Flatulence is the term used to describe the discharge of intestinal gases. It’s often experienced as a nuisance, and can lead to embarrassing social situations and social avoidance behavior. In most cases, flatulence can be treated. The causes and treatment options for flatulence are discussed below.
Top things to know
- Flatulence is caused by a variety of factors
- 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 and are considered first-line therapy
- Various herbal remedies can be used for flatulence
- Excess gas is rarely associated with serious illness or disorders
How does flatulence develop?
Digestible components of food are absorbed by the mucous membrane of the small intestine. Other nondigestible food components in the colon are digested by bacteria, creating excess gas. This is caused by certain foods, medications, or conditions like food intolerances. Lactose intolerance is an example of a food intolerance that leads to excess flatulence.
During this process, intestinal bacteria release the gases methane, hydrogen, hydrogen sulfide or carbon dioxide during. The gases inflate the intestine and can leave the body as intestinal gas.
What is flatulence?
Most people pass between 500 to 1500 ml of gas per day. That amounts to roughly 10-20 episodes of passing gas per day.
Passing gas is normal, but the foul odor involved with the event is what usually causes people embarrassment. In most cases, flatulence isn't anything to be concerned about. Excess flatulence can usually be treated by making dietary changes. If flatulence is accompanied by the following signs and symptoms, you may want to follow up with a healthcare provider:
What causes the smell of flatulence?
The unpleasant smell of flatulence comes from the complex composition of the intestinal gases. The composition of the gas mixture and the smell of intestinal gas are dependent on the food consumed and the individual bacterial colonization of the intestine.
While the odor of flatulence can be embarrassing, it is not harmful and is rarely associated with a disease or harmful health condition.
What substances can cause flatulence?
FODMAPs, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are fermentable short-chain carbohydrates that are prevalent in the diet and cannot be metabolized in the small intestine.
Bacteria in the large intestine then split these substances into hydrogen and carbon dioxide gases, leading to flatulence. A number of medications can also lead to increased gas formation. Flatulence may be present in people with _irritable bowel syndrome _or IBS.
How to treat flatulence
Flatulence can be treated through behavioral changes and herbal products including microbials and medications. Diet changes are the first recommended step in treated unwanted flatulence. Avoiding gas-producing foods from the diet can help eliminate flatulence triggers.
If the flatulence persists and cannot be alleviated, a gastrointestinal specialist can complete a diagnostic investigation to help you find the root cause of excess flatulence. Some alternative causes for excess flatulence beyond dietary intolerances include excess air swallowing, gastroesophageal reflux disease or GERD, celiac disease, or irritable bowel syndrome.
How to get rid of gas
- Refrain from bloating foods such as legumes, various types of cabbage, garlic, leeks, and onions to reduce flatulence.
- If you have a food intolerance, avoid the appropriate foods. This applies in particular to milk and milk products with intolerance to lactose and gluten with celiac disease.
- For flatulence caused by chronic inflammatory, infectious, or other bowel disease, diet and behavior plans can reduce discomfort. Speak to your gastrointestinal specialist or nutritionist about creating a customized nutritional plan.
- 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 prevent bloating.
What medications treat flatulence?
Simethicone (e.g. Pepto Bismol)
Defoaming medications like_ Simethicone_ (Pepto Bismol) are commonly used to treat 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 to 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. However, the best approach to avoid dairy foods containing lactose.
Natural remedies for flatulence
Fennel, anise, caraway, and peppermint are considered calming for the gastrointestinal tract. People with flatulence can take these in the form of teas, as oils, or in capsules. Extracts of certain other herbs such as gentian or lemon balm can also counteract flatulence.
Is frequent flatulence harmful?
Flatulence is neither harmful nor dangerous. Flatulence is considered excessive if it is bothersome to the person. It does not always indicate a digestive system problem that requires treatment. If flatulence is particularly strong and stressful and persists for no specific reason after making dietary changes, it may be useful to have the cause clarified by a healthcare provider.
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.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130(5):1480-1491. doi:10.1053/j.gastro.2005.11.061
Malagelada JR, Accarino A, Azpiroz F. Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge. _Am J Gastroenterol. _2017;112(8):1221-1231.
Richter JE, Castell DO. Gastroesophageal reflux. Pathogenesis, diagnosis, and therapy. Ann Intern Med. 1982;97(1):93-103. doi:10.7326/0003-4819-97-1-93
Tomlin J, Lowis C, Read NW. Investigation of normal flatus production in healthy volunteers. Gut. 1991;32(6):665-669. doi:10.1136/gut.32.6.665