Digestive Disorders > Symptoms

Flatulence – Causes and treatment options

Dr. med. Andre Sommer

Dr. med. Andre Sommer

Flatulence is the term used to describe the excessive discharge of intestinal gases. Those affected often experience flatulence as a nuisance. In addition, it can lead to embarrassing social situations or avoidance behavior. In most cases, flatulence can be treated well. The causes and treatment options for flatulence are shown below.

Overview of flatulence

  • Flatulence can also arise for various reasons.
  • The most common cause is metabolism of food components through bacteria in the large intestine
  • Food intolerances and certain medications can cause flatulence
  • Changing your diet is usually effective against flatulence and should be tried first
  • Also various herbal remedies can be used for flatulence
  • Apparently baseless and frequently occurring flatulence can indicate a problem with the digestive tract and should be clarified with a doctor

How does flatulence develop?

Usable components of the food are usually absorbed by the mucous membrane of the small intestine. But there are also food components in the colon that are digested by bacteria there. This is increasingly the case with certain foods, medicines or diseases such as food intolerances (e.g. fructose or lactose intolerance).

The bacteria release gases such as methane, hydrogen, hydrogen sulfide or carbon dioxide during the metabolic processes. The gases inflate the intestine and can leave the body as intestinal wind through the anus.

Are all bowel winds called flatulence?

The gas discharge is called flatulence if it occurs more frequently than normal. However, there is no fixed, generally applicable limit as to when intestinal winds are considered flatulence. Meteorism describes a large amount of gases in the intestine, which can also lead to gas leakage (flatulence).

How does the smell of flatulence develop?

The unpleasant smell of flatulence comes from the complex composition of the intestinal gases. Even the individual intestinal gases have a characteristic odor in low concentrations. But the mixture leads to the typical foul smell of flatulence. The composition of the gas mixture and thus the smell of intestinal winds are dependent on food and the individual bacterial colonization of the intestine.

Are there any substances that can cause flatulence?

A number of medications or ingredients can lead to increased gas formation. Sugar substitutes like sorbitol, cannot be metabolized in the small intestine. Bacteria in the large intestine then split these substances into hydrogen and carbon dioxide gases among other thingss. Various medications can cause flatulence too. These include, for example laxatives such as lactulose, diabetes medication from the group of alpha-glucosidase inhibitors, the pain reliever diclofenac and some antibiotics.

How is flatulence treated?

Flatulence can be treated through behavioral changes, herbal products including microbial preparations and medication. Changing your diet can also be helpful. Those affected should vavoid all gas-producing foods.

If the flatulence persists and cannot be alleviated, you should go to the doctor. The reason is that with a protracted course a digestive tract disorder or a food intolerance could be the cause of the flatulence.


What can you do about flatulence?

Refrain from bloating foods such as legumes, various types of cabbage, garlic, leeks and onions to reduce flatulence. If you have a food intolerance, you should avoid the appropriate foods. This applies in particular to milk and milk products with intolerance to lactose and gluten with celiac disease. With flatulence caused by chronic inflammatory, infectious or other bowel disease diet and behavior plans can reduce discomfort.

Light massaging of the abdomen can loosen gas accumulations and at least reduce pain and discomfort associated with flatulence. **Physical activity **like regular walks or endurance training can be beneficial for gastrointestinal activity and thus prevent bloating.

What medicines are there to treat flatulence?

Defoaming medications like Simeticon (for example Lefax or Sab simplex) are commonly used against flatulence. Most defoamers contain silicones as active ingredients, which dissolve or fuse small gas bubbles in the intestine. In this way, the substances promote the formation of larger gas bubbles, which the body can get rid of it faster. This will improve the symptoms. Silicones are not absorbed by the intestinal mucosa and are considered to be well tolerated.

Flatulence caused by lactose intolerance can be helped by taking tablets with the enzyme lactase before a meal. With lactose intolerance, a certain enzyme is missing in the intestine, which is the reason for the indigestion. The enzyme lactase, which is supplied as a drug, compensates for this deficiency and thus prevents the formation of gas.

Natural remedies can sometimes also work against flatulence. Fennel, anise, caraway and peppermint are especially considered calming for the gastrointestinal tract. Affected people can take these in the form of teas, in small quantities pure or as finished medication. Extracts of certain other herbs such as gentian or lemon balm can also counteract flatulence.

Is flatulence accompanied by stool normal?

In itself, the simultaneous excretion of flatulence and stool is not uncommon. Fine sensory organs and nerve endings in the rectum usually register the pressure or consistency of intestinal contents. From this, the body can deduce whether there are gases or stool near the intestinal exit. This state can also be perceived consciously. So the unwanted passing of stool together with flatulence is rare.

If unwanted bowel movements occur only once or very rarely, there is usually no need for action. With more frequent incidents, however, the family doctor or a proctologist (specialist for diseases of the rectum) should look for the cause.

Is frequent flatulence harmful?

Flatulence is neither harmful nor dangerous. However, excessive flatulence can indicate adigestive system problem that requires treatment. If flatulence is particularly strong and stressful and persists for no specific reason, it may be useful to have the cause clarified by a general practitioner.

Anheyer D, Frawley J, Koch AK, et al. Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review. _Pediatrics. _2017;139(6).

Lembcke, B., & Stein, J. (2005). Meteorismus und Flatulenz. In Therapie gastroenterologischer Krankheiten (pp. 500-506). Springer, Berlin, Heidelberg, online: https://link.springer.com/chapter/10.1007/3-540-26660-7_49, downloaded on 20.08.2018.

Malagelada JR, Accarino A, Azpiroz F. Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge. _Am J Gastroenterol. _2017;112(8):1221-1231.

Dr. med. Andre Sommer

Dr. med. Andre Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara.

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