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Flatulence

Introduction

Flatulence is passing gas from the digestive system out of the back passage.  It is more commonly known as passing wind or farting.

Farting is often something that is laughed about but excessive flatulence can be embarrassing and make you feel uncomfortable around other people.  However, it can usually be controlled with changes to your diet and lifestyle.

Flatulence is very common and it is something that everyone experiences regularly. Like breathing and sweating, flatulence is a normal biological process.  On average, people pass wind about 15 times a day, some people pass wind only a few times, others a lot more.

Why do we fart?

When you swallow food, water or saliva, you also swallow small amounts of air, which collects in the digestive system. This gas is mostly made up of nitrogen and oxygen. Gas is also released when you digest food, mostly in the form of hydrogen, methane and carbon dioxide.

The body needs to get rid of the build-up of excess gas and does so either by flatulence (farting) or belching (burping).

Sometimes, you may not notice that you have passed wind because the gases are odorless and are often released in small quantities. The bad smell that is commonly associated with flatulence is caused by trace elements of sulphur gases, which can develop if food has not been properly digested and starts to decompose.

There are several possible causes of flatulence. It can be caused by swallowing more air than usual or eating food that is difficult to digest. Or it can be due to an underlying health problem that is affecting the digestive system.

There are also several medical conditions that can cause flatulence, such as constipation and irritable bowel syndrome (IBS), which is a condition that causes indigestion and bloating.

Read more about the causes of flatulence.

When to see your GP

You should visit your GP if you are experiencing other symptoms as well as flatulence, such as abdominal pain, recurring diarrhoea or constipation, unexplained weight loss or blood in your stools. Read more about the symptoms of flatulence.

Treatment

If you have excessive flatulence, the problem can usually be controlled by making changes to your diet and lifestyle. If the cause of your flatulence is related to a separate health problem, you may need medication to help control your symptoms while the underlying health condition is treated.

Read more about treating flatulence.

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Symptoms

Most cases of excessive flatulence are not serious and can be treated using self-care techniques. A visit to your GP is usually only recommended if you have additional symptoms that may suggest that you have an underlying digestive condition.

The symptoms of flatulence are usually only considered troublesome if:

  • you experience frequent episodes of flatulence
  • you pass an excessive amount of wind during an episode of flatulence
  • you consistently produce foul-smelling wind

There are no medical guidelines defining what is the normal frequency or volume of flatulence. Therefore, you are probably the best person to assess your symptoms. Treatment is available if you think that your symptoms have become troublesome.

Read more about treating flatulence.

When to seek medical advice

The additional symptoms listed below could be an indicator of a more serious health problem. You should visit your GP if you experience:

  • persistent abdominal pain and bloating
  • recurring episodes of diarrhoea or constipation
  • unexplained weight loss
  • bowel incontinence 
  • blood in your stools (faeces)
  • symptoms that may suggest that you have an infection, such as a high temperature, vomiting, chills, joint pain and muscle pain
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Causes

There are several natural causes of flatulence. Flatulence can also be caused by some health conditions that are related to the digestive system.

There are three main causes of excessive flatulence. They are:

  • swallowing more air than usual
  • eating food that is difficult to digest
  • having an underlying health condition that affects your digestive system

These are discussed below.

Swallowing air

It is perfectly normal to swallow air while breathing and eating.  However, it is easy to swallow a lot more aire than usual without realising it.  This can lead to symptoms of excessive flatulence.  Excess air can be swallowed by:    

  • chewing gum
  • smoking
  • sucking on pen tops
  • not chewing food slowly and thoroughly (swallowing large pieces of food will result in you swallowing excess air) 

Hot and fizzy drinks also increase the amount of carbon dioxide in your stomach, although this is more likely to lead to symptoms of belching rather than flatulence.

Food

Much of the food that you eat is carbohydrate. Carbohydrates are made up of long chains of sugar molecules.  Some carbohydrates cannot be digested and absorbed by the intestines and pass down into your colon. These are known as unabsorbable carbohydrates. 

Your colon contains more than 500 different types of bacteria. The bacteria start to break down the carbohydrates and, in the process, they produce gas, which is released as flatulence.

Foods that contain a high amount of unabsorbable carbohydrates include: beans, broccoli, cauliflower, cabbage, artichokes, raisins, pulses, lentils, prunes, apples, brussel sprouts.

Slimming products that contain sorbitol (a sugar substitute) or fructose (a type of sugar) can also cause flatulence because both sorbitol and fructose are unabsorbable carbohydrates. Many fruit juices also contain high levels of fructose. 

Many foods that contain unabsorbable carbohydrates are digested over a long period of time. This means that any undigested food will eventually start to decompose. The decomposing food releases a small amount of sulphur gas, which causes the foul smell associated with flatulence.

Health conditions

Medical conditions that can cause symptoms of flatulence include:

  • constipation
  • irritable bowel syndrome (IBS)
  • coeliac disease, which is a common digestive condition where a person has an intolerance to a protein called gluten, which is found in wheat, rye and barley
  • lactose intolerance, which is where the body is unable to break down lactose (a natural sugar found in milk and dairy products) and cannot absorb it into the blood
  • gastroenteritis, which is a stomach and bowel infection
  • malabsorption, which is where the intestines are unable to absorb nutrients properly
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Diagnosis

Flatulence does not usually require a medical diagnosis.  However, if you are also experiencing additional symptoms, such as persistent abdominal pain or blood in your stools you should see your GP.  These symptoms suggest that you may have an underlying digestive condition.

In these circumstances you will be given a blood test. This is used to check for the presence of infection. It can also determine whether you have a condition that is linked to a food intolerance, such as coeliac disease or lactose intolerance.

Your GP may also ask you about your symptoms and bowel movements, such as whether you have to strain to pass a stool or whether you experience abdominal pain after eating.   This type of information can be useful in confirming a diagnosis irritable bowel syndrome (IBS).

If you have additional symptoms that are particularly severe, your GP may refer you for an endoscopy. This is a procedure where a healthcare professional examines the inside of your stomach using a piece of equipment called an endoscope. An endoscope is a long, thin flexible tube that has a light and a video camera at one end.

 

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Treatment

Excessive flatulence can usually be treated by making changes to your diet and lifestyle. There are also several over-the-counter treatments available if your flatulence is becoming a problem.

Self-care advice

Diet

Avoid eating foods that are high in unabsorbable carbohydrates (see causes of flatulence for a list).

However, it is still important for you to eat a healthy balanced diet, including at least five portions of fruit and vegetables a day. You should choose foods that contain carbohydrates that are easy to digest. These include:

• potatoes
• rice
• lettuce
• bananas
• grapes
• citrus fruits, such as oranges
• yogurt

It is important to note that different people will react differently to certain foods, so some of the foods listed above may still cause flatulence. It is therefore recommended that you keep a food diary to see whether certain foods make your symptoms better or worse.

You may find it useful to eat six small meals a day rather than three large ones. Smaller meals are easier to digest and may produce less gas. There is also some limited evidence to suggest that drinking peppermint tea can help improve the symptoms of flatulence.

Swallowing air

When eating, make sure that you chew your food slowly to reduce the amount of air that you are swallowing. This will also help with digestion.

Avoid chewing gum because it can also cause you to swallow more air than usual.

Exercise

Taking plenty of exercise can help to improve the functioning of your digestive system and bowel. It has also been shown to help with bloating and the clearing of gas.

You should also give up smoking if you smoke. Smoking can cause you to swallow more air than usual and tobacco smoke can irritate your digestive system.

Read more information and advice about how to give up smoking.

Medication and other remedies

There are several over-the-counter remedies that can be used to help treat the symptoms of flatulence.

Alpha-galactosidase is a dietary supplement that has been shown to improve the digestion of carbohydrates and reduce the symptoms of flatulence. It is found in a product called 'Beano', which has been shown to have some effect in reducing flatulence and is available from some pharmacists and health food shops.

Charcoal tablets are another type of medication that is available over the counter from pharmacists. The charcoal absorbs gas in the digestive system, which helps to reduce the symptoms of flatulence.

Charcoal tablets may not be suitable for you if you are currently taking other medication. This is because the charcoal might absorb the medication and make it less effective. If you are taking other medication, you should ask your GP or pharmacist for advice before taking charcoal tablets.

Clothing containing activated charcoal, or charcoal pads that are placed inside clothing, is intended to help absorb the gas that is released during flatulence. This can help mask foul-smelling gas.

Probiotics may also be useful in treating flatulence. Probiotics are a dietary supplement, usually sold in liquid form, which encourage the growth of 'friendly bacteria' in your digestive system. The 'friendly bacteria' should help to aid digestion and reduce the symptoms of flatulence, particularly in those with irritable bowel syndrome (IBS).

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