Gas Bloat Syndrome

What is Gas Bloat Syndrome?

Gas bloat syndrome is a common medical condition that affects many people. Gas or air builds up in the digestive tract causing discomfort and the symptoms associated with the disease. Gas includes all the odorless and vaporless constituents of air like carbon dioxide, nitrogen, oxygen, hydrogen, and sometimes methane. The smell that arises from gas passed through the anus is due to the release of sulfur by bacteria in the stomach.(1^✔)

Those who experience flatulence, do not actually produce excessive gas, but are sensitive and hence, react to the smallest of changes in the stomach. Most people experience bloating along with irritable bowel syndrome (IBS) that is a condition in which the bowel movements keep fluctuating from constipation or diarrhea.

A bloated stomach can hinder healthy daily living. While it is not a life-threatening condition, it can deeply affect one's personal and professional life. For some, the gassy feeling and discomfort are temporary and infrequent, while for many others it is a persistent condition. Stomach gas is expelled from the system by burping or passing it through the rectum as flatus. An average adult produces 1-4 pints of gas and passes gas around 14-23 times a day.

What are the Causes of Gas Bloat Syndrome?

The causes of gas in the digestive tract include the following:(2^✔)

• Aerophagia or swallowing air: Talking, eating, chewing gum, and similar habitual acts result in the intake of gas. Wearing loose dentures and smoking also leads to swallowing air. Nowadays, more and more youth are being affected by gas bloat syndrome because of excessive consumption of soda or carbonated soft drinks.

Some of the swallowed gas leaves the stomach through burping, but the remaining gas proceeds to become intestinal gas.

• Decomposition of food by certain bacteria in the intestines: The carbohydrates and sugars that are partially processed by the stomach and small intestines are passed on to the large intestines for further absorption. This complicated breakdown of such sugars, fibers, and undigested starch simultaneously releases gases like hydrogen, carbon, and methane in one-third of the cases. The production of methane can be detected by analyzing stools. A person who produces methane will have floating stools. It is the breakdown of sugars by naturally occurring bacteria in the colon that especially leads to abdominal bloating.
• Dietary influence: Stomach bloating after eating can be due to the kind of food that a person is consuming. Sugars like raffinose, fructose, lactose, and sorbitol contribute to gas bloating. Beans, whole grains, and pulses contain raffinose. Lactose is a part of all dairy products. Sorbitol is a natural constituent of fruits like pears, apples, and peaches. Fructose and sorbitol are used as a sweetener in soft drinks and similar packaged items. All starchy food items except rice can cause a bloated belly. This includes potatoes, noodles, corn, etc. Soluble fibers (that which dissolve in water) and insoluble fibers (that which doesn't dissolve) can also cause bloating and gas. Soluble fibers (found in oats, peas, and beans) are broken down in the large intestine and produce gas. Insoluble fibers (found in wheat bran and some vegetables) smoothly pass through the large intestine and comparatively produce less gas.

• Other conditions that contribute to a gassy stomach: Sometimes gas pain is the result of another ailment. A change in the growth or the type of bacteria in the small intestines can lead to a bloated feeling. IBS and gastroesophageal reflux disease (GERD) are two other conditions that constitute the reasons for bloating. Fundoplication also results in gas bloat syndrome. Fundoplication is the corrective surgery performed to treat GERD. It makes it hard for the gas to pass from the stomach to the intestines. This increases belching. Some medicines can also cause bloating as a side effect, e.g., metformin that is used to treat diabetes and lactulose that is a laxative. Causes of bloating in women have also been linked to ovarian cancer.

What are the Signs and Symptoms of Gas bloat Syndrome?

There are 4 signs and symptoms that are associated with a bloated tummy. All four symptoms may not necessarily occur in all individuals suffering from gas bloat syndrome.(3^✔)

The following are the top indicators of gas bloat syndrome:

• Belching or burping: while it is normal to belch during and right after meal, frequent belching may be due to swallowing of excess air. A person who complains of persistent belching may be suffering from an upper digestive tract disorder like peptic ulcer disease, GERD, or gastritis. An even more severe case of belching occurs in the Meganblase syndrome. An enlarged bubble is formed in the stomach by severe air swallowing. This causes pain and discomfort that is similar to a mini heart attack.
• Flatulence: This refers to the gas that is passed through the rectum. Usually, this happens about 14-23 times in adults, and is one of the commonest symptoms for gas bloat syndrome. It is also quite embarrassing for patients.
• Abdominal pain and discomfort: Gas accumulates on the left side of the colon, leading to abdominal and chest discomfort that is often mistaken for heart disease. When it collects on the right side of the colon it is confused with gallstones or appendicitis.
• Abdominal bloating: The sensation of constant bloating may be due to motility disorders of the digestive tract, which are caused by irregular movements and contractions. Intestinal hernias and colon cancer can also cause abdominal bloating.

How do you Diagnose Gas Bloat Syndrome?

• Doctors find it the hardest to diagnose digestive troubles in patients. Gas bloat syndrome just like other digestive issues poses the same challenge. This is so because what appear to be the symptoms for gas bloat syndrome could be the signs of another unrelated condition. Diseases in other parts of the body easily impact the digestive system; therefore, the symptoms manifested get identified as a gastrointestinal condition.
• A thorough medical history and physical examination are required to diagnose the disease.
• The doctor may also ask for an abdominal X-ray or colonoscopy (passing a flexible tube through the colon) to see if there is any abnormality in the digestive tract or colon respectively.
• Doctors ask the patient to keep a food diary and note down all the food items ingested in order to identify the cause of the gas bloat.
• People suffering from chronic belching may be asked to perform an upper GI series, which involves X-ray imaging of the upper half of the digestive tract that is the esophagus, stomach, and duodenum.(4)

How do you Treat Gas Bloat Syndrome?

• Bloated stomach remedies are decided by the doctor based on several patient-related factors like age, medical history, overall health, reaction to medicines, and the extent of the condition. Most doctors advise their patients to either modify their diet, take medications, or reduce the amount of air swallowed.
• Diet modifications include reducing the consumption of food that cause bloating like milk products, sugars, starches, and fibers. Including probiotic drinks will foster the growth of good bacteria in your stomach and reduce the symptoms of gas bloat syndrome.

• Over the counter medicines like antacids (simethicone) are helpful bloating remedies. Simethicone joins gas bubbles in the stomach and aids in the effective removal of excess gas. Medicines like lactase help people with lactose intolerance to digest the sugar without producing excess gas. Prescription medicines are given to those who suffer from motility disorders like GERD or IBS, and thus, need to be cured of that condition in order to be relieved from bloating.
• To reduce the amount of air swallowed, patients are told not to chew candy or gum and to avoid smoking.(5^✔)

How do you Prevent Gas Bloat Syndrome?

The best way to prevent gas bloat syndrome is by closely monitoring one's diet. Most people experience bloating after meals, and in such cases, it is vital to reduce the consumption of gassy food items. Furthermore, gas bloat syndrome after fundoplication is very common.

Health Tips

Recent studies have also linked stress to bloating. Therefore, one should maintain a healthy lifestyle with a balanced diet in order to prevent gas. Having a diet that is rich in fiber i.e., whole grains, fruits, vegetables can help reduce gas bloating. Water consumption of at least 3-4 liters should be done to keep gas formation under check.(6)

References:

1. Abdominal Gas - (https://www.ncbi.nlm.nih.gov/books/NBK417/)
2. Gas - (https://my.clevelandclinic.org/health/diseases/7314-gas)
3. Definition & Facts for Gas in the Digestive Tract Gas in the Digestive Tract - (https://www.niddk.nih.gov/health-information/digestive-diseases/gas-digestive-tract/symptoms-causes)
4. Gas and Gas Pains - (https://www.mayoclinic.org/diseases-conditions/gas-and-gas-pains/diagnosis-treatment/drc-20372714)
5. Gas in the Digestive Tract - (https://www.hopkinsmedicine.org/health/conditions-and-diseases/gas-in-the-digestive-tract)
6. Why a Healthy Diet Can Cause Gas - (https://www.everydayhealth.com/hs/gas-and-bloating/why-healthy-diet-may-cause-gas/)

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