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Case 1: Flatulence Vexation
(Posted on 1 August 2008)
Mr. Cheung is a 28-year-old whose gastrointestinal discomfort (especially flatulence) began a year ago. In recent years, busy work has led to irregular meals, and he is a smoker as well. The most vexing symptom is passing gas (farting) frequently at inopportune times, causing enormous difficulty to his daily work and social life.
- What is flatulence? Is there anything abnormal about passing gas?
- Is flatulence the same as 'wind' in the belly? Where does this wind come from?
- How to prevent and reduce flatulence?
- Case 2: Infant's flatulence
- Why do infants get flatulence when they drink milk only? Could there be some other major illnesses?
- Is flatulence related to breastfeeding? Should breastfeeding mothers adopt an exclusive diet? How should we choose formula milk and baby food?
- How can parents prevent and reduce infant flatulence during milk feeding?
Source: Quality HealthCare
What is flatulence? Is there anything abnormal about passing gas?
Flatulence refers to pain or uneasiness caused by build-up of gas in the intestines and the stomach. When the intestines or the stomach is filled with gas, soreness or discomfort would ensue from the pressure. Flatulence is very common among city dwellers. Some may experience persistent sickness in the stomach and some in the intestines, flatulence being one of the symptoms.
Some people with flatulence have other disagreeable symptoms like belching, burping, fullness or passing gas, although these may not be directly related to one another. Passing gas is a normal bodily function. Every person passes gas at least 14 times a day, consciously or otherwise, with a total gas volume of 400-1300mL. However, serious cases need to be tackled with regard to the cause, as with Mr. Cheung, whose daily work and social life are being affected.
Is flatulence the same as 'wind' in the belly? Where does this wind come from?
The so-called 'wind' is in fact gas. Gas in the gastrointestinal tract mainly comes from two sources: air swallowed through the mouth, and excessive gas produced by intestinal bacteria, such as carbon dioxide and hydrogen.
1) Swallowing of air
We all swallow air with food when we eat, even more so for those who are under stress, who eat too fast and who talk while eating. Besides, increased salivation (such as denture users) and habitual breathing through the mouth would cause air to be swallowed with saliva, letting more gas into the gastrointestinal tract.
2) Food factors
Certain foods lead to production of copious amounts of gas inside the intestines, like beans, cereals, onion and other starchy food, from which gas is released upon fermentation by bacteria normally residing in the intestines. For individuals allergic to lactose in milk, incomplete absorption may lead to fermentation in the intestines and flatulence. Moreover, oily food delays the arrival of food at the small intestine and affects digestion. Chewing gum, smoking and drinking carbonated beverages (such as soft drink) also introduce more gas to the gastrointestinal tract.
3) Drug reactions
Some drugs slow intestinal peristalsis, while antibiotics can upset the balance of bacteria in the intestines, causing discomfort and flatulence.
4) Functional gastrointestinal disorders
Irritable bowel syndrome and slow intestinal peristalsis may result in flatulence. In addition, flatulence may be symptomatic of indigestion, intestinal allergy or spasm, as well as diseases of the gall bladder and the pancreas. Therefore, you should consult your doctor as soon as possible in case of serious flatulence.
How to prevent and reduce flatulence?
To prevent and reduce flatulence, the cause must be established. To this end, you may set out from your daily life and eating habits. The following questions may help you locate the cause.
- Do you eat too fast?
- Do you eat without chewing the food thoroughly?
- Do you often talk while eating?
- Do you often breathe through the mouth?
- Are you under a lot of stress?
- Do you smoke?
- Do you often chew gum?
- Do you consume too much oily food?
- Do you consume too much beans and cereals?
- Do you often drink carbonated beverages, such as beer or soft drink?
- Are you on long-term medication?
- Are you allergic to lactose?
- Do you have gastrointestinal allergy?
- Do you have indigestion?
- Do you have any disease of the pancreas or the gall bladder?
Improve your living and eating habits gradually once the cause is identified, such as: chew more slowly rather than gulping down the food; avoid talking while eating; quit smoking; chew less gum; stay away from allergic food, oily food, beans, cereals and other gassy foods; and drink less carbonated beverages (like beer, soft drink). Refrain from milk if you are allergic to lactose. Physical exercise can aid intestinal peristalsis and relax the mind. Seek for assistance from doctor or undergo body check if you fail to confirm the cause or if the problem lingers on.
Case 2: Infant's flatulence
Mrs. Wong has to spend 30-45 minutes each time to feed her 6-month-old son as he is prone to distraction and crying. She is worried that his growth may be stunted since he often vomits the milk.
Why do infants get flatulence when they drink milk only? Could there be some other major illnesses?
Flatulence is usual among infants. Air is often swallowed during suckling as the diet largely consists of milk. If they suckle too fast, more air would be taken in. Besides, the digestive system of infants is not mature enough while they cannot burp by themselves, leading to flatulence. Babies with allergy may have to breathe through the mouth due to upper respiratory infection, nasal allergy or congestion, thus taking in a large amount of air which results in flatulence.
Infants suck in a lot of air when they cry. Therefore, crying babies are more vulnerable to flatulence. Parents should bear in mind that infants cannot express themselves by speech. As a result, discomfort due to flatulence may induce more crying and create a vicious cycle in which more air is taken in and that exacerbates flatulence.
Infant flatulence is extremely common and normal. Nevertheless, extreme cases can lead to uncontrollable vomiting or incessant crying. Flatulence together with bellyache and bright-red faeces may indicate more serious condition such as intussusceptions and immediate medical attention must be sought.
Is flatulence related to breastfeeding? Should breastfeeding mothers adopt an exclusive diet? How should we choose formula milk and baby food?
Breastfeeding mothers should be mindful of their diet. For example, flatulence may occur with the infant if the mother eats too much beans, broccoli and onion, due to carry-over via breast milk. Breastfeeding mothers should avoid foods such as beans, broccoli and cereals, and observe if the conditions improve. Furthermore, excessive sugar in breast milk can trigger fermentation in the infant's bowel and lead to flatulence. As a result, mothers should restrict their sugar intake.
Flatulence caused by lactose-containing formula milk may imply lactose allergy. Lactose-free or low-allergic formula may help to alleviate the problem.
Many parents begin to feed rice porridge to the infants when they are around 6 months old, often mixed with green vegetable or gourd. Temporary flatulence due to increased intake of vegetable should be no concern. You may cut down the portion as appropriate so that the intestines can accommodate gradually.
How can parents prevent and reduce infant flatulence during milk feeding?
Put the entire areole into the baby's mouth when breastfeeding. If the infant latches onto the nipple alone, too much air might be taken in as excessive force is required to suckle.
Please note the following if milk bottle is used for feeding:
- Soften the plastic sucker with boiling water for two or three times so as to facilitate suckling.
- The hole of the sucker must be adjusted slowly with regard to the suckling speed. Do not choose a big one just to speed up suckling.
- Do not stir with spoon when preparing formula milk, because it will force air into the milk. Shake the bottle slightly to dissolve the powder slowly and reduce the formation of air bubbles.
- The mouth of the bottle must be covered completely with milk when feeding. The infant will suck in air if any space is left.
- Sterilise the bottle before every use for hygienic reasons. Formula milk should be consumed immediately upon preparation to prevent bacterial gastroenteritis though feeding.
Whether breastfeeding or bottle feeding, it is essential to massage the back of the infant. Gently rub the back to the upward direction once each during and after feeding. This will help the baby burp and reduce flatulence.
Source: Quality HealthCare
