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Relief from intestinal gas

To identify troublesome foods, keep a detailed daily record of everything you eat.

A certain amount of flatulence is a normal part of the digestive process. But if gas or bloating is causing you distress, take heart. “If you’re producing more gas than you would like, you can often do something about it,” says Dr. Jacqueline Wolf, associate professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center.

Getting to the root of the problem starts with keeping track of what
you eat so you can identify potentially troublesome foods and stop eating them temporarily.

Gas in the body

Flatulence is produced by bacteria and other microorganisms in the intestines. They feed off various undigested substances in your diet, typically carbohydrates. Following are some of the foods that commonly lead to gas:

Lactose: Inability to digest lactose, a type of sugar in milk, causes gas as well as abdominal cramping, bloating, and diarrhea. Lactose intolerance means the body doesn’t make enough of the enzyme, lactase, needed to digest lactose, a carbohydrate. The lactose passes undigested through the intestine, where the resident bacteria feed on it. Many people who think they are lactose intolerant actually aren’t. Instead, their intestinal problems may be due to other carbohydrates, like sugar substitutes. A breath test can reveal lactose deficiency. There are several commercially available enzyme formulations (tablets and liquids) that can serve as lactase replacements.

Artificial sugars: Certain plant-derived substitutes for natural sugar, particularly those whose names end in “tol,” also cause gas. These include sorbitol, mannitol, lactitol, and xylitol. They are found in a wide range of processed foods, including sugar-free chewing gum and candies and “low-carb” products. Sorbitol is also naturally present in fruits such as apples, peaches, and nectarines.

Fructose: Some people are intolerant to fructose, a natural sugar found in fruit. Common gas producers include apple or prune juice and dried fruits. Fructose is also found in many processed foods, fruits, and sugar-sweetened beverages, including those containing high-fructose corn syrup

Vegetables: These foods are rich in healthy carbohydrates, but some can trigger gas or bloating. Problem vegetables for many people include broccoli, cabbage, onions, Brussels sprouts, and potatoes. Beans are also universally acknowledged as a “gassy” food. They contain a number of indigestible carbohydrates that bacteria in the gut enjoy feasting on.

Anti-gas products: Do they work?

Various products promise to help control intestinal gas. Many people use them and swear they help, but the formal scientific evidence is either limited or nonexistent.

Remedy

Health claim

Evidence

Alpha-galactosidase (Beano and generic versions

Supplies an enzyme to help you break down hard-to-digest substances in beans.

Limited evidence

Simethicone (Gas-Ex, similar products)

Reduces bloating and discomfort by helping you to pass trapped bubbles of intestinal gas.

No convincing evidence

Bismuth subsalicylate (an ingredient in Pepto-Bismol, similar products)

Decrease flatulence odor from hydrogen sulfide gas made by gut bacteria.

Limited evidence

Activated charcoal (Charcocaps)

Absorbs intestinal gas. Activated charcoal can interact with medications, so check with your doctor before taking this.

Mixed evidence

Peppermint oil or
peppermint tea

Aids digestion and reduces bloating, discomfort, and flatulence.

Mixed evidence

Diagnosing the problem

When Dr. Wolf works with patients about gas problems, she suggests the following steps:

  • Keep a food diary and note what foods seemed to lead to gas.

  • Read ingredient lists to identify hidden troublemakers, like sugar substitutes and milk products.

  • Stop eating suspect foods one by one and then add them back to see how you tolerate them.

If the problem is fruit, you don’t need to completely abandon this healthy food. Some fruits, such as berries, contain a balance of fructose and glucose that you may digest better. Find some new kinds of fruits that sit well with you. If sorbitol is a problem, then it may help to avoid foods that contain a large amount of sorbitol, such as apples, peaches, pears, nectarines, plums, and prunes.

You could also consider trying a low-FODMAP diet, which excludes carbohydrates poorly absorbed in the small intestine. (FODMAPs stands for “fermentable, oligosaccharides, disaccharides, monosaccharides, and polypols.”) Doctors at Monash University in Australia developed the diet to help people with irritable bowel syndrome and other gut disorders, and some studies suggest it’s beneficial. You can find information about the diet online at www.health.harvard.edu/fodmap, or ask your doctor for a referral to a dietician

Posted by: Dr.Health

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