Intestinal Gas, Treating Intestinal Gas, Bloating, belching and intestinal gas

thehealthtime.com

Medical Editor: Dennis Lee, MD

We all produce gas in our intestines, especially our colons, or, at least, our intestinal bacteria produce it, from undigested food. We are fortunate because the overwhelming majority of the gas that is formed by the bacteria is used up by other bacteria in the intestine.

Some people are more fortunate than others. All of the gas produced in their intestines is used up by bacteria, and they pass gas (fart) very little, that is, unless they eat foods that bacteria can use to form lots of gas—like beans—that overwhelm even the most ardent, gas–devouring bacteria. A small amount of intestinal gas is absorbed into the blood from the intestine and is eliminated in the breath. The gas that is not used up by bacteria or eliminated in the breath must be passed. Passing gas relies on the functioning of the intestinal muscles. The gas distends the intestine, and the intestinal muscles respond by contracting and pushing the gas further along the intestine until the gas is finally expelled. Sometimes this process fails.

I recently underwent removal of a portion of my sigmoid colon for diverticulitis. The surgery was done laparoscopically and went very well. There were no complications, and my discomfort was easily controlled with medication. Manipulation of the intestines during surgery “stuns” the intestinal muscles, and they usually stop working for a time. Before patients can eat after surgery, their intestinal muscles must start working. The signs that the muscles are working is the presence of abdominal gurgling (borborygmi) and the passing of gas. Laparoscopic surgery stuns the intestine less than “open” (large incisional) surgery, and the intestinal muscles usually recover quickly

Treating Intestinal Gas
Things you can do to reduce or eliminate gas

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Gas Control Valve
The most common ways to reduce the discomfort of gas are changing diet, taking medicines, and reducing the amount of air swallowed.

Diet
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.

Nonprescription medicines
Many nonprescription, over-the-counter medicines are available to help reduce symptoms, including antacids with simethicone and activated charcoal. 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. The recommended dose is 2 to 4 tablespoons of the simethicone preparation taken 1/2 to 2 hours after meals.

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.

Prescription medicines
Doctors may prescribe medicines to help reduce symptoms, especially for people with a motility disorder, such as IBS. Promotility or prokinetic drugs, such as metoclopramide (Reglan), may move gas through the digestive tract quickly.

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

•Beans

•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 motility 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 or prescription 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.