Flatulence

What you need to know about flatulence

An increase in gas formation and passing wind is defined as flatulence. Gases are produced in the intestine by intestinal bacteria; on average, a person produces half a litre to one and a half litres of intestinal gas per day. These gases leave the body and this is how wind is passed. Gas escapes 25 times a day, much of which you do not notice. Wind consists of intestinal gases such as methane, carbon dioxide, hydrogen and sulphur-containing substances produced by bacteria in the intestine. Mammals, birds, fish and insects also pass wind. A large proportion of wind consists of methane; about half of healthy people produce methane gas. Methane has a biological effect on intestinal function, but an increase can sometimes cause problems. Passing wind is healthy, so it is better not to hold it in, because the gases can cause protrusions of the intestinal wall. When gas production increases, we speak of flatulence, and this can also cause a bloated abdomen. Wind can also smell unpleasant; this often indicates a medical problem.

Symptoms of flatulence

Excessive gas production causes both physical and social problems:

• A bloated abdomen
• Pain or intestinal cramps
• Constipation
• Social discomfort: passing wind in public, at work or at school near friends is a problem that often causes embarrassment

Tests for flatulence

For persistent flatulence, stool testing through Darmklachten.nl may help in identifying the cause. See our recommended test packages and individual modules below.

Causes of flatulence

There are several possible causes of a bloated abdomen or bloated feeling:

• Abnormal intestinal flora
  A decrease in healthy bacteria in the intestine often occurs together with an increase in yeasts, which can result in a bloated abdomen. The use of an antibiotic can also lead to a bloated abdomen, a bloated feeling, flatulence or diarrhoea. An increase in unfavourable intestinal bacteria and a decrease in healthy bacteria such as Lactobacillus is another possible cause of a bloated abdomen.
• Overgrowth of Candida or other yeasts
  Candida albicans is a yeast that produces gases and causes both a bloated feeling and flatulence. Candida can increase through eating starchy foods such as bread. People who are overweight and people with diabetes often have an increase in yeasts in the intestine.
• Infection with intestinal parasites is one of the most common causes
  One of the main causes of a bloated feeling in the abdomen is infection with Dientamoeba fragilis or Blastocystis hominis, parasites that can remain in the intestine for years. Almost no condition causes a bloated abdomen more often than these intestinal parasites. A commonly heard complaint with infection by Dientamoeba fragilis is: “My abdomen is bloated as if I were eight months pregnant.” Blastocystis hominis also causes a bloated abdomen and a bloated feeling, flatulence, nausea and sometimes itching. Some people experience symptoms for years without knowing that they are infected with this parasite.
• Excessive consumption of starch or nuts
  Eating bread and other starchy foods is often the cause of a bloated abdomen or bloated feeling. In addition, excessive starch consumption increases the symptoms of Candida and parasites.
• Gluten intolerance
  Diarrhoea, flatulence and a bloated feeling occur when eating grains that contain gluten in people with gluten intolerance, coeliac disease. Children with coeliac disease more often have diarrhoea and abdominal pain. A characteristic feature is a rounded, bloated abdomen. They may be tired and have anaemia. The intestinal villi can become damaged or break down, resulting in reduced absorption of minerals. In adults, coeliac disease can present as migraine, depression, abdominal pain, a bloated abdomen and osteoporosis.
• Milk sugar intolerance
  Milk sugar intolerance can be the cause of a bloated feeling or bloated abdomen. Lactose is a sugar found in milk and milk products and is also known as milk sugar. Milk sugar intolerance causes flatulence, a bloated abdomen and diarrhoea. In the Netherlands, 15% of people cannot break down milk sugar. This can cause diarrhoea after drinking a glass of milk. Lactose is often added to foods and medicines. People with these conditions should always carefully check the ingredients of their food; even a small amount of milk sugar can cause a bloated feeling or bloated abdomen.
• Increase in histamine due to an enzyme deficiency
  A bloated abdomen, bloated feeling, flatulence or diarrhoea can be caused by high levels of histamine in the intestine. An increase in histamine occurs due to a lack of the enzyme (DAO) that breaks down histamine in the intestine. High histamine levels occur particularly with allergies and after consuming aged cheese, chocolate or red wine.
• Inflammation is accompanied by a bloated feeling in the abdomen, with an abnormal stool pattern
  Crohn’s disease and ulcerative colitis can be accompanied by prolonged severe diarrhoea or watery stools. This can occur as often as 10 times a day. The symptoms can also be milder and present as a bloated feeling and flatulence.
• Disorders of the pancreas or gallbladder
  Poor digestion of fats and starch often causes the abdomen to swell and leads to a bloated feeling. An infection or reduced function of the pancreas and gallbladder, or a decrease or increase in pancreatic elastase or bile salts, can be the cause.
• Constipation
  If someone goes to the toilet only once every 3 or 4 days, a bloated abdomen develops. The pressure in the abdomen is experienced as very uncomfortable. There is often an unproductive urge: you go to the toilet, but nothing comes out.
• Use of acid-suppressing medicines
  When there is insufficient stomach acid, food is not digested properly, which can lead to a bloated abdomen or bloated feeling.
• Overweight
  People who are overweight have more methane-producing bacteria in the intestine and often suffer from flatulence. With overweight there is increased gas formation, which in many cases causes constipation.
• Bacterial infection
• Digestion
  You can swallow air while eating. If you do not chew properly and the food is not digested well, gases can form. When there is insufficient stomach acid or when acid-suppressing medicines are used, digestion decreases.
• Allergies
  All food allergies, including nickel or latex allergy, increase the likelihood of intestinal complaints and flatulence. The same applies to hay fever and grass pollen allergy.
• Vegetable and fruit consumption
  Gas production increases when eating foods such as onions, beans, plums and cabbage varieties; people with intestinal disorders usually need to avoid these products.
• Sweeteners
  Inulin present in Jerusalem artichokes and the supplement FOS form gases. Artificial sweeteners such as sorbitol do as well. Some people have problems with carbonated drinks.

More information about the tests

• Digestive parameters pH, fat, starch, colour and consistency of the stool – read more…
• Helicobacter pylori – Bacterium that causes stomach ulcers – read more…
• Bacterial infection with Salmonella, Campylobacter, Shigella, Yersinia and Clostridioides diffile – read more…
• Intestinal parasites – Testing for infections with intestinal parasites – read more…
• Antigliadin and anti-ht-Transglutaminase – Markers for gluten intolerance – read more…
• Calprotectin – Inflammation marker for Crohn’s disease and ulcerative colitis – read more…
• Intestinal flora analysis – Analysis of part of the intestinal microbiota – read more…

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