One of the most common issues I help patients deal with in the office is the symptoms of gas, bloating and distention. Some patients feel that they pass too much gas while some patients feel they have excessive belching. Some patients have a combination of bloating, distention, cramps and diarrhea. Although these symptoms are very frustrating to deal with, there is frequently a good explanation as to why it is happening and treatments to keep it under control.
WHY DO YOU GET GASSY AND BLOATED?
We as humans don’t make much gas. There are two main sources for intestinal gas: gas that is ingested (usually swallowed air) and gas that is produced by fermentation from bacteria.
Swallowed air is a common source of gas and bloating. We typically all swallow small amounts of air when we eat but sometimes we swallow much larger amounts when we eat too fast. Chewing gum, smoking and drinking liquids to fast is a common cause of increased swallowed air. Once the air makes its way to your stomach it can be expelled as belching or it may go down stream into your small intestine where it can cause symptoms of bloating, distention and cramping.
Some people produce excess amounts of gas as a by-product of fermentation from bacteria in their bowels. There are several reasons why this can happen. Our colon normally contains billions of bacteria, which help us digest certain types of foods and are involved in helping keep our colon healthy. There are certain types of foods that don’t get digested very well by the normal enzymes in our stomach and small intestine and that allows these foods to reach the colon and get fermented by bacteria. These are commonly foods that are high in fiber and carbohydrates.
Some people lose the ability over time to digest certain types of carbohydrates. The two most common categories of this are lactose intolerance and fructose malabsorption. If you have become deficient in these enzyme pathways over time, when foods containing those carbohydrates are ingested they will not be broken down or absorbed in your small bowel like they should. They will then make their way down stream where they get fermented by bacteria and produce gas.