It’s a fact. Everyone produces gas. Ordinarily, most people produce about 1 to 3 pints of gas in a day. Gas is normally painless, creating a feeling of fullness until it is passed.
But sometimes pain is experienced, and when it does it can be either dull or sharp, leaving us feeling bloated or tender in places. It can be localized in one spot, or felt throughout the abdomen.
About 50% of people with celiac disease complain of chronic discomfort from gas at the time of diagnosis.
What is Gas?
The accumulation of gas in the digestive tract is called flatus, and having excessive gas is flatulence. Flatus is primarily made up of odorless gases – oxygen, carbon dioxide, hydrogen, nitrogen, and sometimes methane. The unpleasant odor of expelled gas comes from small amounts of gases containing sulfur (hydrogen sulfide) produced by the fermenting action of normal bacteria in the colon. Gas produced in the colon exits through the rectum while some diffuses into the blood and is released through the lungs.
The Three Major Types of Gas
1. Hydrogen production. Nearly all hydrogen is produced by bacterial breakdown of undigested carbohydrates and amino acids in the colon. Hydrogen is produced in large quantities after eating certain fruits and vegetables that contain indigestible carbohydrates.
In celiac disease, hydrogen production stems from malabsorption. Enzymes are produced by villi. When villi are atrophied or damaged by celiac disease, the enzymes they produce, called disaccharidases, can be deficient. Disaccharidase deficiencies allow large amounts of disaccharides (complex sugars like lactose, maltose, and sucrose) to pass into the colon, which are then fermented to produce hydrogen.
2. Carbon dioxide production. Carbon dioxide may also be produced by bacterial action in the colon. Acid products released by bacterial fermentation of unabsorbed carbohydrates may react with bicarbonate ions to produce carbon dioxide. Large amounts of carbon dioxide may be released into the small intestine following ingestion of a fatty meal. Fortunately, carbon dioxide is rapidly absorbed into the blood, thus preventing intolerable distention.
3. Methane production. People who make methane do not necessarily pass more gas or have unique symptoms. A person who produces methane will have stools that consistently float in water (because of trapped gas, unlike the floating stool of steatorrhea caused by high fat content). This trait appears at infancy and persists for life. Research has not shown why some people produce methane and others do not.
What Causes Gas?
Gas is mainly caused by one or more of three things: 1) Swallowed air, 2) Motility irregularities, and 3) Bacteria action on undigested foods in the colon.
1) Swallowed Air.
Swallowed air during eating, drinking or chewing gum is eliminated from the stomach by burping. Otherwise, it passes into the intestine. Excessive salivation may also lead to increased air swallowing and may be associated with various digestive disorders such as peptic ulcers.
2) Motility Irregularities
Painful bloating from gas is usually the result of poor motility. Motility refers to the contractions that automatically move food through the digestive tract. Food and gas should normally move along the digestive tract until the food is digested and absorbed and the gas is expelled. Poor motility slows the movement of food through the stomach and intestinal tract, leading to trapped air pockets of gas.
Eating fatty foods can affect motility by delaying stomach emptying, leading to bloating.
Magnesium and thiamin (vitamin B1) deficiencies cause slowed motility leading to gas and constipation. Intestinal inflammation caused by celiac disease creates spasms that affect motility, thus trapping gas in pockets between spasming sections of intestine.
Splenic flexure syndrome is a motility problem where gas becomes trapped in the splenic flexure, the loop of bowel located where the transverse colon turns upward near the spleen (below the left ribs) before turning downward to the descending colon. This condition may cause all-over abdominal distention. Fullness and pressure is felt in the left upper region of the abdomen that radiates to the left side of the chest. Sometimes this situation can even make it difficult to take a deep breath. Defecation usually brings relief.
3) Bacteria Action
Bacteria are natural inhabitants of the colon. Foods that produce gas in one person may not cause gas in another owing to the type and balance of bacteria living in the colon.
Dysbiosis causes gas. Some common bacteria in the colon can remove the gas that other bacteria produce. Dysbiosis is an imbalance of these two types of bacteria that results in increased gas.
Overload of undigested nutrients in the colon always causes gas. Digestion is adversely affected by celiac disease and disorders like lactose intolerance and pancreatic insufficiency that cause a deficiency of digestive enzymes. When carbohydrates cannot be properly digested and absorbed in the small intestine due to a shortage or absence of digestive enzymes, large amounts pass into the colon where naturally occurring bacteria ferment them, producing large amounts of gas. This is why we wake up with a flat belly. There is little to ferment.
Many foods contain soluble and insoluble fiber. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Soluble fiber found in beans, peas, and most fruits, is not broken down until it reaches the colon where fermentation by bacteria causes gas. Insoluble fiber on the other hand, passes essentially unchanged through the intestines and produces little gas.
Eating too much food that is high in sugars naturally causes gas. This gas acts to plump up the stool and thereby aids movement through the colon. It does not normally cause pain. Some examples of these sugars are raffinose, fructose and sorbitol.
1. Beans contain large amounts of raffinose. Smaller amounts are found in vegetables such as broccoli, cabbage, Brussels sprouts, onions, artichokes, and asparagus.
2. Fructose is naturally present in honey, most fruits, onions, and artichokes. It is also used as a sweetener. Fructose may be digested normally but may pass so rapidly through the small intestine that there is not enough time for digestion and absorption to take place.
3. Fruits such as pears, apples, plums and peaches contain sorbitol naturally. It is also used as an artificial sweetener in dietetic foods and sugar-free candies and gums. Sorbitol may be poorly digested by the pancreas and small intestine.
When Gas is Painful
Bloating (feeling of fullness) and abdominal pain are more often caused by an irritated colon rather than by too much gas. Besides celiac disease, painful gas stems from other disorders of the intestine such as lymphocytic colitis, collagenous colitis, irritable bowel syndrome, carbohydrate malabsorption and enzyme deficiency disorders that result in lactose intolerance, maltose intolerance, and sucrose intolerance.
Testing for the Cause of Gas.
Painful gas can indicate serious problems such as bacterial overgrowth in the small intestine, intestinal obstruction, and cancer. There are many studies that can quickly identify disorders in celiac disease that contribute to gas.
- Gastric emptying studies detect conditions such as pyloric stenosis and gastroparesis (slow motility) that reduce emptying of the stomach.
- Ultrasound, CT scan, and MRI detect abnormalities such as tumors and bowel twisting.
- 72-hour collection of stool measures fat in the stool to detect increased amounts seen in pancreatic insufficiency.
- Hydrogen/methane breath tests are used to test for bacterial overgrowth of the small intestine by detecting hydrogen/methane elimination through the lungs.
Correcting Gas Naturally.
To prevent or reduce gas from swallowing air:
- Eat slowly and chew thoroughly to improve digestion in the stomach.
- Do not chew gum.
- Refrain from talking while eating.
- Avoid drinking carbonated beverages.
- Maintain good posture. Hunching over traps stomach air.
To Reduce Gas in the Colon:
- Before eating, take probiotic supplements containing these gas-gobbling microorganisms to build up healthy good bacteria populations in the colon. Bifidobacteria bifidus, bifidobacteria bulgaricus, and lactobacillus acidophilus have been found to be beneficial.
- Limit fatty foods because they slow peristalsis (digestive muscle movement) and promote gas buildup.
- Eat small quantities or avoid foods that give you gas or try an enzyme product that helps break down hard-to-digest carbohydrates in beans and other high fiber foods.
- Limit sugar-containing foods to prevent overload.
- Eat the following foods called carminatives. They stimulate peristalsis and remove gas.
- Fennel as fresh vegetable and the seeds. Crush seeds to make into a fast acting tea.
- Raspberry as fresh fruit and crushed for tea.
- Celery fresh or cooked.
- Lemon fresh.
- Horseradish is also digestive stimulant in small amounts.
- Chili or cayenne also act as digestive stimulants.
- Carrot fresh or cooked is also a cleansing digestive tonic.
- Grape is also bile stimulant, cleansing for sluggish digestion, and laxative.
- Enjoy mint tea and camomile tea after eating to promote digestion and reduce gas.
- Take a 15-minute walk after eating. Light exercise mobilizes gas.
- Heat and abdominal massage at the location of the gas will relax any muscle spasm that may be holding the gas and move the gas along.
- Wine before dinner acts to calm the gut.
--------------------------------- Author Information: Cleo Libonati, RN, BSN Cleo Libonati is a Co-Founder of Gluten Free Works, Inc. She is the author of Recognizing Celiac Disease. She can be reached by E-mail.