ASK THE DOCTOR: Flatulence facts
By DR JIM MITTERANDOQ - What can we do to treat flatulence? My husband has an embarrassing problem.
A - Diet has a lot to do with flatulence, but most people pass gas 10 to 20 times a day. People who swallow a lot of air fart and belch more. Some people unconsciously swallow air repeatedly, by gulping, as a nervous habit. Chewing gum, smoking and sucking on candy also cause more air to be swallowed. Carbonated drinks can give some extra gas. Nervous people with fast moving bowels may fart more because less air is absorbed and food may not be completely digested.
Because of the large amount of complex carbohydrates in high fiber foods, like beans, more flatulence is produced. Gas is the exhaust fume of the undigested sugars. Most of this gas, though, is odor-free. High fiber foods, though, promote good health by preventing cancer, lowering cholesterol and preventing constipation.
Foods higher in sulfur content, like cauliflower, broccoli, cabbage, beer, eggs and meats are high in sulfur and produce smelly gas.
A sugar called raffinose is not well digested and tends to cause more gas. It's commonly found in beans, cabbage, cauliflower, brussel sprouts, broccoli, asparagus and some whole grains. Beano, an over-the-counter enzyme, helps to digest this sugar.
With age, we become more flatulent because our bodies make fewer enzymes that digest sugars, like lactose - milk suger. Dairy intake can then lead to gas, diarrhea and cramping. Reducing dairy intake and using lactase enzyme supplements like Lactaid can help digest milk sugars.
Fructose, found in onions, artichokes, fruit drinks and soft drinks, is another digestive troublemaker for some. Sugar-free substitutes found in gum and candy are often poorly digested, too. Likewise, fiber supplements - Metamucil and Fiberall - can commonly cause gas. The fat substitute olestra found in snack foods such as ‘‘fat free'' potato chips can cause gas and cramping and should be avoided.
Reducing odor
Temporary use of Pepto-Bismol can reduce odor. For an important business or social event, take one to two tables four times a day beginning three days before the event. This will reduce the odor, but the not the amount of gas. Pepto-Bismol can cause black stools and a black tongue and should not be taken long-term.
Limiting foods higher in sulfur, like beer, pork and cabbage, will reduce the smell. People who need daily control can use activated charcoal undergarments or pads, which absorb the odor. Activated charcoal seat cushions and mini-blankets are available, but don't absorb as much odor.
To reduce the amount of gas being produced eliminate certain foods that trigger the gas. However, do not avoid all high fiber foods as they are needed for good health.
Try to eat slower, chew thoroughly, sip rather than gulp, minimize carbonated beverages, don't chew gum and eliminate sugar-free substitutes that contain sorbitol or xylitol. Stress reduction and exercise help with habitual swallowing.
Being more active and eating fewer processed foods promotes colon health and will prevent constipation and stagnant gas. Avoid olestra snacks and take Beano when eating hard-to-digest vegetables.
For lactose intolerance consider reducing dairy products or using Lactaid.
The following treatments do not work:
Phazyme, Gax-X and Mylicon do not reduce farting. Oral charcoal does not work either, and can hinder absorption of other medications.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2005 The Patriot Ledger
Transmitted Tuesday, February 15, 2005