We asked physician Barbara Lock an embarrassing question.
Q: I am 54 and have become very gassy. I havent mentioned it to my doctor because frankly I am a little embarrassed to discuss it. But is being so gassy normal?
A: Flatulence, or passing gas, is a healthy and natural phenomenon, but if it is bothering you, you may wish to review the following questions with your doctor:
1) Are you passing gas?
Congratulations, your gut is functioning! If you find that you have been passing more gas than usual, consider: Have you been eating or drinking more foods that make people prone to gas? Gas can be ingested as air in people who eat very quickly or is more commonly a byproduct of the process of digestion of certain foods, especially foods high in fiber and certain difficult-to-digest sugars such as lactose, which is found in dairy products. Legumes, such as beans, are notorious for producing gas, unless prepared correctly.
Many "functional foods" are being loaded with extra fiber or food additives such as insulin in order to promote gut health. One of the side effects of these functional foods is increased flatulence. Check your cabinets for prepared foods and make sure you understand the ingredients.
2) Is your gut functioning less efficiently? Do you have a disease?
People who are recovering from abdominal surgery generally develop a back-up of both stool due to a phenomenon called "ileus"; basically, the gut just stops or slows down its movement, causing the stool and gas to back up, and causing discomfort. This usually resolves in a few days.Uncommonly, a backup or feeling of gas can be caused by cancer or another medical problem. I once saw a patient in the emergency room who said that he had a feeling of "gas," kind of a "tugging" sensation for about a year, but always on the right side of his abdomen. His symptoms didn't make any sense to me; discomfort that is truly associated with gas should move as the gas progresses in the gut, and should not stay fixed in one place.The patient looked well, healthy, robust. He was eating well, had no fever, and had not unintentionally lost weight. I ordered a CT scan, thinking that I was perhaps being a bit too cautious, to look for colon cancer. Much to my surprise and concern, he did have colon cancer. He was admitted to the hospital.3) Do you have a medical emergency?Some people who develop symptoms of cramping and bloating in their upper or lower abdomen attribute the feelings to "gas" when in fact there is something else wrong, even emergently wrong. Of note, most of these are associated with a "feeling" of gas when in fact the patient is not passing any gas.
When gas and stool stops moving entirely, doctors usually look for a cause of intestinal blockage such as small bowel obstruction (frequently in persons who have had abdominal surgery in the past), volvulus (when the gut twists on itself), or intussusception (when the gut folds back into itself the way a telescope closes). These types of blockages require emergency medical attention and sometimes operative intervention.The symptom of "gas" is also used by some patients to describe any type of abdominal discomfort at all. The list of causes of abdominal discomfort could go on for pages, and some of them are life-threatening or require surgical intervention. It is important to discuss your symptoms of gas with your doctor; no internet resource should be relied upon by a layperson to diagnose their own symptoms, especially when it comes to the black box that is abdominal discomfort. Abdominal pain with fever and/or inability to eat nearly always requires medical evaluation. The symptom of "gas" is even used by some patients to describe the discomfort that is associated with heart attack (myocardial infarction)!But here's the real question: Why are you afraid to talk to your doctor about your symptoms? It is likely that no matter how trivial you think your concerns may be, your doctor had heard it before. She is there to help you, but she won't be able to unless you tell her how you feel. If your doctor makes you uncomfortable, find another one!Barbara Lock is a practicing emergency physician and a co-founder of MedPie.com.
