Flatulence-aka gas-is an embarrassing problem. It can’t be broached in polite conversation, and many patients are reluctant to bring it up during a doctor visit. Nonetheless, excessive flatulence is troublesome and should be addressed.
Excessive Flatulence At Night:
Q. I hope you can help with an embarrassing problem. In the afternoons I often have very loud gas.
I do eat breakfast but sometimes skip lunch. Different over-the-counter meds have been mostly useless. The flatulence happens throughout the evening. What can you suggest?
A. The first step in overcoming gas is to keep a “fart chart.” People can be sensitive to different foods. For many, legumes are the culprit. For others it is wheat or barley, especially if they are sensitive to gluten. Milk sugar (lactose) is another potential problem. That’s why keeping track of flatulence and food triggers can be helpful.
You didn’t mention whether you are taking any medications. A surprising number of drugs can trigger flatulence.
What About Simethicone?
Many OTC products advertised to treat gas contain simethicone.
One review notes, however, that:
“Simethicone does not appear to reduce the actual production of gas in the GI tract” (StatPearls, July 21, 2021).
People who have difficulty digesting milk sugar (lactose intolerance) may get benefit from probiotics and lactase enzyme replacement in the form of pills (Diagnostics, June, 2020).
If legumes are the problem, the oral enzyme alpha-galactosidase could be beneficial.
A randomized, double-blind, placebo-controlled trial found this treatment:
“can improve gas-related symptoms in children and adolescents” (BMC Gastroenterology, Sept. 24, 2013).
This enzyme is found in Beano and other OTC digestive aids.
Sugarless Gum and Gas:
This reader was brave enough to mention her gassiness to her gastroenterologist. Here is her question:
Q. I had complained to my gastroenterologist about having lots of gas. He asked if I chew sugarless gum – yes, I responded. I had not known that sugarless gum contains sorbitol which can/will cause gas.
The mystery of excessive flatulence was solved by an alert GI doc. That’s why it is important to mention embarrassing conditions to a health professional. Believe us when we tell you that doctors have heard it all! The good ones will not blink or crack a smile.
Here’s the straight and skinny on excessive flatulence:
A. Sorbitol, maltitol, mannitol, xylitol and other “sugar alcohols” are sweet but not as caloric as sugar. Consequently, they may be used instead of sugar in certain diet desserts, candies or chewing gum.
Because we don’t absorb these compounds ourselves, they provide fodder for our intestinal bacteria to create gas or diarrhea. While most people can tolerate such foods in moderation, some are more sensitive and should avoid them.
How to Manage Excessive Flatulence:
There are lots of things that can cause gas. Of course you know that foods can do it. Remember the old rhyme:
“Beans, beans, they’re good for your heart
The more you eat the more you fart,
The more you fart the better you feel
So eat your beans at every meal.”
Other Unexpected Causes of Excessive Flatulence:
Q. I certainly hope you can help me. My husband is bothered by excessive flatulence unresponsive to everything we have tried. He has taken Charco-Caps, Prevacid, Creon and ALL the OTC stuff.
His current medications are Plavix, diltiazem, Aricept, Uniphyl, Celebrex (3x/week), aspirin, a multi-vitamin, calcium with vitamin D, vitamin C and vitamin E. The Plavix and Aricept were started this past fall but the flatulence was present over a year ago.
He is convinced that if he remains seated that the gas is not so bad. But one cannot sit forever!
He takes Tums by the handfuls thinking that it will help, but to no avail. He also uses inhalers, with a spacer, for his asthma—Aerobid, Atrovent, and Proventil prn and Beconase nasal inhaler.
I know that he does “suck air” with the inhaler use but cannot get him (even after 18-20 years) to use the inhalers correctly.
I am wondering if there is any interaction of his medications that could cause the problem. In addition, he is now taking Metamucil daily and thinking that it will help. I cannot see any improvement of any kind with any of the things he’s tried. I am sure the Metamucil helps with the occasional constipation he gets from sitting around so much. Any thoughts or insight on this problem?
Drugs That Contribute to Flatulence:
A. Some of your husband’s medications might be contributing to his gas production. Aricept and Celebrex can contribute to flatulence in some individuals, but he may not be able to discontinue them. Inhaled air, or as you describe it, sucking air, when he uses his asthma inhalers could also add to the problem.
There may not be an easy solution when medications contribute to gas formation. Many people do not appreciate how many drugs can actually do this. Here is just a partial list:
- Aciphex (rabeprazole)
- Ambien (zolpidem)
- Augmentin (amoxicillin – clavulanate)
- Avapro (irbesartan)
- Chantix (varenicline)
- Cipro (ciprofloxacin)
- Depakote (divalproex)
- Diovan (valsartan)
- Eligard (leuprolide)
- Effexor (venlafaxine)
- Evista (raloxifene)
- Fosamax (alendronate)
- Hyzaar (losartan – hydrochlorothiazide)
- Klonopin (clonazepam)
- Lamictal (lamotrigine)
- Lexapro (escitalopram)
- Lipitor (atorvastatin)
- Lyrica (pregabalin)
- Mevacor (lovastatin)
- Naprosyn (naproxen)
- Paxil (paroxetine)
- Premarin (conjugated estrogens)
- Prinivil (lisinopril)
- Vytorin (ezetimibe & simvastatin)
You will note that drugs contributing to the problem include some acid-suppressing drugs as well as statin-type cholesterol-lowering medications. Many people try to change their diet to solve their gas problem. But if a medication is contributing, then modifying food intake won’t make a huge difference.
Why He Should Talk with his Doctor:
This is one of those side effects that is considered by many health professionals to be “minor.” But if it affects your lifestyle, limits your socializing or causes embarrassment, then we do not consider it minor. Although it is not always possible to eliminate an offending medicine, it is definitely worth a conversation with the prescriber. It may be possible to switch to a different medication that is less likely to cause gas.
While you are at it, ask the doctor to demonstrate the correct method for using an inhaler. Sometimes using a “spacer” can be helpful.
Finally, you may find our eGuide to Overcoming Digestive Disorders of some value. It lists other “fart-producing drugs,” foods that are especially likely to cause flatulence and some other strategies for dealing with this challenge. When all else fails, a Flatulence Filter that you sit on can be helpful. You will also find information on heartburn, celiac disease, constipation and diarrhea in this newly revised electronic health resource. It is available in our Health eGuides section at this link.
We welcome suggestions from visitors to this website. What causes your excessive flatulence? Has anything worked for you to control the problem? Share your secrets in the comment section.