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Increasing Flatulence

Q: This is really embarrassing. As I've gotten older, I've developed an increasing problem with passing gas. It happens all the time without warning, like when I sit down or pick up something heavy. It's getting to the point where I feel too anxious to go out to a restaurant or party. I've already tried cutting out problem foods like dairy and beans, but it hasn't helped! Is there anything else I can try?

Dr. Donnica:
Age-related changes in the large intestine, along with increased use of medications and reduced physical activity, tend to slow the transit of stool through the large intestine causing an increased incidence of flatulence (gassiness) as well as constipation. Flatulence occurs when a food does not break down completely in the stomach and small intestine. As a result, it gets into the large intestine in an undigested state.

There are certain foods known to produce more flatulence than others, either because they contain more indigestible carbohydrates than others (beans) or because the individual lacks the enzymes necessary to digest them. This is the case with people who have developed lactose intolerance and have trouble digesting milk and dairy products. If you are lactose intolerant, products such as Lactaid™ would be helpful.

There are several non-prescription products marketed to help reduce flatulence in general, such as Gas-Ex™ and Beano™. I also recommend that you try a gas-reducing diet. There are many approaches (visit www.gicare.com/pated/edtgs12.htm for some examples) but the object of all of them is to identify which particular foods cause you the most problems with gas and to either eliminate them from your diet or limit the consumption of that particular kind of food. There are two general approaches. The first is to continue to eat as you normally do, but eliminate one category of gas producing foods for at least a week. If there is no lessening of gas, put those foods back in your diet and then eliminate another category for a week. Follow this procedure until you reach a level of flatulence that is tolerable.

Since your situation is so bothersome that it's interfering with your social life, I recommend the second approach. Severely restrict all categories of gas producing foods for four days. Then reintroduce one food at a time. If this addition causes no increased flatulence, continue to enjoy it. If you notice an increase in gas, eliminate the food item permanently and go on to try the next food. Continue this process until you've identified all of the foods that cause gas. The foods that are the worst offenders in flatulence production vary greatly among individuals, but they generally include: all kinds of beans; all kinds of milk and dairy products; onions; celery; carrots; raisins; apricots; prunes; wheat products; and Brussels sprouts.

Created: 5/18/2005  -  Donnica Moore, M.D.

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