Diseases & Conditions

Gas and gas pains

Gas and gas pains can strike at the worst possible moment — during an important meeting or on a crowded elevator. And although passing intestinal gas (flatus) usually isn't serious, it can be embarrassing.

Everyone has gas and gas pains, and passes gas generally at least 12 or more times a day. But some people have excessive gas and gas pains that bothers them most of the time. In some cases, gas you can't expel can cause intense, intermittent abdominal pain.

The good news is that although you can't stop gas and gas pains, a few simple measures can help reduce the amount of gas you produce and relieve your discomfort and embarrassment.

For most people, the signs and symptoms of gas and gas pain are all too obvious. They include:

• The voluntary or involuntary passing of gas, either as belching or as flatus.
• Sharp, jabbing pains or cramps in your abdomen. These pains may occur anywhere in your abdomen and can change locations quickly. You may also have a "knotted" feeling in your stomach. The pain may sometimes be so intense that it feels like something is seriously wrong. When the pain occurs on the upper left side, gas pain may be mistaken for heart disease. When the pain occurs on the right side, it may be mistaken for gallstones or appendicitis.
• Abdominal bloating (distension).

When to see a doctor
It's considered normal to pass gas between 10 to 20 times a day. But call your doctor if you have severe, prolonged or recurrent pain in your abdomen, especially if you also have nausea, vomiting, bleeding, weight loss, fever or chest pain. In addition, talk to your doctor if your gas or gas pains are so persistent or severe that they interfere with your ability to live a normal life. In most cases, treatment can help reduce or alleviate the problem.

You swallow air every time you eat or drink. You may also swallow air when you're nervous, eat too fast, chew gum or drink through a straw. Some of that air finds its way into your lower digestive tract. But most lower intestinal gas is produced when bacteria in your colon ferment carbohydrates that aren't digested in your small intestine.

Unfortunately, healthy foods — such as fruits, vegetables, whole grains and legumes (beans and peas) — are often the worst offenders. That's because these foods are high in fiber. Fiber has many health benefits, including keeping your digestive tract in good working order and regulating blood sugar and cholesterol levels. But fiber can also lead to the formation of gas. Fiber supplements containing psyllium, such as Metamucil, may cause such problems, especially if added to your diet too quickly. Carbonated beverages, such as soda and beer, also are causes of gas.

Other causes of excess gas include:

• Another health condition. Excess gas may be a symptom of a more serious chronic condition. Examples include diverticulitis or an inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.
• Antibiotics. In some cases of excess gas, antibiotic use may be a factor because antibiotics disrupt the normal bacterial flora in your bowel.
• Laxatives. Excessive use of laxatives also may contribute to problems with excess gas.
• Constipation. Constipation may make it difficult to pass gas, leading to bloating and discomfort.
• Food intolerances. If your gas and bloating occur mainly after eating dairy products, it may be because your body isn't able to break down the sugar (lactose) in dairy foods. Many people aren't able to process lactose efficiently after age 6, and even infants are sometimes lactose intolerant. Other food intolerances, especially to gluten — a protein found in wheat and some other grains — also can result in excess gas, diarrhea and even weight loss.
• Artificial additives. It's also possible that your system can't tolerate the artificial sweeteners sorbitol and mannitol found in some sugar-free foods, gums and candies. Many healthy people develop gas and diarrhea when they consume these sweeteners.

Anything that causes intestinal gas or is associated with constipation or diarrhea can lead to gas pains. These pains generally occur when gas builds up in your intestines and you're not able to expel it. Gas pains are usually intense, but brief. Once the gas is gone, your pain often disappears. The gas you pass is a combination of oxygen, nitrogen, hydrogen, carbon dioxide and methane.

Your doctor will likely determine what's causing your gas and gas pains based on your medical history, a review of your dietary habits and a physical exam. During the exam, your doctor may check to see if your abdomen is distended and listen for a hollow sound when your abdomen is tapped. A hollow sound usually indicates the presence of excess gas.

Depending on your other symptoms, your doctor may recommend further tests in order to rule out conditions that are more serious, such as partial bowel obstruction.