Lactose Intolerance.
(This text from http://www.coolmd.com/pg/farting.html).
Lactose intolerance is one of the most common true causes of excessive flatulence. Symptoms of lactose intolerance include diarrhea, cramping and excessive flatulence especially after consuming dairy products (15 to 20 minutes). For people with severe lactose intolerance avoidance of milk, ice cream etc is necessary to avoid the cramping, gas and diarrhea.
Infections and Malabsorption Syndroms.
Sometimes after a person has been sick with diarrhea ("stomach virus"), they get a temporary deficiency of lactase and will become intolerant to milk for a short period of time. It is good practice to avoid dairy products for a few days after a bout of diarrhea or stomach flu. Other infections such as that caused by the parasite, Giardia, are notorious for producing abdominal bloating and flatulence.
There are many less common intestinal "malabsorption syndromes" where the gut is not able to properly digest and absorb carbohydrates, fats and proteins. Usually these syndromes are manifested by marked diarrhea, weight loss and cramping although occasionally flatulence can be the predominant problem.
Irritable bowel syndrome.
(This text if from http://www.merck.com/pubs/mmanual/section3/chapter32/32a.htm).
Irritable bowel syndrome is the cause of Denise Brunettes chronic flatulence.
Treatment.
Therapy is supportive and palliative. A physician's sympathetic understanding and guidance are of overriding importance. The physician must explain the nature of the underlying condition and convincingly demonstrate to the patient that no organic disease is present. This requires time for listening and explaining normal bowel physiology and the bowel's hypersensitivity to stress, food, or drugs. These explanations form the foundation for attempting to reestablish regular bowel routine and individualizing therapy. The prevalence, chronicity, and need for continuing care of IBS should be emphasized. Psychologic stress and anxiety or mood disorders should be sought, evaluated, and treated (see Chs. 187 and 189). Regular physical activity helps relieve stress and assists in bowel function, particularly in patients who present with constipation.
Patients with abdominal distention and increased flatulence may benefit from dietary reduction or elimination of beans, cabbage, and other foods containing fermentable carbohydrates. Reduced intake of apple and grape juice, nuts, raisins, and bananas may also lessen the incidence of flatulence. Sorbitol and mannitol are artificial sweeteners used in dietetic foods and as drug vehicles, whereas fructose is a common constituent of berries, fruits, and plants.
Increasing dietary fiber can help many patients with IBS, particularly those with constipation. These agents help retain water in the bowel and prevent constipation. Fiber added in small amounts may also help reduce IBS-induced diarrhea by absorbing water and solidifying stool.
Anticholinergic (antispasmodic) drugs (eg, hyoscyamine 0.125 mg 30 to 60 min before meals) may be used in combination with fiber agents. The use of narcotics, sedative hypnotics, and other drugs that produce dependency is discouraged. In patients with diarrhea, diphenoxylate 2.5 to 5 mg (one to two tablets) or loperamide 2 to 4 mg (one to two capsules) may be given before meals. Because tolerance to the antidiarrheal effect may occur, chronic use of antidiarrheals is discouraged. Antidepressants (eg, desipramine, imipramine, and amitriptyline 50 to 150 mg daily) help many patients with either type of IBS. In addition to constipation and diarrhea, abdominal pain and bloating are relieved by antidepressants. These drugs can also reduce pain by down-regulating the activity of spinal cord and cortical afferent pathways arriving from the intestine. Certain aromatic oils (carminatives) can relax smooth muscle and relieve pain caused by cramps in some patients. Peppermint oil is the most commonly used agent in this class.
MANY PEOPLE THINK that if their digestive system is normal, they won't have any gas unless they eat a particular food, like beans. The fact is that normal people on an average diet expel nearly a quart of intestinal gas each day. Most of us aren't aware of this. When we become aware of the gas that it can become embarrassing and uncomfortable, it's.
Gas is formed when certain foods reach the large intestine without being completely and adequately digested. Bacteria that reside there go to work to digest them and in the process produce gas when they arrive. This is a normal process; in most cases, intestinal gas is not a sign of a disease. Today, when we're eating more high-fiber foods and 'fruits and vegetables-- which can be sources of intestinal gas-- the problem of flatulence is more common.
The major cause of occasional excess flatulence is gas-promoting foods. Most people know that beans are a major suspect, but there are other foods that will put you at risk including apricots, bananas, broccoli, Brussels sprouts, cabbage, cauliflower, eggplant, radishes, and onions.
Obviously the first step in reducing flatulence is avoiding the foods that give you gas. Some people have found that corn, oats, and even bagels give them gas.
There are ways to reduce the amount of gas produced by one of the main offenders: beans. Soaking beans in water for at least twelve hours and then cooking them welt will help reduce their gas-producing properties. Make sure that you discard the soaking water. Rinse beans thoroughly and be certain to cook them thoroughly until they are completely tender with no "bite" left.
There are other methods to help reduce gas while still eating problematic foods. The most effective one seems to be a new product called Beano. You use it as a condiment, adding a few drops to your first spoonful of offending food. It has a mild soy sauce-type flavor that usually works well with beans and other gas producers.
Some people find that activated charcoal tablets, which are available at health food stores, help cut down on their gas production. The charcoal absorbs the problem odors. Be careful to avoid taking them within two hours of any other medication if you try activated charcoal tablets. They can absorb your medicines and make them unavailable to your body because they are so effective at absorbing chemicals. When on antibiotics, it is not uncommon to experience intestinal gas and bloating. As I've discussed, antibiotics kill off good as well as bad bacteria in your system, and an overgrowth of yeast can result. Yeast overgrowth is a common cause of flatulence and can be easily remedied by following a yeast-free diet as well as taking acidophilus tablets available in health food stores.
Many people are unaware that milk products can be a cause of flatulence but, in that, lactose intolerance is probably the major cause of chronic excessive gas and bloating, I've had a number of patients who have developed lactose intolerance and complained of gas and bloating. If you suspect that you are lactose intolerant, avoid all dairy products including milk, cheese, and the like for ten days to see if your symptoms are alleviated.
There are also some dietary and lifestyle changes that can help. Smoking, chewing gum, drinking carbonated drinks, and drinking from water fountains can all introduce excess air and gas into your system, thus promoting flatulence.
If you have chronic flatulence it's possible that you're suffering from something other than a simple case of gas.
Today, when we're eating more high-fiber foods and 'fruits and vegetables-- which can be sources of intestinal gas-- the problem of flatulence is more common.
Obviously the first step in reducing flatulence is avoiding the foods that give you gas. There are other methods to help reduce gas while still eating problematic foods. Some people find that activated charcoal tablets, which are available at health food stores, help cut down on their gas production. Many people are unaware that milk products can be a cause of flatulence but, in that, lactose intolerance is probably the major cause of chronic excessive gas and bloating, I've had a number of patients who have developed lactose intolerance and complained of gas and bloating.
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