Gas & Belching
Passing gas and belching are natural and common. Everybody produces gas, but this can be embarrassing and when accompanied by abdominal distention, bloating or discomfort, it can interfere with daily activities. Although they can be annoying, these symptoms rarely represent any serious underlying condition. Certain foods and medical conditions can cause excessive production of gas.
Sources of gas:
Air swallowing: It is normal to swallow some air while eating or drinking or swallowing saliva. Excess air swallowing can occur while eating fast or gulping liquids or chewing gum or smoking.
Belching is the body’s way of getting rid of excess air in the upper GI tract. Swallowed air can get trapped in the esophagus and result in belching. Belching typically occurs after eating to release air that stretches the stomach.
Bacterial production: Certain carbohydrates are not completely digested by the enzymes in the stomach and the small intestine and therefore they reach the colon allowing colonic bacteria to digest them. That process produces mostly odorless gases. Malodorous gases are due to the presence of a small amount of sulfur.
- Passing excessive amounts of gas
- Burping frequently
- Abdominal pain or discomfort
Causes of increased gas:
- Air swallowing (aerophagia)
- Certain foods contain short-chain carbohydrates called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). FODMAPs are poorly absorbed and can result in bloating and gas production. Starch and soluble fibers can also increase gas production.
- Lactose intolerance which occurs when the body has difficulty digesting lactose, the sugar found in dairy products.
- Intolerance to certain sugars such as fructose and sorbitol.
- Small intestinal bacterial overgrowth which occurs more frequently in diabetics and with conditions that affect the motility of the bowel.
- Certain diseases such as celiac disease and short bowel syndrome.
Most people do not require any testing but in certain cases your doctor may recommend one or more of the following tests:
- Breath test for lactose intolerance
- Stool tests to rule out increased fat in the stools or infections
- Blood tests to look for celiac disease
- An upper endoscopy and or a colonoscopy.
Prevention and treatment:
- Dietary changes: Avoid foods that seem to aggravate your symptoms. Common gas-producing foods include beans, peas, lentils, cabbage, onions, broccoli, cauliflower, whole-grain foods, mushrooms, certain fruits, and beer and other carbonated drinks. If dairy products seem to aggravate your symptoms, try a lactose free diet or use lactose-reduced milk or over-the-counter lactase supplements (eg: Lactaid). Avoid foods high in fructose if you have fructose intolerance. Temporarily cut back on high fiber foods.
- Eat and drink slowly
- Stop smoking
- Try over the counter products that contain simethicone (eg, Maalox Anti-Gas, Mylanta Gas, Gas-X, Phazyme) or activated charcoal (eg, CharcoCaps, CharcoAid).