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Gastroenterology (Expert Forum)
Flatulence
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Flatulence
by rockbottom, Mar 01, 2004 12:00AM
For years I have had a very strange digestive problem that must sound humerous, but has been a cause of serious problems in my life, and has recently gotten worse. For some reason I am at times unable to keep gas escaping from my intestines. I have no way of predicting when this will happen, and clearly it makes my personal and professional life extremely difficult and frustrating. The problem is a bit complicated and I have had some time to observe and think about it, so please bear with me as I try to articulate everything I think relevant to your being able to respond usefully.
The most important thing is that it does NOT seem to involve what I eat. I have been sticking to a very healthy diet (brown rice, whole grain bread, spinach/tomatoe salads, fish) for months and getting excercise (daily sittups/pushups, running) and the problem persists. Diet only effects the smell of the gas that escapes. Thus I think it's a problem with my intestines, perhaps muscular in nature. I think I'm getting pockets of gas way too low in my intestines, at times I get "growling stomach" sensations way below my stomach, sometimes in my groin and sometimes near the anus. It seems to me that once the gas gets down there it seeps out on its own no matter how I twist and turn. Even worse, when I excuse myself to go to the toilet, nothing comes out, neither feces or a regular fart, and it just continues the same when I go back.
Other relevant factors: I get constipated at times and go as many as 3 days without having a bowel movement. I don't have problems with diarhea. I have loose stool at times, but this has slightly decreased as I've added some fiber to my diet, though without improving the flatulence at all. I don't think it's IBS, because uncontrollable flatulence isn't one of its symptoms.
It doesn't seem to be caused by excessive amounts of gas. I eat no gas-causing foods and no dairy, and I generally don't feel bloated or have gas pains. I suspect that the problem is connected to issues of stress, in that it gets worse when I'm under stress, but not that it's completely caused by them.
This has caused me to avoid social situations and to miss days of work, and please don't think this is all in my head, because it has become something of a public joke where I live. It's very real, and yet I'm starting to feel like I'm the only person that has ever suffered from this debilitating condition.
It doesn't seem to be a widespread problem, partly becaue I've never heard of anyone else suffering from it, and partly because the doctor I visited had absolutely nothing useful to say. This is partly because I have a cheap, student's health care plan and could not get referred to a gastroenterologist. Please let me know if these syndroms sound at all familiar to you, and what you think the problem might be. If I can get some specifics maybe I'll be able to get an appointment with a specialist.
Doctor's Answer
by Kevin Pho, MD, Mar 03, 2004 12:00AM
, Mar 03, 2004 12:00AM
There are a variety of reasons for the perception of increased gas. This can include irritable bowel syndrome, carbohydrate malabsorption (i.e. lactose intolerance), bacterial overgrowth, any type of GI infection, or irritation of anus or esophagus.
Specific tests to consider would include the following:
- Examination of stool to detect the presence of blood, abnormally increased levels of fat (steatorrhea), or the presence of Giardia lamblia.
- A lactose tolerance test, during which patients are provided with a test dose of lactose by mouth. Breath or blood samples are obtained during the test to confirm the presence of lactose intolerance.
- X-ray examination of the small intestine.
- Upper endoscopy, sigmoidoscopy, or colonoscopy (in which the inside of the stomach, upper intestines or colon are examined via a tube with a camera at the end).
- Antibody tests for celiac disease.
You may want to consider discussing these tests with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Specific tests to consider would include the following:
- Examination of stool to detect the presence of blood, abnormally increased levels of fat (steatorrhea), or the presence of Giardia lamblia.
- A lactose tolerance test, during which patients are provided with a test dose of lactose by mouth. Breath or blood samples are obtained during the test to confirm the presence of lactose intolerance.
- X-ray examination of the small intestine.
- Upper endoscopy, sigmoidoscopy, or colonoscopy (in which the inside of the stomach, upper intestines or colon are examined via a tube with a camera at the end).
- Antibody tests for celiac disease.
You may want to consider discussing these tests with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
have you ever tried beano??
i have never tried beano as i dont eat much beans,wonder if this will help you.
over the counter gas x and extra strength gas x will neutralise gas in your body,result will be you will fart.
may be better to let it get out before you go out in the public.
I thought I was the only one in the world with this problem! I am too embarrased to talk to any one about it except for my Doctor. She has sent me for an ultrasound of my gallbladder, and that was okay. Next, a colonoscopy, and they did remove a polyp, but the problem is not any better. Two weeks ago she put me on zelnorm, and although my bowel movement are more regular, it has not helped with the gas at all. One specialist actually told me to keep a cotton ball tucked into my rectum-that only made the problem worse,and was extemely uncomfortable, but I am willing to try anything.Beano, gas-ex, charcol, diet changes- none of these work.
I also wonder if it has to do with nerves, because it is worse when i am around other people, but I think that may be because at home you don't try to hold it in.....
Now i am thinking that i may have find a new job where i don't have to work close to other people. The embarrasement is so bad-people at work sometimes spray air freshener around me. I avoid so many social situaions because of this. If you find anything that works, please let me know. Thanks
You are definitely not alone. I'm to the point of becoming a hermit due to frequent flatulence following bowel surgery. I had a large section of large intestine removed, and now the smell is incredibly foul. I've been too embarrased to seek any treatment, and just avoid people and social situations now.
EagleUK
I also saw on another site, Med Help International, a similar situation, of which the good Doctor gave some great advise, but there was no word from the Sufferer if there was resolution/closure on the issue.( FYI, the site address is www.medhelp.org/per16/gastro/archive/2707.html) If anyone out there can help me in regard to how things turned out, I'd b stoked to hear. I will post a similar note on "eyeore's" forum also, as they are very closely related to my situation.
Remember rockbottom to let us know how you are getting on.
From last night, for a start, I have given up the Homebrew Beer & normal beer.
Thanx, I WONDER!
Sooooo.....has anyone found any relief for the situation...medication, change of diet, surgery to relieve the symptoms completely??? Someone please come forward with a solution for us!!!
I have been way to embarrassed to mention this to a doctor.
This forum has been a help to me already, however as ive mentioned previous, it would be sooooo much better if those with who have had their problems sorted out, posted there feedback so we can learn from them, although I appreciate that we are all different & have differing situations.
Please let us know anyone if there is some good feedbak, particularly ""Rockbottom or eyeore""....Thanks>>>>> I WONDER
I am suffering from the same problem as rockbottom. The symptoms r almost the same. I am suffering from this for the past 4 years approx. i have always had a sensitive stomach. i will describe my sypmtoms as i am experiencing it, as i feel that i can get better help if i do so.
i am seeking help desperately. i am unable to discuss this with anyone as its so embarrasing. also my professional and social life have been hit. i am 24 yrs old.
i am not overweight. i also exercise. i dont smoke nor drink. i eat normal food like wheat, rice etc well just like a normal person.
gas