About Gas And Bloating
Excessive gas and bloating is a common intestinal symptom. Passing gas through the rectum, or flatulence is normal, and in fact healthy subjects can pass gas up to 20 times per day. Belching is also common. When these conditions become troublesome, it is time to speak to your gastroenterologist.
What Causes Gas in the Intestinal Tract?
There are multiple causes of gas in the intestinal tract.
Swallowing air can cause excessive belching. Large amounts of air can be swallowed if you eat too rapidly. Other causes of excessive swallowed air are smoking, chewing gum, and using hard candies.
Eating certain foods can also cause excessive gas. Common foods associated with excessive gas include broccoli, cabbage, beans, onions, bananas, pretzels, and bagels. Drinking carbonated beverages such as soda, or carbonated water will also cause excessive gas. Artificial sweeteners and sugar substitutes used in drinks and candy are also associated with bloating and gas.
Lactose intolerance can cause excessive bloating and flatulence, especially after eating or drinking dairy products. Sometimes this can be the only symptom of lactose intolerance. Gluten intolerance, or celiac disease, may also present with excessive gas.
An infection in the intestinal tract may be associated with excessive gas. This can be a parasite such as giardia or an overgrowth of bacteria in the small intestine.
Bloating and Fullness
Bloating is a sensation that the abdomen is too full. The abdomen can also become distended which means there is an actual increase in waist size. Everyone feels gas in their intestinal tract differently. Some people will be more sensitive to excessive gas than others. You may develop crampy abdominal pain, while others may feel distended or develop discomfort in the upper sides of the abdomen. This is because the colon has many curves and angles that may trap pockets of gas and cause bloating.
Testing for the Cause of Excessive Gas
Although there are many tests available, the appropriate testing will be depend on your symptoms, your age, and physical examination findings. A breath test can be used to test for lactose intolerance and blood tests can be performed to test for wheat intolerance or celiac disease. A stool sample may be needed to check for blood in the stool, unusual levels of fat, or an infection. Finally, an EGD or a colonoscopy may be recommended. Samples of tissue can be obtained during an endoscopy to check for bacterial infections in the stomach, colitis, or celiac disease. These procedures may provide the most information.
Treatment of Excessive Gas
The treatment of excessive gas will depend upon the cause. There are however, some general recommendations. If the main symptom is repetitive belching, then recommendations may be made to decrease swallowing air. This often includes cutting out chewing gum, carbonated beverages and smoking. It is also important to not gulp food quickly. If food is eaten slowly then less air may be swallowed. Dietary changes are helpful if the main symptom is passage of too much gas per rectum. A trial of a lactose-free diet or a gluten-free diet may be considered. A low FODMAP diet can also improve bloating. This diet can be discussed with your gastroenterologist or with a dietitian. Over-the-counter medications such as simethicone or Beano can be used if the problems persist. Prescription antibiotics followed by a course of a probiotic may also be tried if there is a suspicion of altered bacteria of bacterial overgrowth in the gut.
Can this be “Serious”?
Occasionally, excessive gas and bloating may be the only symptom of a more serious disorder. Warning signs of a more serious problem would include blood in the stool, weight loss, fevers, or abdominal pain, especially pain that wakes you up from sleep at night. Bloating associated with a change in your bowel habits, either diarrhea or constipation, also warrant further evaluation.