An understanding of excessive intestinal gas
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Complaints of “excessive gas” from patients are very common but are difficult, if not impossible, for the physician to document. This review addresses the pathophysiology and management of such complaints, looking at the sources and routes of elimination, excessive eructation, bloating, and distention. In addition, common flatulence problems are summarized, including escessive flatus volume and noxious flatus.
- Kirk E: The quantity and composition of human colonic flatus. Gastroenterology 1949, 12:782–794.
- Levitt MD: Volume and composition of human intestinal gas determined by means of an intestinal washout technique. N Engl J Med 1971, 284:1394–1398. CrossRef
- Suarez FL, Furne JK, Springfield JR, Levitt MD: Identification of gases responsible for the odor of human flatus and evaluation of a device purported to reduce this odor. Gut 1998, 43:100–104. CrossRef
- Maddock WG, Bell JL, Tremaine MJ: Gastrointestinal gas: observation of belching during anesthesia, operations, pyelography and rapid passage of gas. Ann Surg 1949, 130:512. CrossRef
- Pouderoux P, Gulchin AE, Shezhang L, Kahrilas PJ: Esophageal bolus transit imaged by ultrafast computerized tomography. Gastroenterology 1996, 110:1422–1428. CrossRef
- Tomlin J, Lowis C, Read NW: Investigation of normal flatus production in healthy volunteers. Gut 1991, 32:665–669.
- Levitt MD, Furne JK, Aeolus MR, Suarez FL: Evaluation of an extremely flatulent patient: case report and proposed diagnostic and therapeutic approach. Am J Gastroenterol 1998, 93:2276–2281. A recent case report that may be of interest.
- Baume P, Tracey M, Dawson L: Efficacy of two minor tranquilizers in relieving symptoms of functional gastrointestinal distress. Aust NZ J Med 1975, 5:503–506.
- Maxton DG, Martin DF, Whorwell PJ, Godfrey M: Abdominal distention in female patients with irritable bowel syndrome: exploration of possible mechanisms. Gut 1991, 32:662–664.
- Chami TN, Schuster MM, Bohlman ME, et al.: A simple radiologic method to estimate the quantity of bowel gas. Am J Gastroenterol 1991, 86:599–602.
- Serra J, Azpiroz F, Malagelada J-R: Intestinal gas dynamics and tolerance in humans. Gastroenterology 1998, 115:542–550. CrossRef
- Alvarez WC: Hysterical type of nongaseous abdominal bloating. Arch Intern Med 1949, 84:217–245.
- Ritchie J: Pain from distention of pelvic colon by inflating a balloon in the irritable bowel syndrome. Gut 1973, 14:125–132.
- Levitt MD, Furne J, Olsson S: The relation of passage of gas and abdominal bloating to colonic gas production. Ann Intern Med 1996, 124:422–424.
- Schuffler MD, Sinanan MN: Intestinal obstruction and pseudo-obstruction. In Gastrointestinal and Liver Diseases, edn 6. Edited by Sleisenger MH, Fordtran JS. Philadelphia: WB Saunders; 1998:898–916.
- Strocchi A, Levitt MD: Intestinal gas. In Gastrointestinal and Liver Diseases, edn 6. Edited by Sleisenger MH, Fordtran JS. Philadelphia: WB Saunders; 1998:153–160.
- Suarez FL, Savaiano DA, Levitt MD: A comparison of symptoms in people with self-reported severe lactose intolerance after drinking milk or lactose-hydrolyzed milk. N Engl J Med 1995, 333:1–4. CrossRef
- Jain NK, Patel VP, Pitchumoni S: Activated charcoal, simethicone, and intestinal gas: a double-blind study. Ann Intern Med 1986, 105:61–62.
- Holtmann G, Gschossmann J, Karaus M, et al.: Randomised double-blind comparison of simethicone with cisapride in functional dyspepsia. Aliment Pharmacol Ther 1999, 13:1459–1465. Results from a notable recent study. CrossRef
- Van Outryve M, Milo R, Toussaint J, et al.: ‘Prokinetic’ treatment of constipation predominant irritable bowel syndrome: a palcebo-controlled study of cisapride. J Clin Gastroenterol 1991, 13:49–57. CrossRef
- Johnson AG: Controlled trial of metoclopramide in the treatment of flatulent dyspepsia. Br Med J 1971, 2:12–16. CrossRef
- Suarez FL, Furne JK, Springfield J, Levitt MD: Failure of activated charcoal to reduce the release of gases produced by the colonic flora. Am J Gastroenterol 1999, 94:208–212. Results from a study assessing the effectiveness of activated charcoal. CrossRef
- Hall RG, Thompson H, Strother A: Effects of orally administered activated charcoal on intestinal gas. Am J Gastroenterol 1981, 75:192–196.
- Potter T, Ellis C, Levitt M: Activated charcoal: in vivo and in vitro studies of effect on gas formation. Gastroenterology 1985, 88:620–624.
- Suarez FL, Levitt MD, Adshead J, Barkin JS: Pancreatic supplements reduce the symptomatic response of healthy subjects to a high fat meal. Dig Dis Sci 1999, 44:1317–1321. Recent study with important clinical implications. CrossRef
- Bowel A, Church H: Food Values of Portions Commonly Used, edn 16. Philadelphia: JB Lippincott; 1994.
- Scrimshaw NS, Murray EB: The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr 1988, 48:1083–1159.
- Bergoz R: Threhalase malabsorption causing intolerance to mushrooms. Gastroenterology 1971, 60:909–912.
- Suarez FL, Springfield J, Furne JK, et al.: Gas production in humans ingesting a soybean flour derived from beans naturally low in oligosaccharides. Am J Clin Nutr 1999, 69:135–139.
- Anderson IH, Levine AS, Levitt MD: Incomplete absorption of the carbohydrate in all-purpose wheat flour. N Engl J Med 1981, 304:891–892. CrossRef
- Englyst HN, Wiggins HS, Cummings JH: Determination of the non-starch polysaccharides in plant foods by gas-liquid chromatography of constituent sugars as alditol acetates. Analyst 1982, 107:307–318. CrossRef
- Strocchi A, Levitt MD: Factors affecting production and consumption by human fecal flora: the critical role of hydrogen tension and methanogenesis. J Clin Invest 1992, 89:1304–1311. CrossRef
- Suarez FL, Savaiano DA, Arbisi P, Levitt MD: Tolerance to the daily ingestion of two cups of milk by individuals claiming lactose intolerance. Am J Clin Nutr 1997, 65:1502–1506.
- Suarez FL, Adshead J, Furne JK, Levitt MD: Lactose maldigestion does not represent an impediment to the intake of 1500 mg of calcium/day as dairy products. Am J Clin Nutr 1998, 68:1118–1122.
- Sutalf LO, Levitt MD: Follow up of a flatulent patient. Dig Dis Sci 1979, 24:652–654. CrossRef
- Briet F, Pochart P, Marteau P, et al.: Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect? Gut 1997, 41:632–635. CrossRef
- Moore JG, Jessop LD, Osborne DN: Gas-chromatographic and mass-spectrometric analysis of the odor of human feces. Gastroenterology 1987, 93:1321–1329.
- Levine J, Furne JK, Levitt MD: Fecal hydrogen sulfide production in ulcerative colitis. Am J Gastroenterol 1998, 93:83–87. CrossRef
- Suarez FL, Furne JK, Springfield JR, Levitt MD: Insights into human colonic physiology obtained from study of flatus composition. Am J Physiol 1997, 272:G1028-G1033.
- Suarez FL, Furne JK, Springfield J, Levitt MD: Bismuth subsalicylate markedly decreases hydrogen sulfide release in the human colon. Gastroenterology 1998, 114:923–929. Of clinical interest. CrossRef
- Hasking GJ, Duggin JM: Encephalopathy from bismuth subsalicylate. Med J Aust 1982, 2:167.
- Gordon MF, Abrams RI, Rubin DB, et al.: Bismuth subsalicylate toxicity as a cause of prolonged encephalopathy with myoclonus. Mov Disord 1995, 10:220–222. CrossRef
- An understanding of excessive intestinal gas
Current Gastroenterology Reports
Volume 2, Issue 5 , pp 413-419
- Cover Date
- Print ISSN
- Online ISSN
- Current Medicine Group
- Additional Links