Stomach Gas

Flatus is produced in human beings either due to the breakdown of food by bacteria in the gastrointestinal tract or intake of air unintentionally. It causes flatulence or belching. The gut contains about <200 ml of gas whereas about 600-700 ml of gas is expelled daily from the body in the form of flatus. Flatulence is a normal physiological activity. The frequency and amount of flatus released vary from person to person. It can be discomforting and embarrassing. The flatus contains gases such as hydrogen, methane and carbon dioxide. The odour is similar to that of hydrogen sulphide.

The symptoms of excessive intestinal gas are as follows:

• Belching (Burping)
  It results from an excessive accumulation of air (during swallowing or talking) primarily in the upper parts of the digestive tract (stomach and small intestine).
• Flatulence (Farting)
  It is due to the accumulation of gas or flatus, mainly in the large intestine. The leading cause is the breakdown of fermented food or plant fibre or complex carbohydrates by bacteria. Sometimes gas can be produced due to incomplete digestion of food.
• Bloating
  It is a feeling of fullness without much accumulation of intestinal gas. People often feel abdominal distension and may not be able to pass the produced gas by burping or flatulence. (Read more - Home remedies for bloating)

The frequency at which belching or flatulence occurs rises to more than 25 times a day. It may increase at night during sleep.

Causes

The primary cause of intestinal gas is the food that we eat along with some of our habits. Certain foods lead to excessive production of intestinal gas. These are:

• Pulses
• Beans
• Cruciferous vegetables like cabbage, cauliflower, broccoli, Brussel sprouts
• Dairy products
• Carbohydrates like fructose or artificial sweeteners like sorbitol
• Aerated beverages like soda and beer
• Alcohol
• Starchy foods like potatoes and rice
• Excessive usage of chewing gums and sweets
• Smoking

Sometimes excessive intestinal gas appears as a symptom in the case of the following disorders:

• Pancreatitis (Autoimmune type)
  It is an inflammation of the pancreas.
• GERD (Gastroesophageal reflux disorder)
  A condition where there is repetitive reflux or flowing back of the contents of the stomach into the food pipe causing excessive burping.
• Diabetes
  Long-standing high blood sugar causes delayed emptying of the bowel (known as gastroparesis) leading to a feeling of fullness (bloating), distended belly and gas production.
• Ulcerative Colitis or Crohn’s disease
  Chronic inflammatory diseases that cause swelling of the digestive tract and hamper digestion that may lead to overproduction of intestinal gas along with other symptoms, such as diarrhoea, stomach pain, fever, weight loss among others.
• Irritable Bowel Syndrome
  A condition characterized by symptoms, such as constipation or diarrhoea, bloating, and cramps without any detectable or known cause.
• Peptic Ulcer 
  A condition where there is a formation of open sores (ulcers) due to a loss of the protective lining in the stomach or intestines.
• Celiac disease
  An autoimmune disorder in which ingestion of gluten or wheat-containing foods results in an immune response that starts damaging the gut wall.
  
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Risk factors

There are a few risk factors associated with intestinal gas, namely :

• IBS (Irritable Bowel Syndrome).
• Lactose intolerance (inability to digest lactose-containing dairy products.
• Protein-rich diet.
• Excessive consumption of certain fruits and vegetables like cabbage, cauliflower, and apple.
• Consumption of carbonated beverages.
• Smoking.

People who have undergone a surgery of the digestive tract are at a higher risk of developing an increased intestinal bacterial growth, thereby causing excessive gas production. 

To prevent intestinal gas, there are some precautions which you can take.

To reduce burping, you may take the following measures:

• Drink liquids and chew food slowly and thoroughly.
• Avoid aerated beverages and alcohol.
• Avoid chewing gums and candies.
• Quit smoking.
• Get ill-fitting dentures corrected.
• Go for a small walk after meals.
• Treat acidity by consulting a specialist if it persists.

To reduce flatulence, try these remedies:

• Avoid or reduce the consumption of foods like cruciferous vegetables and pulses like beans and lentils.
• Avoid artificial sweeteners like sorbitol.
• Have a lactose-free or limited lactose diet if you are lactose-intolerant but make sure you fulfil your daily calcium requirement by consuming other foods, such as calcium-fortified soy milk, dark green leafy vegetables, almonds, and more.
• Skip oily and fast foods.
• Limit fibre intake.
• Limit intake of fatty foods like deep-fried foods.
• Exercise regularly.

To reduce bloating, following remedies may help:

• Avoid drinking water with meals.
• Take small meals at regular intervals.
• Release stress by meditating and doing yoga.
• Avoid sugar or salt intake in excess.
• Stay away from spicy and oily junk food.
• Drink plenty of water.
• Eat a healthy and balanced diet.

It is difficult to diagnose and find the exact cause of overproduction of intestinal gas. There are no proper tests to confirm the same.

• A detailed history of food consumed can help to find the exact cause.
• Simple blood tests don't provide with a confirmatory diagnosis.
• Endoscopy can be performed to confirm the presence of conditions like GERD or peptic ulcers responsible for overproduction of intestinal gas.
• An X-Ray, ultrasound or MRI of the abdomen can also help to diagnose bloating and its location in the intestinal tract.
• Breath tests to find out the amount of hydrogen in the intestinal gas can be performed to confirm an H. pylori infection as a cause of overproduction of intestinal gas.
• Sometimes, simple maintenance of a record of the duration of expelled intestinal gas can be helpful. 

There is no specific treatment plan to reduce the production of intestinal gas; it is usually symptomatic and includes dietary modifications as the most important step.

Over-the-counter drugs are available which can provide relief from discomfort caused by intestinal gas. Drugs containing charcoal help to reduce flatulence. Bismuth salicylate helps lessen the sulphide odour from flatus expelled. Alpha-d-galactosidase helps in digesting complex carbohydrates. People suffering from IBS can benefit from antispasmodics, which diminish cramp-like pain caused due to an excess intestinal gas. Antibiotics can be administered in the case an increased bacterial growth is confirmed.

Lifestyle management

Simple measures can be undertaken to reduce the overproduction of intestinal gas. Diet modifications like avoidance of food items which cause increased gas production are the mainstay of lifestyle modification. These include avoiding cruciferous vegetables, fibrous fruits like apples, sugar and sugar substitutes, smoking, and alcoholic beverages. Stress can cause digestion-related complaints too, which can lead to increased intestinal gas production. Hence, stress management is a must. Regular exercises keep the body, especially the abdominal muscles, toned and the digestive tract active.

Prognosis

The outcome for overproduction of intestinal gas is generally excellent. Intestinal gas can be reduced or minimised by undertaking specific preventive measures and making necessary lifestyle changes.

Complications

There are no known complications of excessive intestinal gas as it is a common and naturally occurring phenomenon.