How to Prevent and Treat Gas and Bloating
Bloating is an unpleasant sensation of fullness or abnormal swelling in the abdomen that is usually a result of the build-up of gas in the abdomen. Gas occurs everywhere throughout the gastrointestinal tract, including the esophagus, stomach and both intestines.
Abdominal gas mostly results from swallowing air when eating or drinking. People tend to swallow more air, when they eat or drink too quickly. Most of it ends up in the stomach. Gas also develops in the colon as bacteria present in the intestine consume undigested food with gas being the byproduct.
The average person produces between 0.5 to 2.0 liters (about 1-4 pints) of gas per day while passing gas 15 to 25 times per day. Some gas is absorbed into the blood through the gastrointestinal lining, which is then excreted by the lungs. The remaining gas is released by burping or flatulence.
Abdominal pain, which usually accompanies bloating, can occur anywhere in the abdomen and can change location fairly quickly. This pain is often caused by gas being trapped in the large intestine in areas where the colon bends sharply. Pain that occurs in the upper left side may be mistaken for a heart problem. When it occurs in the right side, it may be mistaken for appendicitis. But, in most cases, the abdominal pain caused by gas subsides with a bowel movement. Some individuals suffer from increased production of abdominal gas. They may include:
- People with certain food intolerances or chronic intestinal conditions, such as lactose intolerance or irritable bowel syndrome
- People who often eat a lot of gas-producing foods, such as cabbage
- Individuals who regularly drink carbonated beverages or beverages high in sulfates such as wine
- Those who regularly chew gum
Potential Causes of Gas and Bloating
Gas is an inevitable by-product of digestion. Besides that it is also a result of air swallowing. A number of factors, ranging from diet to lifestyle habits, contribute to its symptoms. Swallowed air makes up most of the gas in the stomach. Most common ways to swallow air include:
- Eating fast
- Drinking from straws or small-mouthed bottles
- Activities that stimulate the production of saliva, such as chewing gum
- Cigarette smoking
- Loose-fitting dentures
When people are nervous they swallow more air. Stress may also increase an individual’s sensitivity to normal levels of gas. Therefore, symptoms of gas may worsen in periods of stress or anxiety.
Gas is also produced in the intestines. Foods containing carbohydrates and fiber are usually responsible for gas. There are two kinds of fiber in our diet. Soluble fiber dissolves in water. It is not broken down until it reaches the colon, where it produces gas in a process called fermentation. Many foods, including oat bran, beans, peas, lentils, carrots and most fruits contain soluble fiber. Fiber supplements, containing soluble fiber, may also cause gas. Insoluble fiber passes through the digestive tract practically intact. Because it is not digested, it produces little gas. Wheat bran, corn bran, green beans, seeds, nuts and some vegetables contain insoluble fiber.
Rice happens to be the only carbohydrate that does not produce gas because it gets broken down completely in the small intestine. However, many carbohydrates contain components that can be difficult to digest, such as:
- Lactose is a sugar found in milk and dairy products. In many people the ability to properly digest lactose decreases with age. Certain ethnic groups, such as Chinese, have naturally poor ability to process lactose. Some individuals are lactose intolerant because they lack lactase, an enzyme that breaks down the milk sugar lactose.
- Raffinose is a common sugar present in different vegetables, beans and whole grains. Human bodies cannot process raffinose because they do not have any enzyme to break it down.
- Fructose is a sugar present in honey, many fruits, artichokes, onions and wheat. It is widely used as a sweetener in soft drinks, fruit juices and processed foods. Fructose may not cause gas in all people.
- Sorbitol is a sugar alcohol found in many fruits (e.g., apples, apricots, peaches, pears and prunes) commonly used as a sugar substitute in sugar-free foods, candies, chewing gums and toothpaste for people with diabetes. Although most people have little problem digesting sorbitol, it may cause large amounts of gas in some individuals.
There are many foods that cause gas or bloating even though they are not too difficult to digest. Carbonated beverages contain carbon dioxide, which is released into the digestive tract contributing to gas. Fatty foods may delay stomach emptying, which often causes bloating. Foods such as chocolate or peppermint relax the muscle between the esophagus and stomach, which can lead to increased belching, acid reflux and heartburn.
Certain medications can interfere with the normal process of digestion, for example by inhibiting digestive enzymes. Antibiotics usually disrupt the balance of normal intestinal flora, killing some bacteria while allowing others to overgrow. The overgrown bacteria may produce increased amounts of odorous gas. The overuse of laxatives can also contribute to gas.
In some cases gas can signal the presence of an underlying health condition, such as food intolerance. Food or its component that the body is unable to properly digest passes into the colon, where fermentation takes place, forming gas. Food intolerance is often associated with intestinal inflammation, which causes malabsorption of nutrients resulting in excessive gas.
Other medical conditions associated with gas and bloating include:
- Abdominal surgeries
- Bowel obstruction
- Gastroesophageal reflux disease (GERD)
- Inflammatory bowel disease
- Irritable bowel syndrome
- Meganblase syndrome
- Pancreatitic insufficiency
- Premenstrual syndrome (PMS)
- Short bowel syndrome
Patients are advised to seek medical help for gas symptoms in a number of instances, including:
- Change in the location of abdominal pain
- Onset of new symptoms in patients over 40 years of age
- Substantial increase in severity or frequency of current symptoms
- Presence of certain accompanying symptoms, including:
- Blood in the stool
- Diarrhea or constipation
- Gastrointestinal bleeding
- Nausea and vomiting
- Persistent heartburn
- Unexplained weight loss
Diagnosing, Treating and Preventing Gas and Bloating
Gas and bloating, which is accompanied by severe, recurrent or prolonged abdominal pain and by other symptoms such as bleeding, fever, nausea, vomiting or weight loss, may indicate the presence of another underlying condition. As a first step, the doctor will perform a physical examination and record a thorough medical history. Screening tests, such as a colonoscopy, endoscopy or sigmoidoscopy may also be needed in order to establish the cause of gas and bloating.
Gas symptoms, which are not associated with another medical condition, are typically short in duration. Therefore, problematic gas that is unrelated to another medical condition is treated by identifying and eliminating the factors that cause it. A food diary can be used to identify these factors. A food diary is a journal in which patients track the times, the amounts and the kinds of food consumed and any resulting gas symptoms.
A large amount of gas is caused by swallowing air when eating and drinking. Therefore, taking steps to prevent swallowing excess air may help reduce gas. These steps include:
- Do not gulp beverages
- Do not drink during meals
- Do not drink through a straw or out of small-mouthed bottles
- Do not suck on hard candy or chew gum
- Do not eat when particularly upset, anxious or in a hurry
- Do not smoke
- Do not attempt to induce belching
- Eat and drink slowly, chew with mouth closed
- Make sure your dentures fit properly
Gas and bloating can also be relieved by simple dietary changes. Foods that are causing problems to many people include various vegetables, whole grains and especially beans that all contain raffinose mentioned earlier. Milk products and fruits contain lactose that many people also find difficult to digest. Hence, patients should eliminate or reduce their intake of gas-producing foods once they know precisely which foods are causing the excess gas. Cutting back on fat may also help relieve symptoms of gas because a diet high in fat may extend the duration of fermentation in the colon.
Fiber commonly causes bloating in many people. It is often recommended to temporarily cut back on high-fiber foods. Once you start slowly reintroducing fiber back to your diet, it is necessary to increase your intake of liquids. In fact, in some cases, fiber may actually help ease gas and its symptoms. Patients are also advised to eat smaller, more frequent meals to make digestion easier while avoiding carbonated beverages.
Other substances that may help improve the symptoms of gas include digestive enzymes, such as lactase, which enables people with lactose intolerance digest dairy products; antacids containing the foaming agent simethicone, which may help with stomach gas (however, avoid antacids containing bicarbonate or carbonate that may worsen gas); activated charcoal and chlorophyll; and some medications used to treat diarrhea and constipation, which may also effectively relieve gas and bloating in some people.
Physical exercise, e.g. walking, should help most people stimulate the passage of gas through the digestive tract, thus easing gas symptoms. Also, avoid tight-fitting garments and belts and lying down immediately after eating. In addition, alternative therapies, such as relaxation therapy, behavioral therapy or hypnotherapy, may be useful for relieving gas and bloating in some patients.