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home : columns : ask the doctors September 30, 2020

5/29/2020 12:31:00 PM
Passing gas is a fact of life

Dear Doctor: I'm 102 years old and a World War II veteran. My problem is that I pass a lot of gas. Several days ago, I had an apple and a small piece of sweet potato, and I stunk up the whole house. I had to open all of the windows and doors. Do you have any suggestions?

Dear Reader: We do have some thoughts on your issue, but first we want to congratulate you on a long life. Our readers often include their age in their letters, and you have surpassed them all by several years.

Internal gas is a fact of life. Whether it's emitted through the mouth as a burp or through the anus as flatulence, it's actually a sign the body is functioning properly. Gas can accumulate as a result of air ingested while eating, drinking, speaking or swallowing. It's also a byproduct of digestion, during which gut bacteria help break down food and emit a range of gases as they work. Most flatulence is made up of carbon dioxide, methane and hydrogen, which are essentially odorless. A small percentage of passed gas includes hydrogen sulfide, which has a powerful odor. Believe it or not, we humans pass gas from one dozen to two dozen times per day.

When excessive gas is accompanied by additional symptoms such as bloating, abdominal pain, loose stool or diarrhea, poor appetite, nausea and unexplained weight loss, it can signify the presence of underlying intestinal issues. These can include irritable bowel syndrome, inflammatory bowel disease, celiac disease, Crohn's disease or small-intestinal bacterial overgrowth. If you do have these additional symptoms, be sure to let your doctor know.

Another factor in excessive gas is a person's age. Due to ongoing changes in our bodies as we grow older, our digestive systems become less efficient at processing the food we eat. Some people may even develop lactose or fructose intolerance.

One approach to the problem is to identify the specific food triggers. You can do this by eliminating all suspected foods from your diet, then gradually reintroducing them one by one. Common culprits include high-fiber foods, certain fruits, cruciferous vegetables, beans and items with the artificial sweetener sorbitol. Keep track of symptoms, and you'll be able to identify not only the specific foods that lead to excess gas, but also the serving size at which it becomes a problem.

You have several options to manage flatulence. Some people swear by probiotic foods and supplements, which can balance the gut. Your health care provider can help you decide if this is an option for you and advise you on specifics. Over-the-counter anti-gas preparations, such as Beano, or those that contain simethicone (Mylanta II, Maalox II) or bismuth (Pepto-Bismol) can reduce gas. Taking Lactaid, an enzyme supplement, helps people who have trouble with milk products.

And take a look at your prescription medications. Blood pressure drugs, narcotics and allergy meds, which can slow digestion and are associated with excess gas. Always check with your doctor before making any changes to medications.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.





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