Depending on the symptoms you get with your gas production you will likely undergo testing to include blood work, abdominal ultrasound, breath testing for carbohydrate fermentation and small intestinal bacterial overgrowth and even upper endoscopy or colonoscopy depending on what associated symptoms you have.

What Can I do to Reduce the Intestinal Gas?

Although we don’t have great “anti-gas” medications to reduce intestinal gas, there are many things we can try:

  • Avoid taking in excess air – do not use straws when drinking, stop chewing gum and chew food more slowly.
  • Gradually introduce more fiber to your diet or try decreasing high fiber food and use stool softener if needed.
  • Eat more cultured vegetables; raw ones tend to ferment more
  • Eliminate sugars and carbonated beverages (would be good for your overall health anyway)
  • Drink more water
  • Increase exercise and daily activities
  • Try things like simethicone, Gas-X or over the counter anti-gas aids.  Usually not very helpful but they are relatively cheap and some people get benefit
  • Try Atrantil (www.atrantil.com) which is an OTC supplement developed by a gastroenterologist in Dallas that I have had great success with for decreasing gas and bloating
  • If all else fails, see a gastroenterologist in San Antonio, there is usually many things we can do to improve on your symptoms

I hope this has been helpful.  Thank you.  RH