Flatulence

What is Flatulence?

Passing wind or flatulence is a natural bodily function. Flatus comprises mainly carbon dioxide and other non-smelling gases like oxygen, nitrogen and hydrogen. The foul smell comes from sulphur compounds, which make up <1% of the gas.

SYMPTOMS of FLATULENCE

Flatulence is a natural process that occurs daily in all people, and the average person passes flatus 8-20 times per day. Whilst this may be embarrassing,the urge to pass gas can be controlled, and be released at an appropriate time or discreetly.

Occasionally, flatulence may also occur when there is an excess volume of the stomach and intestinal gas within the body.

Some common symptoms of flatulence include:

  • Constant passing of wind
  • Loud and smelly flatus
  • Abdominal discomfort and distension
  • Churning at the lower abdomen
WHEN to See a Doctor for FLATULENCE

It is time to seek medical attention and immediate flatulence treatment in either of the following scenarios. When a person cannot control the urge to pass gas or faecal materials or if the act of passing gas affects one’s quality of life.

CAUSES of FLATULENCE

During digestion, food passes from the stomach to the small intestine. As food passes through the tract and gets broken down, it will be absorbed when it reaches the small intestines. Food that is not absorbed then passes into the colon, where bacteria in the colon break it down into waste products. Bacterial fermentation in the colon produces gas and gets released through the anus as flatus. Carbohydrates such as sugars produce the most gas as they ferment easily, while fibre is indigestible but helps to regularise your bowel movements and keep the digestive system healthy.

Flatus comprises mainly carbon dioxide and other non-smelling gases like oxygen, nitrogen and hydrogen. The foul smell comes from sulphur compounds, which make up <1% of the gas. Most red meats and proteins contain high amounts of sulphur, so eating such foods may result in a more foul smelling flatus. This can also be due to certain medical conditions like internal intestinal bleeding and intestinal infections.

RISK FACTORS of FLATULENCE

Some factors can result in excessive flatulence, and these include:

  • Constipation, as the longer food waste remains in the colon, the more time it has to ferment.
  • An underlying digestive disorder that affects the digestion and absorption of food components and causes them to present in excessive amounts for fermentation. This includes lactose intolerance and celiac disease (which causes gluten intolerance).
  • Eating and drinking too quickly without pacing yourself results in more gas entering the intestines.
  • Excess amount of bacteria in the small intestine, which produces gas in addition to the gas produced in the colon
  • Eating gassy foods or drinking carbonated drinks
  • Stress or anxiety.
DIAGNOSIS of FLATULENCE

The first thing is to visit a flatulence doctor who will evaluate your symptoms, medical history and risk factors to narrow down the possible causes of your flatulence problem. 

Aside from a physical examination, he may also run tests such as CT scan, endoscopy, blood test and breath test to determine the condition of your digestive tract.

A Hydrogen-methane breath test can also be performed for sugar intolerance and bacterial overgrowth, which can help patients to address the underlying cause of excessive gas. After the following tests and evaluating the results, the flatulence doctor will recommend an effective treatment plan.

TREATMENT of FLATULENCE

Treatment would depend on the underlying cause. For example, if there is a presence of a small intestinal bacterial overgrowth, antibiotics can be prescribed. Antibiotic treatment can help reduce the bacterial population. If there is a carbohydrate malabsorption such as lactose intolerance, you will be referred to a dietician to advise you on certain diet restrictions and modifications.