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.
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.
The treatment of excessive intestinal gas depends on the cause.
If there is
maldigestion of specific sugars-lactose, sorbitol, or fructose--the offending
sugars can be eliminated from the diet.
In the case of lactose in milk, an
alternative treatment is available. Enzymes that are similar to intestinal
lactase can be added to the milk in order to break down the lactose prior to its
ingestion so that it can be absorbed normally. Some people find that yogurt, in
which the lactose has been broken down partially by bacteria, produces less gas
than milk.
There also are certain types of vegetables and fruits that contain
types of starches that are poorly digested by people but well digested by
bacteria. These include beans, lentils, cabbage, brussel sprouts, onions,
carrots, apricots, and prunes. Reducing the intake of these vegetables
and fruits, as well as foods made from whole grains, should reduce gas and
flatulence. However, the list of gas-producing foods is rather long, and it may
be difficult to eliminate them all without severely restricting the diet.
When maldigestion is due to pancreatic insufficiency, then supplemental
pancreatic enzymes can be ingested with meals to replace the missing enzymes.
If
maldigestion and/or malabsorption is caused by disease of the intestinal lining,
the specific disease must be identified, most commonly through a small bowel
biopsy. Then, treatment can be targeted for that condition. For example, if
celiac disease is found on the biopsy, a
gluten-free diet can be started.
An interesting form of treatment for excessive gas is alpha-D-galactosidase,
an enzyme that is produced by a mold. This enzyme, commercially available as
Beano, is consumed as either a liquid or tablet with meals. This enzyme is able
to break down some of the difficult-to-digest polysaccharides in vegetables so
that they may be absorbed. This prevents them from reaching the colonic bacteria
and causing unnecessary production of gas. Beano has been shown to be effective
in decreasing the incidence of intestinal gas.
Two other types of treatment have been promoted for the treatment of gas;
simethicone (Phazyme; Flatulex; Mylicon; Gas-X; Mylanta Gas) and activated charcoal. It is unclear if simethicone has an effect
on gas in the stomach. However, it has no effect on the formation of gas in the
colon. Moreover, in the stomach, simethicone would be expected only to affect
swallowed air, which, as previously mentioned, is an uncommon cause of excessive
intestinal gas. Nevertheless, some individuals are convinced that simethicone
helps them. Activated charcoal has been shown to reduce the formation of gas in
the colon, though the way in which it does so is unknown.
If there is a physical obstruction to the emptying of the stomach or passage
of food, liquid, and gas through the small intestine, then surgical correction
of the obstruction is required. If the obstruction is functional, medications
that promote activity of the muscles of the stomach and small intestine are
given. Examples of these medicines are
erythromycin or
metoclopramide (Reglan).
Bacterial overgrowth of the small bowel usually is treated with antibiotics.
However, this treatment is frequently only temporarily effective or not
effective at all. When antibiotics provide only a temporary benefit, it may be
necessary to treat patients intermittently or even continuously with
antibiotics. If antibiotics are not effective,
probiotics (for example, lactobacillus)
can be tried although their use in bacterial overgrowth has not been studied.
This condition may be difficult to treat.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Diverticulitis symptoms include: abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Treatment methods include prescription medications, and in some cases, diverticulitis surgery.
There are many types of ovarian cancer, epithelial carcinoma is the most common. Women with a family history of ovarian cancer have an increased risk of developing the disease. Some ovarian cancer symptoms include abdominal pain, nausea, diarrhea, constipation, and abnormal vaginal bleeding, however, they usually do not present until the disease has progressed. Early diagnosis is important for successful treatment.
In lactose intolerance, the digestive system cannot digest lactose (the main sugar in milk). Symptoms of lactose intolerance include diarrhea, flatulence, abdominal pain, abdominal bloating, abdominal distention, and nausea. There are several tests to diagnose lactose intolerance. Treatment is generally made with dietary changes, supplements, and adaptation to small amounts of milk.
IBS (irritable bowel syndrome) is a common gastrointestinal disorder involving abnormal gut contractions (motility) characterized by abdominal pain,
bloating, mucous in stools, and irregular bowel habits with alternating diarrhea
and constipation, symptoms that tend to be chronic and to wax and wane over the
years. Treatment options include medication and lifestyle changes such as diet, exercise, and stress management to control symptoms. Also called spastic colitis, mucus colitis, nervous colon syndrome.
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Signs and symptoms of celiac disease include malabsorbption (diarrhea, foul smelling gas, bloating, and increased amounts of fat in the stool) and malnutrition (weight loss, edema, anemia, bruising easily, neuropathy, and infertility). Treatment for celiac disease is a gluten free diet, and at times if necessary, medications
Gallbladder (gall bladder) pain can be caused by gallbladder disease such as gallstones or cholecystitis. Causes of gallbladder pain can be caused from biliary colic. Biliary colic is pain caused by gallstones trapped in the bile ducts. Cholecystitis is inflammation of the
gallbladder. Symptoms of gallbladder disease include nausea, vomiting, abdominal bloating and belching, sweating, and shortness of breath. Treatment of gallbladder pain depends on the cause.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine. There are many conditions associated with small intestinal bacterial overgrowth, to include: diabetes, scleroderma, Crohn's disease, and others. There is a striking similarity between the symptoms of irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome. Symptoms of SIBO include: excess gas, abdominal bloating, diarrhea, and abdominal pain.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Gastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Patients with celiac disease are required to eat a gluten-free diet. Gluten is found in rye, barley, and wheat. Gluten damages the intestine in patients with celiac disease. Some mediations contain gluten, so careful monitoring of products consumed is imperative. Patients with celiac disease are also at risk for developing nutritional deficiencies. The information in this article contains both foods that contain gluten, and foods that do not contain gluten.
Hirschsprung's disease (Hirschsprung), is a disease of the nerve cells of of the large intestine. The primary symptom of Hirschsprung's disease is constipation. Hirschsprung's disease is diagnosed through barium enema, and treatment is surgery.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Irritable bowel syndrome (IBS) in children is a functional gastrointestinal disorder with symptoms of abdominal pain, bloating, diarrhea or constipation. The cause of IBS is unknown, however, certain foods, stress, anxiety, and depression may contribute to the symptoms of IBS. There is no cure for IBS in children; however, medications, dietary changes, and stress management may relieve symptoms.
Irritable bowel syndrome (IBS) is a functional disease that can affect the quality of those who suffer from this condition. Individuals with IBS can make lifestyle changes that may modify or control the number and severity of episodes. Certain foods, medications, and hormone levels may trigger IBS episodes. Learn how to prevent the number and severity of IBS episodes of diarrhea and constipation.
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