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Picture: Intestinal gas can cause pain in the abdomen.
Intestinal Gas (Belching, Bloating, Flatulence)

Intestinal Gas
(Belching, Bloating, Flatulence)

Medical Author:
Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Intestinal gas facts

  • The usual cause of belching is excessive gas in the stomach that comes from swallowed air. However, discomfort in the abdomen for any reason may also cause belching. Therefore, belching does not always indicate the presence of excessive gas in the stomach.
  • Bloating is the subjective feeling that the abdomen is enlarged but does not necessarily mean that the abdomen is, in fact, enlarged. Distention is the objective enlargement of the abdomen.
  • Continuous distention of the abdomen is usually caused by fluid, tumors, enlarged organs, or fat within the abdomen.
  • Intermittent distention of the abdomen may be caused by excessive formation of intestinal gas, as well as physical or functional obstruction of the intestines.
  • Flatulence (farting) results from the production of gas by bacteria within the intestines when they digest sugars and polysaccharides.
  • Excessive production of gas and increased flatulence may occur because of: (1) the greater ability of some bacteria to produce gas; (2) maldigestion or malabsorption of sugars and polysaccharides; and (3) bacterial overgrowth of the small intestine.
  • Belching, bloating/distention, and flatulence are evaluated with a medical history, simple abdominal X-rays, small intestinal X-rays, gastric emptying studies, ultrasound examination, computerized tomography (CT), magnetic resonance imaging (MRI), tests for maldigestion and malabsorption, and hydrogen breath testing.
  • The treatment of excessive intestinal gas depends on the underlying cause and may include dietary changes, medications that reduce the amount of gas, medications that stimulate the muscles of the intestine, or antibiotics.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 4/18/2012


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Intestinal Gas - Effective Treatments Question: What kinds of treatments have been effective for your intestinal gas?
Intestinal Gas - Bloating Causes Question: For some, it's eating a certain food. What is the usual cause of your bloating (intestinal gas)?
Intestinal Gas - Flatulence Causes Question: It may be embarrassing, but what is often the cause of your flatulence (intestinal gas)?
Intestinal Gas - Causes Question: What was the cause of your intestinal gas?
Gallstones and Bloating

Gum for Gas?

Medical Author: Jay W. Marks, MD
Medical Editor: Dennis Lee, MD

We all produce gas in our intestines, especially our colons, or, at least, our intestinal bacteriaproduce it, from undigested food. We are fortunate because the overwhelming majority of the gas that is formed by the bacteria is used up by other bacteria in the intestine.

Some people are more fortunate than others. All of the gas produced in their intestines is used up by bacteria, and they pass gas (fart) very little, that is, unless they eat foods that bacteria can use to form lots of gas?like beans?that overwhelm even the most ardent, gas?devouring bacteria. A small amount of intestinal gas is absorbed into the blood from the intestine and is eliminated in the breath. The gas that is not used up by bacteria or eliminated in the breath must be passed. Passing gas relies on the functioning of the intestinal muscles. The gas distends the intestine, and the intestinal muscles respond by contracting and pushing the gas further along the intestine until the gas is finally expelled. Sometimes this process fails.

I recently underwent removal of a portion of my sigmoid colon for diverticulitis. The surgery was done laparoscopically and went very well. There were no complications, and my discomfort was easily controlled with medication. Manipulation of the intestines during surgery "stuns" the intestinal muscles, and they usually stop working for a time. Before patients can eat after surgery, their intestinal muscles must start working. The signs that the muscles are working is the presence of abdominal gurgling (borborygmi) and the passing of gas. Laparoscopicsurgery stuns the intestine less than "open" (large incisional) surgery, and the intestinal muscles usually recover quickly.

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