Thursday 13 December 2018

Dear Dr Nina: My husband suffers from very bad flatulence - or more like I suffer. But we all eat the same food. Should he get it checked out?

"It is extremely unpleasant and I want him to get it checked out." Stock photo
High fibre foods produce more gas, which may be more offensive

Question: My husband suffers from very bad flatulence - or more like I suffer. It doesn't seem to bother him. He eats the same food as the rest of the family, but it seems to cause him a lot of very smelly wind. It sounds funny, but it is extremely unpleasant and I want him to get it checked out. Could it indicate an underlying problem?

Dr Nina replies: Intestinal wind is present all the time throughout our gut. It's only when it is excessive or causes pain that we become aware of it. Excess gas may cause pain, bloating or cramping throughout the abdomen. It is normal to pass wind each day. Doctors are more concerned if you don't pass any flatus on a daily basis as this can suggest an obstruction in the gut. Most people will burp at times and it is normal to pass flatus up to 20 times per day, the average being 14.

Excess wind in the upper gut is commonly due to swallowing air either when talking, chewing gum or drinking fizzy drinks. It can produce an uncomfortable full feeling that is relieved by burping. Excess wind lower in the gut is usually a by-product of the fermentation and digestion of food. It can more rarely be caused by an overgrowth of bacteria or due to some digestive disease.

Certain foods are more likely to produce excess wind and gas. These include beans and pulses, cruciferous vegetables, sugars such as lactose, fructose, and sorbitol (an artificial sweetener) and polysaccharide or starch containing foods (particularly whole grains). Wind-producing digestive diseases include coeliac disease, irritable bowel syndrome, lactose intolerance and food allergy or intolerance.

The amount of gas produced in the gut, therefore, depends on the type of food eaten and how it is digested. It has also been suggested that some individuals are more sensitive to gas in the gut than others and therefore will feel more bloated and uncomfortable even with normal amounts of gas. If you are finding your husband's flatulence particularly offensive it may be down to the diet he eats and the bacteria that colonise his gut. High-fibre foods produce more gas, which may be more offensive.

A simple remedy for bloating and gas may be to keep a food diary and identify foods that cause more discomfort than others. Consulting a dietitian and trying the Low FODMAP diet may help. If milk seems to be a culprit try using lactose-free varieties or eating cheese or yoghurts as the cultures in these partially digest lactose. Products containing peppermint make help in some people. If gut transit is slow medicines such as metoclopramide are also an option. More recently there are a number of excellent probiotic preparations available that can help with symptoms of bloating and flatulence.

If none of the above remedies are helping, and symptoms are causing on-going problems, it is worth talking to your doctor.

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