Patient Education

Gas and Bloating

Gas, bloating, belching (burping), and passing gas can be uncomfortable and embarrassing. However, they are a normal part of the digestive process. Understanding what causes bloating and gas can help reduce some symptoms and provide relief.

Slow-moving or trapped gas can cause pain, known as gas pains. Some foods are more likely to produce gas in the digestive system. Eating these foods less often can help reduce gas.

Some digestive conditions like celiac disease and irritable bowel syndrome can also cause an increase in gas or gas pains.

If you think you have excessive gas or gas pains, schedule an appointment today.

Symptoms of Gas & Bloating

• Belching (Burping)
• Passing gas (flatus)
• Abdominal cramping
• A full feeling in the abdomen (bloating)
• Swollen abdomen from internal pressure (distention)

Burping is a normal part of digestion, especially after meals. Passing gas 15-20 times a day is also normal.  Burping and passing gas may cause embarrassment, but rarely indicate a medical problem.

What Causes Gas & Bloating?

There are two main causes of gas in the digestive tract (esophagus, stomach, small intestine, large intestine).

1. Digestion and fermentation of foods – Your digestive tract contains beneficial bacteria that break down food and nutrients.  In your large intestine, gas is formed during the fermentation process of carbohydrates like fiber and sugar.
2. Swallowing Air – Everyone swallows some air while eating and drinking. Drinking or eating quickly, smoking, chewing gum, or even loose dentures can cause some to swallow more air.  The medical term for swallowing air is aerophagia.

Foods That Cause Gas

Most foods with carbohydrates can cause gas while protein and fats cause little gas.

Sugars

Sugars such as lactose, fructose, raffinose, stachyose, verbascoce, and sorbitol can cause gas.

High Fiber Foods

• Beans (legumes)
• Vegetables
• Fruits
• Whole grains

Even though high-fiber foods can increase gas, fiber is critical for a healthy digestive tract.

Other Dietary Considerations

Carbonated beverages, fiber supplements, and artificial sweeteners can also cause excess gas in the digestive system.

Medical Conditions that Cause Gas

Some medical conditions can increase intestinal gas, gas pains, or bloating including:

• Intestinal diseases – chronic intestinal diseases like Crohn’s disease, ulcerative colitis, and diverticulitis can cause excess gas.
• Overgrowth of bacteria – A change or increase in small intestine bacteria may cause excess gas, weight loss, or diarrhea.
• Food intolerance – some food intolerances can cause excess intestinal gas.  This is caused by an inability to properly break down the sugar in dairy products (lactose intolerance) or gluten (celiac disease).
• Constipation – It may be difficult to pass gas when experiencing constipation.

Diagnosing Gas, Gas Pains, and Bloating

Even though gas and bloating are common, a medical evaluation may sometimes be necessary. If you experience blood in the stool, diarrhea, fevers, anemia, or weight loss, you should talk to a doctor.

Medical History & Physical Exam

First, your doctor will review your medical history and ask questions about your symptoms and dietary habits.

The doctor may also examine your abdomen for tenderness or anything that feels abnormal.  A stethoscope may be used to help the doctor determine how well the digestive tract is working.

The results of these preliminary tests will help determine the next level of diagnosis if necessary.

Additional Tests for Gas, Gas Pains, and Bloating

• Breath tests – Breath tests can help determine problems of malabsorption or intestinal bacteria overgrowth.
• Colonoscopy – In patients 50 or older, or who have a family history of colorectal cancer, the possibility of colon cancer may be considered.
• Imaging – If chronic belching is a problem, x-rays may be used to inspect the small intestine, stomach, and esophagus. This is known as an upper GI series

Treatment for Gas, Gas Pains, and Bloating

If your gas and gas pains are caused by an underlying condition, treatment for that condition may provide relief. Usually, gas can be treated through lifestyle modifications, dietary changes, and over-the-counter medications.

Dietary Considerations

Not everyone has the same reaction to all foods.  Keeping a food diary can help you determine which foods cause increases in gas and bloating.  Eliminating or reducing certain foods may be necessary to reduce your symptoms.

High-Fiber Foods

Foods that can cause gas due to high fiber include whole wheat, bran, prunes, peaches, apples, pears, asparagus, artichokes, cauliflower, cabbage, Brussels sprouts, broccoli, onions, and beans.  You may try avoiding high-fiber foods for a week or two and gradually start to eat them again. You should visit a doctor or dietitian to make sure you’re getting enough fiber.

Dairy

Some people do not easily digest lactose, the sugar found in dairy products.  Reducing or eliminating dairy products could help you reduce symptoms of gas and bloating. There are often lactose-free options for some products like milk.

Artificial Sweeteners

You may try eliminating sugar substitutes or trying a different type.

Fatty/Fried Food

Fat in your digestive tract can slow down digestion, allowing food to ferment longer and produce gas. Reducing fat in your diet may help lessen symptoms.

Carbonated Beverages

Soda, beer, sparkling water, or other carbonated drinks can increase the amount of gas in your digestive tract.

Fiber Supplements

Some fiber supplements could cause an increase in gas and bloating.  Visit with your doctor about what types of fiber supplements might be right for you.

Water

Drink more water throughout the day and with meals.  This will reduce the chances of constipation.

Over-The-Counter Medications for Gas

Beano, BeanAssist –  these alpha-galactosidase medications aid in the digestion of carbohydrates often found in vegetables and beans. These supplements are taken right before you eat.

Lactaid, Digest Dairy Plus – Lactase supplements aid the digestive process of lactose, the sugar in dairy products. They will help reduce symptoms in people who are lactose intolerant. If you are breastfeeding or pregnant, talk to your doctor before using lactase supplements.

Gas-X, Mylanta Gas Minis – Simethicone can break down gas bubbles making it easier for gas to pass through the digestive tract. However, there is minimal evidence showing it reduces symptoms.

Actidose-Aqua, CharoCaps – Activated charcoal, taken before and after a meal, may reduce symptoms. Research has not proven these claims. Activated charcoal could also interfere with the absorption of medications.  It can also stain your clothing and the inside of your mouth.

Prescription Medications for Gas

For those with more serious, underlying conditions like irritable bowel syndrome, your doctor may prescribe prescription medications.

Lifestyle Changes to Reduce Gas

Some lifestyle adjustments can help reduce gas, gas pains, and bloating.

• Eat smaller portions – Many healthy foods can also cause gas.  Eating smaller portions may help reduce excess gas.
• Chew completely and slow down – If you eat too fast, it could cause gas.  Tip: put down your fork between each bite.
• Avoid
  • drinking through straws
  • chewing gum
  • sucking on hard candies
• Secure dentures properly – If dentures are loose, they can cause you to swallow excess air when eating and drinking.
• Don’t smoke – Smoking can increase the amount of air you swallow.
• Get regular exercise – exercising most days will help reduce the risk of constipation, which blocks gas from exiting your colon.