Gas Moves in Funny Ways

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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 bacteria produce 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. Laparoscopic surgery stuns the intestine less than "open" (large incisional) surgery, and the intestinal muscles usually recover quickly.

I was particularly pleased since after surgery my abdomen never stopped making noise. It was even making noise in the surgical recovery room. Forty-eight hours after the surgery, I was feeling very well, and I began passing gas. (Quoting my surgeon, it was "music to his ears.") As a reward for my, actually my intestine's, good behavior, I was given a breakfast of clear liquids. Within an hour of finishing the meal, I stopped passing gas, my stomach began making less noise, and my abdomen became distended with gas. My intestinal muscles had stopped working.

I was disappointed. My surgeon was reassuring, however, saying that my intestines just weren't ready. "Tomorrow they'll be working, and we'll try again."

That night I began passing gas again, much more than the previous day. My abdomen became flat and I actually became hungry. Surely my intestines were ready now. In came the clear liquid breakfast again, and I relished it. Within an hour I stopped passing gas, my stomach began making less noise, and my abdomen became distended. What was going on?

Needless to say I was now very disappointed. My intestines were keeping me from going home. As I lay in the hospital bed I remembered reading an article-in Time magazine, no less-in recent weeks, about a study that looked at the effect of chewing gum on the return of intestinal muscle function following laparoscopic surgery. The study found that chewing gum led to a substantially quicker return of intestinal function.

At the time I remembered this, a friend was visiting me in the hospital. I asked her to go to the hospital's gift shop and buy me a few packs of chewing gum, which she gladly did. I began chewing.......and chewing.......and chewing. Within twenty minutes I started passing gas like crazy, and it never stopped. (Fortunately, my visitor had already left.) I had a great lunch and went home the following morning.