Flatulance

Flatulence can be embarrassing, but it is a common problem and affects everyone at some point. Flatulence is often referred to as passing or breaking wind, and occurs when you need to expel the excess air that builds up in your body throughout the day.
The gut (the long muscular tube that stretches all the way from your oesophagus – or gullet – to your rectum) contains a lot of gases, mainly:
nitrogen and oxygen – taken into the body through the mouth during eating and talking
carbon dioxide – produced when the acid present in the stomach comes into contact with bile and juices from the pancreas

hydrogen and methane – produced when the bacteria in the colon starts to ferment the residues delivered from the small intestine.

Much of this gas is absorbed into the blood and will be breathed out in due course. The rest is passed out through the rectum.

Certain foods such as kidney beans and artichokes cause an overproduction of bacteria in the stomach, which can in turn lead to excessive flatulence. Food containing a lot of fibre such as baked beans and brown rice are also common causes of flatulence.

Many people have also noted that lettuce, apples, cabbage, cauliflower, turnip, swede, onions, brussels sprouts, garlic, leeks, and products made with malt extracts can also be causes of flatulence.

More serious causes of flatulence can be digestive disorders such as gastroenteritis or irritable bowel syndrome (IBS). However, if there are no other symptoms, this is very unlikely.

Gastroenteritis means inflammation of the stomach and the intestine causing vomiting and diarrhoea. Gastroenteritis is caused mainly by viruses, such as the rotaviruses commonly found in infected shellfish. Bacteria and other organisms such as Escherichia coli, Salmonella or Giardia lamblia can also be a cause. These can be picked up from contaminated food or water, and often reflect poor hygiene during food preparation.

IBS is a persistent disorder, featuring recurrent abdominal pain and intermittent diarrhoea, often alternating with constipation, for which no obvious cause can be found. Symptoms include frequent bowel motions, a sense of fullness (bloating) and often headache and anxiety.

Excess flatulence may be accompanied by other symptoms caused by bowel gas:

Belching (burping). When gas is expels through the mouth in a sudden reflex movement. This occurs when the stomach becomes filled with excess swallowed air usually during the course of eating, drinking or smoking.
Bloating. This feels like your stomach is very full and may make you feel as if you need to belch. It is often caused by eating rich foods that take a long time to digest properly.
Borborygmi (rumbling stomach). This occurs when the stomach contracts rapidly, causing the contents of the intestine to be pushed backwards and forwards. It most commonly happens when you are hungry but can also be triggered by anxiety and nervousness.

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If you are generally healthy, then flatulence should not be a cause for concern. Treatment may be necessary if the flatulence become very severe or is accompanied by other symptoms such as abdominal pain, vomiting or diarrhoea, in which case you should first get advice from your GP.

There are some gut relaxant drugs available, which can help to ease bloating and the symptoms associated with flatulence. Asmebeverine and Alverine are available in over-the-counter treatments or on prescription through your GP.

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Diet can be an important factor in helping to reduce flatulence. Rich foods or foods that are high in fibre can be difficult to digest and can result in excess can being produced inside the gut.

Sometimes flatulence can be helped by eating and chewing more slowly.
Avoid eating foods that produce excess gas e.g. beans, cabbage cauliflower, brussels sprouts, broccoli, and peas
Some people may notice that they have a sensitivity to certain foods and produce more gas after eating them. E.g. gluten, lactose (milk sugar), if this is the case intake of these foods should be limited.

However, it is important to have some fibre in your diet as it can keep your intestine healthy by helping waste products to travel through the bowel and preventing constipation. Some research suggests that fibre may also help to reduce the risk of bowel cancer. NHSDEC07