Dr. Decipher: Should You Hold Your Gas, or Let It Pass

By Dr. John Janousek, M.D. Monday, December 12, 2011

Nothing instantly brings laughs to our teen-age sons like the sound of flatus - commonly known as gas, wind, flatulence, toot or a "fart." This natural body phenomenon is not openly accepted in polite society, but conversely is revered in the world of male adolescence.

According to Dr. Michael Levitt, a Minneapolis gastroenterologist, the mean flatus frequency is 13.6 episodes/day. The gas is a byproduct of digestion as well as swallowed gases. The composition includes nitrogen, hydrogen and carbon dioxide, with lesser amounts of oxygen and methane. Very small amounts of sulfur containing compounds are produced, resulting in the stink.

Interestingly, a baby's intestinal flora results from colonization with bacteria from the mother and through its diet and environment. The gas that is produced by a particular person is unique, and is a combination of the foods, liquids, and gases ingested as well as one's individual intestinal bacterial flora.

Carbohydrate metabolism produces, gas, especially complex carbs, less gas is produced from digestion of proteins and fats. Highest on the flatulogenic list are: beans, carrots, raisins, bananas, onions, milk and milk products. High fiber foods also produce gas.

Medium on the flatulence scale are pastries, potatoes, citrus fruits, apples, and breads. The least gassy foods are meats, fish, grapes, berries, potato chips, nuts and eggs.

In January of this year, a juggler and comedian in England set a Guinness record by sitting on 30 whoopee cushions in 30 seconds. The various sounds of flatus are intensely funny to my kids, and result from the vibration of the anus sphincter. The act of releasing flatus has been considered to be insulting, as in the Monty Python and the Holy Grail saying, "I fart in your general direction." The sounds have been described for centuries; according to Wikipedia, St. Augustine in The City of God wrote of men who "have such command of their bowels, that they can break wind continuously at will, so as to produce the effect of singing."

Well, I don't know about the singing part, but we all have tried to control flatus in social situations. Beano is a product which contains the enzyme alpha-galactosidase to aid in breaking down complex sugars, thereby decreasing gas. Simethicone (Gas X) is an antifoaming agent marketed to decrease gas, but has been mainly used for colic.

Studies have shown that Beano decreases gas in persons with a high fiber diet, but  I have not found studies showing simethicone has any appreciable effect on gas or colic.

Because of the methane in flatus, it has been implicated by some as contributing to global warming from the greenhouse effect, especially in cows. In reality, most of the methane from cows is contained in their belches not the flatus. However, next time you hear someone passing gas, you can accuse them of harming not just the local environment but globally, too.

One of my physician colleagues has a theory that diverticulitis is caused by holding in flatus instead of letting it out. I think he is just looking for an excuse to "fart at will" himself!