Ask the Gastro: 10 Things to Know About Gas and Bloatingby Constance Pietrzak, M.D. Health Professional
Heavy, overly full, low appetite, self-conscious and even cranky -- these can all accompany uncomfortable gas and bloating. There are many reasons why these two gastrointestinal symptoms can occur in the body. But no matter the reason, we all end up concluding with the same question: "What can I do to get rid of it?!"
1. What kinds of intestinal gas symptoms can we experience?
Intestinal gas can result in many different gastrointestinal complaints, including belching, bloating in the upper and lower gut, and a wide range of abdominal pains from gassy distention of the stomach and intestines. Gas and bloating can be attributed to many non-threatening conditions, however, there are some medical conditions which require urgent or emergent medical attention.
When gas symptoms persist or worsen, it is prudent to seek out medical opinion.** 2. Where does gastrointestinal gas come from?Gastrointestinal gas can comes from a variety of sources. Excessive air swallowing** when we eat or drink, and well as when chewing gum or smoking, can cause stomach distention, bloating, and pain - which can also cause people to have issues with belching.
A significant amount of gas is also produced within the intestines. As a part of our digestive system, bacteria metabolize the foods we eat and produce different types of gases as byproducts. Some gaseous byproducts include methane, carbon dioxide, hydrogen, and sulfide, which can contribute to the bad odor we sense with passing gas.
Some people's systems also have problems with absorbing carbohydrates. This can lead to increased gas in the intestines, as well. As the carbohydrates pass through the digestive organs, they provide bacteria with substances to ferment, releasing gas. For example, those who are lactose intolerant cannot ingest dairy products due to bacterial fermentation of the lactose causing significant gas, bloating, pain, and sometimes diarrhea.
3. Is gas/bloating normal?
A certain amount of gas is normal. After eating, it is normal for the gut to metabolize the proteins, fat, and carbohydrates from the food we eat. As a result, gas is produced. However, releasing the gas should relieve any abdominal bloating, distention, or pain. If you cannot release the gas or have worsening or severe pain without being able to release the gas or have a bowel movement, a more serious condition requiring medical attention should be considered.
4. What disorders cause gas/bloating?There are many different causes for gas and bloating. Diet and lifestyle can lead to increased gas production, such as eating rapidly, drinking carbonated beverages, drinking alcohol, consuming very large meals, smoking, and eating foods known to cause you gas production.
Other disorders of the gastrointestinal tract can lead to increased gas production, including carbohydrate malabsorption (ex. lactose intolerance), small intestinal bacterial overgrowth (where colon bacteria moves backwards colonizing the small intestines, resulting in too high numbers of bacteria in the small intestines), or impaired gut motility.
5. Is what I'm eating causing gas?Possibly, yes. What you eat may affect whether your body produces more or less gas. Some foods are known culprits for producing gas when digested, including broccoli, cabbage, onions, garlic, brussel sprouts, wheat, and potatoes. Again, other foods may cause gas in some individuals, but not others, such as dairy products containing lactose.
6. Should I change my diet on my own?
If you notice a particular food causes gas time and time again, avoiding that food is safe to do on your own. Such "elimination diets" could provide your doctor with helpful information when you discuss your gas concerns with them. However, going on diets for specific or certain disorders (i.e. gluten free diet for celiac disease or a low FODMAPs diet for irritable bowel syndrome (IBS)) is not recommended, and is actually discouraged.
These diets require monitoring by healthcare professionals, including your gastroenterologist, nutritionist and dietician to ensure you are receiving adequate nutrition from your diet. In addition, being on some of these diets could result in false negative test results making it difficult to determine if your symptoms are normal or if you have an underlying gastrointestinal disorder.
7. What if my gas is not related to foods?
If you avoid foods you think may be causing your symptoms, but gas persists or worsens, it is important that you talk to your doctor. As mentioned, there are many conditions that could be causing your symptoms, and medical testing may be needed.
8. Is gas causing my acid reflux to worsen?
Increased in intra-abdominal pressure from intestinal gas can increase the pressure on the muscle sphincter connecting the esophagus with the stomach. When the pressure is high enough, stomach contents can reflux back into the esophagus. This can cause heartburn, regurgitation, and even belching. Managing gas from below can help your upper abdominal gas/bloating and pressure symptoms.
9. Should I try probiotics?
The balance of bacteria in your gut may also affect how much gas is produced. Probiotics have found to be helpful in a subset of people who have irritable bowel syndrome, by restoring the balance of bacteria to normal in the intestines. This topic remains controversial and many stronger studies are needed to prove their overall efficacy. Studies have shown that there are some people with certain medical conditions for whom probiotics are not recommended and can lead to severe illness if taken. Therefore, before taking any probiotics, you should discuss this with your physician.
10. Will it ever go away completely?
Our bodies will always produce gas, the amount of which is dependent on many factors. This can include foods we eat, any pre-existing gastrointestinal conditions, the bacteria balance in the gut, and how we perceive the effects of the gas produced in our bodies.
Gas can be minimized by maintaining regular bowel movements, avoiding trigger foods, and treating any underlying conditions with proper management.
Constance Pietrzak, MS MD is a gastroenterologist with Advocate Medical Group in Chicago. Through her work with HealthCentral, she strives to expand knowledge on Gastroesophageal reflux disease (GERD) and Inflammatory Bowel Disease (IBD). Follow Constance on Facebook and Twitter for timely updates on IBD, and more.