Gas in the Digestive Tract

National Digestive Diseases Information Clearinghouse

What is gas?
U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH

Gasisairinthedigestivetractthelarge, musculartubethatextendsfromthemouth totheanus,wherethemovementofmuscles, alongwiththereleaseofhormonesand enzymes,allowsforthedigestionoffood.Gas leavesthebodywhenpeopleburpthroughthe mouthorpassgasthroughtheanus. Gasisprimarilycomposedofcarbondioxide, oxygen,nitrogen,hydrogen,andsometimes methane.Flatus,gaspassedthroughthe anus,mayalsocontainsmallamountsof gassesthatcontainsulfur.Flatusthat containsmoresulfurgasseshasmoreodor. Everyonehasgas.However,manypeople thinktheyburporpassgastoooftenandthat theyhavetoomuchgas.Havingtoomuch gasisrare.

Mouth

Esophagus

Stomach

Large intestine

Small intestine Anus Thedigestivetract

Colon (shaded)

What causes gas?

Gasinthedigestivetractisusuallycaused byswallowingairandbythebreakdown ofcertainfoodsinthelargeintestineby bacteria. Everyoneswallowsasmallamountofair wheneatinganddrinking.Theamountofair swallowedincreaseswhenpeople eatordrinktoofast smoke chewgum suckonhardcandy drinkcarbonatedorfizzydrinks wearloose-fittingdentures

Rectum

Burpingallowssomegastoleavethe stomach.Theremaininggasmovesintothe smallintestine,whereitispartiallyabsorbed. Asmallamounttravelsintothelarge intestineforreleasethroughtheanus. Thestomachandsmallintestinedonot fullydigestsomecarbohydratessugars, starches,andfiberfoundinmanyfoods. Thisundigestedfoodpassesthroughthe smallintestinetothelargeintestine.Once there,undigestedcarbohydratesarebroken downbybacteriainthelargeintestine,which releasehydrogenandcarbondioxideinthe

process.Othertypesofbacteriainthelarge intestinetakeinhydrogengasandcreate methanegasorhydrogensulfide,themost commonsulfurgasinflatus. Studieshavedetectedmethaneinthebreath of30to62percentofhealthyadults.1A largerpercentageofadultsmayproduce methaneintheintestines,butthelevelsmay betoolowtobedetected.Researchsuggests thatpeoplewithconditionsthatcause constipationaremorelikelytoproduce detectableamountsofmethane.1More researchisneededtofindoutthereasons fordifferencesinmethaneproductionand toexploretherelationshipbetweenmethane andotherhealthproblems. Someofthegasproducedintheintestinesis absorbedbythebloodstreamandcarriedto thelungs,whereitisreleasedinthebreath. Normally,fewbacterialiveinthesmall intestine.Smallintestinalbacterial overgrowthisanincreaseinthenumberof bacteriaorachangeinthetypeofbacteria inthesmallintestine.Thesebacteriacan produceexcessgasandmayalsocause diarrheaandweightloss.Smallintestinal bacterialovergrowthisusuallyrelated todiseasesordisordersthatdamagethe digestivesystemoraffecthowitworks, suchasCrohnsdiseaseaninflammatory boweldiseasethatcausesinflammation,or swelling,andirritationofanypartofthe gastrointestinal(GI)tractordiabetes.

digestcarbohydratesandthetypeofbacteria presentintheintestines. Somefoodsthatmaycausegasinclude beans vegetablessuchasbroccoli,cauliflower, cabbage,brusselssprouts,onions, mushrooms,artichokes,andasparagus fruitssuchaspears,apples,andpeaches wholegrainssuchaswholewheatand bran sodas;fruitdrinks,especiallyapple juiceandpearjuice;andotherdrinks thatcontainhigh-fructosecornsyrup,a sweetenermadefromcorn milkandmilkproductssuchascheese, icecream,andyogurt packagedfoodssuchasbread,cereal, andsaladdressingthatcontainsmall amountsoflactose,asugarfoundin milkandfoodsmadewithmilk sugar-freecandiesandgumsthat containsugaralcoholssuchassorbitol, mannitol,andxylitol

What are the symptoms of gas?

Themostcommonsymptomsofgas areburping,passinggas,bloating,and abdominalpainordiscomfort.However,not everyoneexperiencesthesesymptoms. Burping.Burping,orbelching,onceina while,especiallyduringandaftermeals, isnormal.However,peoplewhoburp frequentlymaybeswallowingtoomuchair andreleasingitbeforetheairentersthe stomach. Somepeoplewhoburpfrequentlymay haveanupperGIdisorder,suchas gastroesophagealrefluxdiseaseachronic conditioninwhichstomachcontentsflow

Which foods cause gas?

Mostfoodsthatcontaincarbohydratescan causegas.Incontrast,fatsandproteins causelittlegas.Foodsthatproducegasin onepersonmaynotcausegasinsomeone else,dependingonhowwellindividuals

1SahakianAB,JeeSR,PimentelM.Methaneandthe gastrointestinaltract.Digestive Diseases and Sciences. 2010;55(8):213543.Epub2009Oct15.

2 GasintheDigestiveTract

backupintotheesophagus.Peoplemay believethatswallowingairandreleasingit willrelievethediscomfort,andtheymay intentionallyorunintentionallydevelopa habitofburpingtorelievediscomfort. Passing gas.Passinggasaround13to 21timesadayisnormal.2Flatulenceis excessivegasinthestomachorintestinethat cancausebloatingandflatus.Flatulence maybetheresultofproblemsdigesting certaincarbohydrates. Bloating.Bloatingisafeelingoffullnessand swellingintheabdomen,theareabetween thechestandhips.Problemsdigesting carbohydratesmaycauseincreasedgasand bloating.However,bloatingisnotalways causedbytoomuchgas.Bloatingmay resultfromdiseasesthataffecthowgas movesthroughtheintestines,suchasrapid gastricemptying,orfromdiseasesthatcause intestinalobstruction,suchascoloncancer. Peoplewhohavehadmanyoperations, internalhernias,orbandsofinternalscar tissuecalledadhesionsmayexperience bloating. Disorderssuchasirritablebowelsyndrome (IBS)canaffecthowgasmovesthrough theintestinesorincreasepainsensitivity intheintestines.IBSisafunctionalGI disorder,meaningthatthesymptomsare causedbychangesinhowthedigestivetract works.ThemostcommonsymptomsofIBS areabdominalpainordiscomfort,often reportedascramping,alongwithdiarrhea, constipation,orboth.IBSmaygivea sensationofbloatingbecauseofincreased sensitivitytonormalamountsofgas. Eatingalotoffattyfoodcandelaystomach emptyingandcausebloatinganddiscomfort, butnotnecessarilytoomuchgas.
2Gas-relatedcomplaints.TheMerckManuals

Abdominal pain and discomfort.People mayfeelabdominalpainordiscomfortwhen gasdoesnotmovethroughtheintestines normally.PeoplewithIBSmaybemore sensitivetogasandfeelpainwhengasis presentintheintestines.

How is the cause of gas found?

Peoplecantrytofindthecauseofgason theirownbykeepingadiaryofwhattheyeat anddrinkandhowoftentheyburp,passgas, orhaveothersymptoms.Adiarymayhelp identifyspecificfoodsthatcausegas. Ahealthcareprovidershouldbeconsultedif symptomsofgasarebothersome symptomschangesuddenly newsymptomsoccur,especiallyin
peopleolderthanage40
gasisaccompaniedbyothersymptoms, suchasconstipation,diarrhea,orweight loss Thehealthcareproviderwillaskabout dietaryhabitsandsymptomsandmayaska persontokeepafooddiary.Carefulreview ofdietandtheamountofburpingorgas passedmayhelprelatespecificfoodsto symptomsanddeterminetheseverityofthe problem.Recordinggassymptomscanhelp determinewhethertheproblemistoomuch gasintheintestinesorincreasedsensitivity tonormalamountsofgas. Ifmilkormilkproductsarecausinggas,the healthcareprovidermayperformbloodor breathteststocheckforlactoseintolerance, theinabilityorinsufficientabilitytodigest lactose.Lactoseintoleranceiscausedbya deficiencyoftheenzymelactase,whichis neededtodigestlactose.Thehealthcare providermaysuggestavoidingmilkproducts forashorttimetoseeifsymptomsimprove.

OnlineMedicalLibrary.www.merckmanuals.com/ professional/sec02/ch008/ch008d.html.Updated October2007.AccessedJune26,2012.

3 GasintheDigestiveTract

Thehealthcareprovidermayperforma physicalexamandorderothertypesof diagnostictests,dependingonapersons symptoms.Thesetestscanruleoutserious healthproblemsthatmaycausegasor symptomssimilartothoseofgas.

How is gas treated?

Gascanbetreatedbyreducingswallowed air,makingdietarychanges,ortakingoverthe-counterorprescriptionmedications. Peoplewhothinktheyhavetoomuchgascan trytotreatgasontheirownbeforeseeinga healthcareprovider.Healthcareproviders canprovideadviceaboutreducinggasand prescribemedicationsthatmayhelp. Reducing swallowed air.Swallowinglessair mayhelpreducegas,especiallyforpeople whoburpfrequently.Ahealthcareprovider maysuggesteatingmoreslowly,avoiding gumandhardcandies,orcheckingwitha dentisttomakesuredenturesfitcorrectly. Making dietary changes.Peoplemaybeable toreducegasbyeatinglessofthefoodsthat causegas.However,manyhealthyfoodsmay causegas,suchasfruitsandvegetables,whole grains,andmilkproducts.Theamountofgas causedbycertainfoodsvariesfrompersonto person.Effectivedietarychangesdependon learningthroughtrialanderrorwhichfoods causeapersontohavegasandhowmuchof theoffendingfoodsonecanhandle. Whilefatdoesnotcausegas,limitinghighfatfoodscanhelpreducebloatingand discomfort.Lessfatinthediethelpsthe stomachemptyfaster,allowinggasestomove morequicklyintothesmallintestine. Taking over-the-counter medications.Some over-the-countermedicationscanhelpreduce gasorthesymptomsassociatedwithgas: Alpha-galactosidase(Beano),anoverthe-counterdigestiveaid,containsthe sugar-digestingenzymethatthebody 4 GasintheDigestiveTract

lackstodigestthesugarinbeansand manyvegetables.Theenzymecomes inliquidandtabletform.Fivedrops areaddedperservingoronetabletis swallowedjustbeforeeatingtobreak downthegas-producingsugars.Beano hasnoeffectongascausedbylactoseor fiber. Simethicone(Gas-X,MylantaGas)can relievebloatingandabdominalpainor discomfortcausedbygas. Lactasetabletsordropscanhelppeople withlactoseintolerancedigestmilkand milkproductstoreducegas.Lactase tabletsaretakenjustbeforeeating foodsthatcontainlactose;lactasedrops canbeaddedtoliquidmilkproducts. Lactose-freeandlactose-reducedmilk andmilkproductsareavailableatmost grocerystores. Taking prescription medications.Health careprovidersmayprescribemedicationsto helpreducesymptoms,especiallyforpeople withsmallintestinalbacterialovergrowthor IBS.FormoreinformationaboutIBS,see theIrritable Bowel Syndromefactsheetfrom theNationalDigestiveDiseasesInformation Clearinghouseatwww.digestive.niddk.nih.gov.

Eating, Diet, and Nutrition

Peopleseatinghabitsanddietaffectthe amountofgastheyhave.Forexample, eatinganddrinkingtoofastmayincrease theamountofairswallowed,andfoods thatcontaincarbohydratesmaycausesome peopletohavemoregas. Trackingeatinghabitsandsymptomscan helpidentifythefoodsthatcausemoregas. Avoidingoreatinglessofthesefoodsmay helpreducegassymptoms.

Points to Remember
Gasisairinthedigestivetract. Everyonehasgas.However,many peoplethinktheypassgastoo oftenandthattheyhavetoomuch gas.Havingtoomuchgasisrare. Gasinthedigestivetractisusually causedbyswallowingairandbythe breakdownofcertainfoodsinthe largeintestinebybacteria. Mostfoodsthatcontain carbohydratescancausegas.In contrast,fatsandproteinscause littlegas. Foodsthatproducegasinone
personmaynotcausegasfor
someoneelse.
Themostcommonsymptoms ofgasareburping,passinggas, bloating,andabdominalpainor discomfort. Gascanbetreatedbyreducing swallowedair,makingdietary changes,ortakingover-the-counter orprescriptionmedications.

IBS.SelfAdministeredCognitiveBehavior TherapyforIrritableBowelSyndrome, fundedunderNIHclinicaltrialnumber NCT00738920,assessestheshort-and long-termefficacyofcognitivebehavior therapyforIBSusingtwotreatmentdelivery systems:selfadministeredandtherapist administered.Long-termprojectgoals includedevelopmentofaneffectiveselfadministeredbehavioraltreatmentprogram thatcanenhancequalityofpatientcare, improveclinicaloutcomes,anddecreasethe economicandpersonalcostsofIBS. SafetyStudyofProbioticsinAdultswith IrritableBowelSyndrome,fundedunder NIHclinicaltrialnumberNCT00971711,isa phaseIstudyofthesafetyandeffectiveness ofVSL#3inadultswithIBS.VSL#3isa high-potencyprobioticmedicalfoodthat iscommerciallyavailable.Acupuncture/ MoxibustionforIrritableBowelSyndrome (Acu/MoxalIBS),fundedunderNIH clinicaltrialnumberNCT00945074,tests theefficacyofacupunctureincombination withmoxibustionforsymptomimprovement inadultswithIBS.Moxibustionisthe applicationofheatfromaburningherbat theacupuncturepoint.Allparticipantswill receivemoxibustionandwillbeassignedto oneofthreetreatmentprotocols:standard acupuncture,individualizedacupuncture, andshamacupuncture. Participantsinclinicaltrialscanplayamore activeroleintheirownhealthcare,gain accesstonewresearchtreatmentsbefore theyarewidelyavailable,andhelpothers bycontributingtomedicalresearch.For informationaboutcurrentstudies,visit www.ClinicalTrials.gov.

Hope through Research

TheNationalInstituteofDiabetesand DigestiveandKidneyDiseases(NIDDK) sponsorsresearchintodigestiveconditions, includinggas.Researchersarestudying disordersthatmaycausegassymptoms,such asIBS. TheNIDDKandothercomponentsof theNationalInstitutesofHealth(NIH) areconductingclinicaltrialsaimedat improvingthediagnosisandtreatmentof

5 GasintheDigestiveTract

For More Information

Academy of Nutrition and Dietetics 120SouthRiversidePlaza,Suite2000 Chicago,IL606066995 Internet:www.eatright.org(ClickonFinda RegisteredDietitian) International Foundation for Functional Gastrointestinal Disorders P.O.Box170864 Milwaukee,WI532178076 Phone:18889642001or4149641799 Fax:4149647176 Email:iffgd@iffgd.org Internet:www.iffgd.org

National Digestive Diseases Information Clearinghouse

2InformationWay Bethesda,MD208923570 Phone:18008915389 TTY:18665691162 Fax:7037384929 Email:nddic@info.niddk.nih.gov Internet:www.digestive.niddk.nih.gov TheNationalDigestiveDiseasesInformation Clearinghouse(NDDIC)isaserviceofthe NationalInstituteofDiabetesandDigestive andKidneyDiseases(NIDDK).The NIDDKispartoftheNationalInstitutesof HealthoftheU.S.DepartmentofHealth andHumanServices.Establishedin1980, theClearinghouseprovidesinformation aboutdigestivediseasestopeoplewith digestivedisordersandtotheirfamilies, healthcareprofessionals,andthepublic. TheNDDICanswersinquiries,developsand distributespublications,andworksclosely withprofessionalandpatientorganizations andGovernmentagenciestocoordinate resourcesaboutdigestivediseases.

Acknowledgments
PublicationsproducedbytheClearinghouse arecarefullyreviewedbybothNIDDK scientistsandoutsideexperts.This publicationwasreviewedbyBrooksD.Cash, M.D.,F.A.C.P.,F.A.C.G.,NationalNaval MedicalCenter.

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