Gas and gas pains can strike at the worst possible moment — during an important meeting or on a crowded elevator. Although passing intestinal gas (flatus) usually isn't serious, it can be embarrassing.

Anything that causes intestinal gas or is associated with constipation or diarrhea can lead to gas pains. These pains generally occur when gas builds up in your intestines, and you're not able to expel it. Most people pass gas at least 10 times a day.

The good news is that although you can't stop gas and gas pains, a few simple measures can help reduce the amount of gas you produce and relieve your discomfort and embarrassment.

For most people, the signs and symptoms of gas and gas pain are all too obvious. They include:

  • Voluntary or involuntary passing of gas, either as belches or as flatus.
  • Sharp, jabbing pains or cramps in your abdomen. These pains may occur anywhere in your abdomen and can change locations quickly and get better quickly.
  • A 'knotted' feeling in your abdomen.
  • Swelling and tightness in your abdomen (bloating).

Sometimes, gas pains may be constant or so intense that it feels like something is seriously wrong.

Gas can sometimes be mistaken for:

  • Heart disease
  • Gallstones
  • Appendicitis

When to see a doctor

It's considered normal to pass gas as flatus between 10 and 20 times a day. That amount varies from day to day, however.

Call your doctor if your gas is accompanied by:

  • Prolonged abdominal pain
  • Bloody stools
  • A change in stool color or frequency
  • Weight loss
  • Chest pain
  • Persistent or recurrent nausea or vomiting

In addition, talk to your doctor if your gas or gas pains are so persistent or severe that they interfere with your ability to live a normal life. In most cases, treatment can help reduce or alleviate the problem.

Gas forms when bacteria in your colon ferment carbohydrates that aren't digested in your small intestine. Unfortunately, healthy, high-fiber foods are often the worst offenders. Fiber has many health benefits, including keeping your digestive tract in good working order and regulating blood sugar and cholesterol levels. But fiber can also lead to the formation of gas.

High-fiber foods that commonly cause gas and gas pains include:

  • Fruits
  • Vegetables
  • Whole grains
  • Beans and peas (legumes)

Fiber supplements containing psyllium, such as Metamucil, may cause such problems, especially if added to your diet too quickly. Carbonated beverages, such as soda and beer, also cause gas.

Other causes of excess gas include:

  • Swallowed air. You swallow air every time you eat or drink. You may also swallow air when you're nervous, eat too fast, chew gum, suck on candies or drink through a straw. Some of that air finds its way into your lower digestive tract.
  • Another health condition. Excess gas may be a symptom of a more serious chronic condition. Examples include diverticulitis or an inflammatory bowel disease, such as ulcerative colitis or Crohn's disease. Excess gas and bloating may also be a symptom of bacterial overgrowth in the small intestine from conditions such as diabetes.
  • Food intolerances. If your gas and bloating occur mainly after eating dairy products, it may be because your body isn't able to break down the sugar (lactose) in dairy foods. Other food intolerances, especially to gluten — a protein found in wheat and some other grains — also can result in excess gas, diarrhea and even weight loss.
  • Artificial additives. It's also possible that your system can't tolerate artificial sweeteners, such as sorbitol, mannitol and xylitol, found in some sugar-free foods, gums and candies. Many healthy people develop gas and diarrhea when they consume these sweeteners.
  • Constipation. Constipation may make it difficult to pass gas, leading to bloating and discomfort.

You're more likely to have problems with gas if you:

  • Are lactose or gluten intolerant
  • Eat a diet rich in fruits, vegetables, whole grains and legumes
  • Drink carbonated beverages
  • Have a chronic intestinal condition, such as irritable bowel syndrome or inflammatory bowel disease

Neither age nor sex affect how often you pass gas.

Because appointments can be brief, it's a good idea to come prepared.

What you can do

Before your appointment, make note of:

  • Your symptoms, including the frequency of your gas and the intensity of your abdominal pain.
  • Your key medical information, including any other health problems and the names of any medications, vitamins or supplements that you're taking.
  • Questions to ask your doctor.

For gas and gas pains, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Do I need any tests?
  • Are there any treatments or home remedies that might help me feel better?
  • Do I need to limit or avoid certain foods or drinks?
  • Are there any other lifestyle changes that could help prevent gas pains?

Don't hesitate to ask additional questions as they occur to you during your appointment.

What to expect from your doctor

Your doctor will likely have questions for you, too. He or she may ask:

  • How long have you noticed an increase in gas or gas pains?
  • Does your pain go away or get better when you belch or pass gas?
  • How many times do you pass gas each day?
  • Does eating certain foods seem to trigger your symptoms?
  • Have you added any new foods or drinks to your diet recently?
  • Have you been diagnosed with irritable bowel syndrome or another intestinal condition?
  • Are you currently taking any antibiotics or other medications?
  • Do you have nausea or vomiting with your gas pains?
  • Have you unintentionally lost weight?
  • Do you drink sodas or other carbonated beverages?
  • Do you frequently chew gum, suck on candies or drink through a straw?

What you can do in the meantime

Keep a journal of what you eat and drink, how many times a day you pass gas, and any other symptoms you experience. Bring the journal to your appointment. It can help your doctor determine whether there's a connection between your gas or gas pains and your diet.

Your doctor will likely determine what's causing your gas and gas pains based on:

  • Your medical history
  • A review of your dietary habits
  • A physical exam

During the physical exam, your doctor may check your abdomen to see if it's distended and listen for a hollow sound while gently tapping your abdomen. A hollow sound usually indicates the presence of excess gas.

Depending on your other symptoms, your doctor may recommend further tests to rule out conditions that are more serious, such as partial bowel obstruction.

If your gas pains are caused by another health problem, treating the underlying condition may offer relief. Otherwise, bothersome gas is generally treated with dietary measures, lifestyle modifications or over-the-counter medications. Although the solution isn't the same for everyone, with a little trial and error, most people are able to find some relief.

Diet

The following dietary changes may help reduce the amount of gas your body produces or help gas move more quickly through your system:

  • Try to identify and avoid the foods that affect you the most. Foods that cause gas problems for many people include beans, onions, broccoli, Brussels sprouts, cabbage, cauliflower, artichokes, asparagus, pears, apples, peaches, prunes, sugar-free candies and chewing gum, whole-wheat bread, bran cereals or muffins, milk, cream, ice cream, ice milk, and beer, sodas and other carbonated beverages.
  • Try cutting back on fried and fatty foods. Often, bloating results from eating fatty foods. Fat delays stomach emptying and can increase the sensation of fullness.
  • Temporarily cut back on high-fiber foods. Add them back gradually over several weeks. For most people, it takes about three weeks for your body to get used to extra fiber. But, some people never adapt.
  • Go easy on fiber supplements. Try cutting back on the amount you take and build up your intake gradually. If your symptoms remain, you might try a different type of fiber supplement. Be sure to take fiber supplements with a glass of water and drink plenty of liquids throughout the day.
  • Reduce your use of dairy products. Try using low-lactose dairy foods, such as yogurt, instead of milk. Or try using products that help digest lactose, such as Lactaid or Dairy Ease.

    Consuming small amounts of milk products at one time or consuming them with other foods also may make them easier to digest. In some cases, however, you may need to eliminate dairy foods completely.

Over-the-counter remedies

Some products may help, but they aren't always effective. Consider trying:

  • Beano. Add Beano to beans and vegetables to help reduce the amount of gas they produce. For Beano to be effective, you need to take it with your first bite of food. It works best when there's only a little gas in your intestines.
  • Lactase supplements. Supplements of the enzyme lactase (Lactaid, Dairy-Ease), which helps you digest lactose, may help if you are lactose intolerant. You might also try dairy products that are lactose-free or have reduced lactose.
  • Simethicone. Over-the-counter products that contain simethicone (Gas-X, Gelusil, Mylanta, Mylicon) help break up the bubbles in gas. Although these products are widely used, they haven't been proved effective for gas and gas pain.
  • Activated charcoal. Charcoal tablets (CharcoCaps, Charcoal Plus, others) taken before and after a meal also may help. Like simethicone, there's no definitive evidence that charcoal relieves gas. In addition, charcoal may stain the inside of your mouth and your clothing if the tablets get on your clothes.

Making lifestyle changes may help reduce or relieve excess gas and gas pain:

  • Try smaller portions. Many of the foods that can cause gas are part of a healthy diet. So, try eating smaller portions of problem foods to see if your body can handle a smaller portion without creating excess gas.
  • Eat slowly, chew your food thoroughly and don't gulp. If you have a hard time slowing down, put down your fork between each bite.
  • Avoid chewing gum, sucking on hard candies and drinking through a straw. These activities can cause you to swallow more air.
  • Check your dentures. Poorly fitting dentures can cause you to swallow excess air when you eat and drink.
  • Don't smoke. Cigarette smoking can increase the amount of air you swallow.
  • Exercise. Physical activity may help move gas through the digestive tract.

If the odor from passing gas concerns you, limiting foods high in sulfur-containing compounds — such as broccoli, Brussels sprouts or other cruciferous vegetables, beer, and foods high in protein — may reduce distinctive odors. Pads, underwear and cushions containing charcoal also may help absorb unpleasant odors from passing gas.

May 02, 2014