Flatulence / Excess Gas

Flatulence is the accumulation of gas in the digestive tract. The intestine produces about 500-2000 mL of gas per day, mostly as a result of swallowed air and bacterial fermentation of carbohydrates in the GIT.

The passing of gas via the rectum is normal in humans and the amount can vary from individual to individual. However, gas may be excessive or involuntary, have offensive odour or be associated with abdominal pain and bloating. Increased or excessive flatulence is not always the result of excessive gas formation but rather decreased intestinal motility, bacterial overgrowth of the colon or small intestinal bacterial overgrowth (SIBO). 

Causes of Flatulence & Excess Gas

• Improper diet: in particular, high sugar and refined carbohydrates or excessive animal protein
• Digestive enzyme or acid deficiency
• If malodorous: suggests inadequate breakdown of proteins
• If non-odorous: suggests inadequate breakdown of carbohydrate
• Food allergy / intolerance
• Gut dysbiosis: healthy gut flora needed for breakdown of indigestible carbohydrates
• SIBO
• Gallbladder / liver disorder
• Malabsorption syndromes
• Consumption of gas-forming foods: legumes, cruciferous vegetables, corn, cucumbers, onions, turnips, apples, avocados, melons

TREATMENT STRATEGY FOR FLATULENCE / EXCESS GAS

• Identify and address underlying causes (poor diet, SIBO, gut dysbiosis, food allergy, etc)
• Remove bacterial overgrowth of small intestine or colon
• Support digestive function
• Balance / rebuild gut flora

Diet plan for Flatulence / Excess Gas

• Remove triggering or allergenic foods:
• Avoid sugars, refined carbohydrates and processed foods
• May need elimination diet to assess food sensitivities
• Wheat gluten or lactose may be problematic
• Low FODMAP diet may be trialed; however, the inability to digest fermentable carbohydrates most likely due to gut dysbiosis
• Support digestive process
• Eat smaller, more frequent meals; eat slowly, chew food thoroughly
• Increase fibre intake to support elimination and gut flora balance
• Avoid drinking water with meals
• Proper preparation of difficult-to-digest foods e.g. soaking and/or fermenting of grains and legumes
• Include herbs & spices to aid digestion: ginger, cinnamon, caraway, fennel, peppermint, chamomile

Supplements that support Flatulence / Excess Gas

• Charcoal: 1-2 tablets/hr in acute flatulence
• Digestive acids and/or enzymes including betaine hydrochloride and / or ox bile with meals
• Probiotics – can exacerbate symptoms if incorrect strains are used

Herbal medicine treatment for Flatulence / Excess Gas

• Digestive stimulants: gentian, ginger, agrimony
• Carminatives: chamomile, peppermint, fennel, cinnamon

FUNCTIONAL MEDICINE TREATMENT OF EXCESSIVE FLATULENCE

Excessive flatulence is usually the result of SIBO or bacterial overgrowth in the colon.  This is often preceded by low stomach acid and poor digestion of fats, proteins and carbohydrates. 

Investigation through medical testing is required to identify the presence of SIBO and bacterial overgrowth.  Digestive markers such as long and short chain fatty acids, butyrate and phospholipids are used to assess adequate digestion of proteins, carbohydrates and fats.

We also commonly uncover multiple food intolerances that are exacerbated through poor digestion, impaired bile production and the presence of intestinal permeability.

Treating the underlying dysfunction allows patients to be able to eat a much wider variety of foods rather than continually limiting an ever growing list of reactive foods.

At our Perth clinic of Advanced Functional Medicine we have experience with excessive flatulence and other digestive disorders.

 If you or a family member require assistance with excessive flatulence or another digestive disorder we would love to hear from you.  What are you main triggers for flatulence?  What testing did you use to investigate the root cause of your flatulence?  Please write a comment below.

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