Gastrointestinal Gas | Digestive Disorders That Cause Gas

What Is Gastrointestinal Gas?

Everybody has gas in his or her digestive tract (the esophagus, stomach, small intestine/bowel, and large intestine/bowel). The amount of gas varies and there is a wide range of normal (7-14 Tbsp. or 100-200 ml). What this gas is made up of and how it is distributed through the intestines are determined by how it is produced, how it moves through various areas of the bowel, and how it is eliminated

Intestinal gas can occur in the stomach and upper intestine if you swallow air while eating, drinking or chewing gum. Intestinal gas related to swallowed air is usually passed by burping or belching.

Intestinal gas can also form in the lower, or large, intestine (colon) as a normal byproduct of the bacterial breakdown of undigested food. Intestinal gas related to bacterial action is made up of hydrogen, carbon dioxide and sometimes methane, and is usually passed through your rectum (flatulence).

Most people pass gas rectally several times a day as a normal part of daily activities and food breakdown. Sometimes, excessive intestinal gas can indicate a digestive disorder.

What Causes of Gastrointestinal Gas?

But what causes these noisy, embarrassing, and sometimes foul-smelling eruptions? And is there a way to prevent them? There are several ways by which gas enters the body or is produced by it, and several ways that the body can dispose of it.

Gas enters the digestive tract through:

1. Swallowing of air. People swallow air to varying extents. We get rid of some of the swallowed air by belching. The rest is passed into the intestines. You can increase the chances of swallowing air by:
* Smoking
* Chewing gum
* Drinking through a straw
* Sucking on hard candies
* Drinking a lot of carbonated beverages
* Eating or drinking too quickly
* Wearing loose dentures

2. Back-passage of gas from the blood stream into the intestines.

3. The production of gas through chemical reactions within the intestines.

4. As a by-product of the fermentation of food by intestinal bacteria.

5. Foods. What Foods Cause Gas? The foods that are likely to cause gas are carbohydrates. This is because carbohydrates pass through the gastrointestinal tract mostly undigested. When carbohydrates enter the colon they are further broken down by bacterial
fermentation. This fermentation can generate gas. The processing of fats and proteins cause little gas.

The following foods are likely to cause gas:

* Starches: Starch is a carbohydrate. Starches such as potatoes, corn,noodles, and wheat all produce gas.

* Dietary Fiber: Fiber is a complex carbohydrate present in edible plants. Though fiber can temporarily cause gas, fiber is important for stoolproduction and regularity. Dietary fiber is divided into two types: Insoluble and Soluble.

• Insoluble Fiber: Insoluble fiber is found in fruit and vegetable peels, corn, and wheat bran. Insoluble fiber swells up with fluids and helps to create volume and moisture in the stools. However, since it is not further broken down by bacteria it produces little gas.
• Soluble Fiber: Soluble fiber is found in the flesh of fruits and vegetables, seeds, legumes, oats, some grains and can be found in high concentrations in dried fruit. Bacteria is able to break soluble fiber down into a gel that helps to make stools moist, soft and flexible. This bacterial activity can generate gas.

* Sugars: Sugar is a carbohydrate. Sugar can cause gas. The sugars that cause gas are raffinose, lactose, fructose, and sorbitol. Sources of these sugars are:

• Raffinose: Raffinose is a complex carbohydrate. It can be found in beans, cabbage, brussels sprouts, broccoli, asparagus, other vegetables, and whole grains.
• Lactose: Lactose is the natural sugar in milk and milk products such as cheese and ice cream. It is also found in many processed foods, such as bread, cereal, and salad dressing. Some people have low levels of the enzyme lactase that is needed in order to digest lactose. This can result in gas. With age, enzyme levels may decrease. As a result, some people may experience increasing amounts of gas after eating foods containing lactose.
• Fructose: Fructose is a natural sugar present in onions, artichokes,pears, grapes and wheat. It is also used as a sweetener in some soft drinks and fruit drinks.
• Sorbitol: Sorbitol is a natural sugar found in fruits, such as apples, pears, peaches, and prunes. Sorbitol is also used as an artificial sweetener in many of the diet industry foods. It can also be found in “sugar free” candy and gum.
  

Excessive production of gas

Excessive production of gas by bacteria is a common cause of intermittent abdominal bloating/distention. Bacteria can produce too much gas in three ways:

1. First, the amount of gas that bacteria produce varies from individual to individual. In other words, some individuals may have bacteria that produce more gas, either because there are more of the bacteria or because their particular bacteria are better at producing gas.
2. Second, there may be poor digestion and absorption of foods in the small intestine, allowing more undigested food to reach the bacteria in the colon. The more undigested food the bacteria have, the more gas they produce. Examples of diseases of that involve poor digestion and absorption include lactose intolerance, pancreatic insufficiency, and celiac disease.
3. Third, bacterial overgrowth can occur in the small intestine. Under normal conditions, the bacteria that produce gas are limited to the colon. In some medical conditions, these bacteria spread into the small intestine. When this bacterial spread occurs, food reaches the bacteria before it can be fully digested and absorbed by the small intestine. Therefore, the bacteria in the small intestine have a lot of undigested food from which to form gas. This condition in which the gas-producing bacteria move into the small intestine is called bacterial overgrowth of the small intestine (bowel)
   

Excessive production of gas by bacteria is usually accompanied by more flatulence. Increased flatulence may not always occur, however, since gas potentially can be eliminated in other ways-absorption into the body, utilization by other bacteria, or possibly, by elimination at night without the knowledge of the gas-passer.

Digestive Disorders That Cause Gas

Excessive intestinal gas — belching or flatulence more than 20 times a day — sometimes indicates a digestive disorder such as:

* Celiac disease
* Dumping syndrome
* Food intolerance vs. food allergy: What's the difference?
* Gastroparesis
* GERD
* Irritable bowel syndrome
* Lactose intolerance
* Peptic ulcer
* Short bowel syndrome

How To Reduce The Gas?

Everyone has to contend with some belching and intestinal gas every day.

But if it's really bothering you, or if you feel that the amount of gas you're producing is excessive, there are some steps you can take. There are a few things you can try which may help to reduce digestive gas:

• Avoiding anything that might increase your chances of swallowing air, such as smoking, drinking through straws, and eating too quickly.
• Avoiding or cutting down on problematic foods, such as carbonated drinks, beans, and some raw vegetables.
• Considering a food diary. If you can't figure out what may be causing your increased gas, try keeping a journal of what you eat. You may find one or two foods that seem to increase your symptoms.
• Try cutting back on fried and fatty foods. Often, bloating results from eating fatty foods. Fat delays stomach emptying and can increase the sensation of fullness.
• Increase Bacterial Populations. Buttermilk, kefir, yogurt, and Pro-biotic supplements that contain live bacteria can help to increase healthy bacteria in the colon.
• Eat Slowly. Eating slowly and chewing your food well can help to cut down on the amount of air that you may swallow.
• Increase fluid intake. Fluids are the basis of mucus that helps to moisturize the colon lining. This helps promote healthy bacterial growth. Caution: Drinking a lot of fluid quickly in a very shot period of time can cause painful stomach gas.
• Try a cup of peppermint tea. Peppermint oil contains menthol, which appears to have an antispasmodic effect on the smooth muscles of your digestive tract. You may find that a warm cup of peppermint tea can provide relief from gas and gas pain. On the other hand, peppermint may contribute to heartburn and acid reflux
• Exercise. Movement, even walking, can help your body to release trapped gases.
• Massage. Gentle abdominal massage can help to reduce painful trapped gas.
• Medicines are available to help reduce symptoms, including antacids with simethicone and activated charcoal. 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.
• Consult a Doctor. Talk to your doctor if you are having persistent problems with gas, or if you have excessive gas production.
  

What The Symptoms of Gastrointestinal Gas?

The most common symptoms of gas are:

• Belching.
• Bloating
• Flatulence. Passing out through the anus (flatus).
• Abdominal Pain
• Excessive or foul-smelling air
• Difficult gas evacuation

Belching



Belching, also known as burping, is the act of expelling gas from the stomach out through the mouth. The usual cause of belching is a distended (inflated) stomach caused by swallowed air. The distention of the stomach causes abdominal discomfort, and the belching expels the air and relieves the discomfort. The common reasons for swallowing large amounts of air (aerophagia) are gulping food or drink too rapidly, anxiety, and carbonated beverages. People are often unaware that they are s wallowing air. "Burping" infants during bottle or breast feeding is important in order to expel air in the stomach that has been swallowed with the formula or milk.

Excessive belching is a common gas related complaint that doctors see. Patients who belch a lot accidentally swallow air that gathers in the stomach, and is then released by belching. Often, belching is triggered by an uncomfortable feeling of fullness in the upper abdomen that patients mistake as excessive gas in the stomach. During repeated but ineffective attempts at belching, air is actually drawn into the stomach with increasing discomfort, although some relief may be felt when belching finally does occur. In most of the cases a clear explanation can resolve the problem. The solution is to avoid intentional belching, thereby preventing additional air swallowing. If the upper abdominal discomfort persists, another problem may be present that a doctor will need to diagnose and treat.

Bloating

It is important to distinguish between bloating and distention. Bloating is the subjective sensation (feeling) that the abdomen is larger than normal. Thus, bloating is a symptom akin to the symptom of discomfort. In contrast, distention is the objective determination (physical finding) that the abdomen is actually larger than normal. Distention can be determined by such observations as the inability to fit into clothes or looking down at the stomach and noting that it is clearly larger than normal. In some instances, bloating may represent a mild form of distention since the abdomen does not become physically (visibly or measurably) enlarged until its volume increases by one quart. Nevertheless, bloating should never be assumed to be the same as distention.

There are three ways in which abdominal distention can arise. The causes are an increase in air, fluid, or tissue within the abdomen. The diseases or conditions that cause an increase of any of these three factors are very different from one anther. Therefore, it is important to determine which of them is distending the abdomen.

Flatulence

Flatulence, also known as farting, is the act of passing intestinal gas from the anus. Gas in the gastrointestinal tract has only two sources. It is either swallowed air or it is produced by bacteria that normally inhabit the intestines, primarily the colon. Swallowed air is rarely the cause of excessive flatulence. The usual source is the production of excessive gas by intestinal bacteria. The bacteria produce the gas (hydrogen and/or methane) when they digest foods, primarily sugars and polysaccharides (e.g., starch, cellulose), that have not been digested during passage through the small intestine. Sugars that are commonly poorly digested (maldigested) and malabsorbed are lactose, sorbitol, and fructose. Lactose is the sugar in milk. The absence of the enzyme lactase in the lining of the intestines, which is a genetic trait, causes the maldigestion. Lactase is important because it breaks apart the lactose so that it can be absorbed. Sorbitol is a commonly used sweetener in low calorie foods. Fructose is a commonly used sweetener in all types of candies and drinks.

Starches are another common source of intestinal gas. Starches are polysaccharides that are produced by plants and are composed of long chains of sugars. Common sources of different types of starch include wheat, oats, potatoes, corn, and rice. Rice is the most easily digested starch and little undigested rice starch reaches the colon and the colonic bacteria. Accordingly, the consumption of rice produces little gas. In contrast, the starches in wheat, oats, potatoes, and, to a lesser extent, corn, all reach the colon and the bacteria in substantial amounts. These starches, therefore, result in the production of appreciable amounts of gas.

The starch in whole grains produces more gas than the starch in refined (purified) grains. Thus, more gas is formed after eating foods made with whole wheat flour than with refined wheat flour. This difference in gas production probably occurs because the fiber present in the whole grain flour slows the digestion of starch as it travels through the small intestine. Much of this fiber is removed during the processing of whole grains into refined flour. Finally, certain fruits and vegetables, for example, cabbage, also contain poorly digested starches that reach the colon and result in the formation of gas.

Most vegetables and fruits contain cellulose, another type of polysaccharide that is not digested at all as it passes through the small intestine. However, unlike sugars and other starches, cellulose is used only very slowly by colonic bacteria. Therefore, the production of gas after the consumption of fruits and vegetables usually is not great unless the fruits and vegetables also contain sugars or polysaccharides other than cellulose.

Too much and/or foul-smelling gas -

Some patients complain of bad smelling air, which may become socially disabling. Odor stems from the presence of small quantities of sulfide substances that are produced by specific bacteria in the colon. Other patients complain of too much passage of gas through the anus. The frequency of anal gas evacuation in healthy subjects varies depending on the diet, but is usually around twenty times per day. There are parts in the normal diet that are not completely absorbed in the small bowel and are fermented in the colon. These tend to increase gas production and include:

* Fermentable dietary fiber.
* Dietary starch.
* Complex carbohydrates, that appear to be the most important source of gas, in beans.
* Sugars such as sorbitol and fructose.

Furthermore some substances contained in beans block the intestinal enzyme that normally digests starch so that starch cannot be absorbed in the small bowel and passes into the colon, where it is fermented increasing gas production.

Some diseases, which are easily recognizable by a doctor, affect the normal absorption of nutrients within the small bowel. Patients with these usually treatable diseases may have excessive gas production and evacuation. Regardless of the cause, those with increased gas production and evacuation do not complain of abdominal symptoms unless they have associated irritable bowel syndrome (IBS), because healthy subjects handle most gas loads without difficulty or symptoms.

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.

Difficult gas evacuation

While some patients have excess gas, others find gas difficult to get rid of. The process of gas evacuation requires effective muscle-nerve coordination, which not everybody has. Lack of coordination may also produce constipation with retention of stool. In some patients these problems can be resolved by biofeedback treatment. When normal coordination is restored there is also less retention of stool, which in turn leads to reduced fermentation time and reduced gas production.
Abdominal gas symptoms in IBS and related syndromes

Patients with functional GI disorders such as IBS frequently attribute their abdominal symptoms to gas. Bloating, for instance, where the abdomen feels distended and full, is one the most common and bothersome complaints in many patients with functional GI disorders. These patients usually feel gas as the cause of their symptoms, but there is little experimental evidence to support this feeling.

How To Treatment Gastrointestinal Gas?

Medical Treatment

The goal of treatment of flatulence is to reduce gas and odor. Medical intervention includes treatment with antibiotics if bacterial overgrowth of the GI tract is suspected or evidence of parasitic infection is seen.

* Some promising studies have investigated feeding nonoffensive strains of bacteria to push out the bacteria that are offensive, although no established treatments are available at this time.

* Regulation of bowel function is essential. Constipation should be treated with increased dietary fiber or certain laxatives.

* In cases where anxiety causes you to swallow air, your doctor may suggest you seek mental health counseling to change habit patterns.

Medications

If you do not desire to avoid the foods that cause gas for you, many nonprescription medicines are available to help reduce symptoms.

• Beano is an enzyme supplement that may be useful with bean ingestion. It contains the sugar-digesting enzyme that the body lacks to digest the sugar in beans and many vegetables. Beano has no effect on gas caused by lactose or fiber. You can buy the enzyme over-the-counter. Add 3-10 drops per serving just before eating to break down the gas-producing sugars.
• 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. These can be taken before meals. Dosage varies so read the labels.
• Activated charcoal tablets (Charcocaps) may provide relief from gas in the colon. Gas can be reduced if tablets are taken before and after a meal. The usual dose is 2-4 tablets taken just before eating and 1 hour after meals.
• Certain prescription medicines may help reduce symptoms, especially if you have a disorder such as irritable bowel syndrome. Some medicines such as metoclopramide (Clopra) have also been shown to decrease gas complaints by increasing gut activity.
  

resource:
* By Mayo Clinic Staff
* WebMd
* GIResearch
* Asumex
* Fruit Eze
* eMedicine