Excessive Gas in the Upper Gut Causes and Remedies

Excessive gas in the stomach or intestines may present with a number of signs and symptoms. Some of these symptoms arise as a result of a higher than normal gas content in the gut and other symptoms occur due to the causes of excessive gas.

The gut contains about 200 milliliters of gas. Most of the gas in the upper gut is passed out with belching but some of the gas may pass further down the gut where it is expelled as flatus. Gas passed out from the upper gut as a belch is similar in chemical composition to air.

Gas in the digestive tract is normal. Some of it is expelled orally as a belch. Remaining gas is expelled via the rectum as flatus. Just what quantity constitutes excessive gas is debatable. It is known that most people will pass flatus between 15 to 20 times a day. The number of belches daily varies greatly from one person to another. While the exact quantity cannot be definitively identified, most of us know when we are passing too much gas. Not only is it embarrassing in a social setting, it can also be uncomfortable.

Sources of Digestive Gas

The composition of gas expelled as a belch varies from that of flatus. A belch mainly consists of air which means that air is swallowed and then later expelled. Flatus is also largely composed of air but may also contain other gases like methane and hydrogen. The additional gases in flatus are produced by the normal intestinal flora (primarily bacteria) and the chemical processes that occur with digestion and decomposition.

Since the activity of the intestinal bacteria is necessary for bowel health, and chemical digestion and decomposition in the intestine is a normal process, the main way of remedying excessive digestive gas is to reduce air intake. Swallowing air when we eat, drink and to some extent with breathing is normal. But some people swallow more air than others for a number of different reasons as outlined in the causes of gas and bloating. However, there are also disorders and diseases where excessive gas is a symptom.

It is therefore important to differentiate excessive gas due to dietary and lifestyle factors from diseases. Sometimes abdominal distention is associated with excessive gas but it is unlikely that the otherwise minor accumulation of digestive gas can cause the enlargement experienced by some people. This is known as functional abdominal bloating rather than being due to gas bloating.

Symptoms of Excessive Gas

The main symptoms associated with excessive gas is :

• Excessive belching (burping) due to gas in the upper gut
• Excessive flatulence (flatus) due gas in the lower gut
• Abdominal bloating which is a sensation of fullness or pressure with/without abdominal distension (enlargement)

Other symptoms may be due to large volumes of gas or is linked to one of the causes of excessive gas. This includes :

• Stomach cramps or intestinal cramps – stretching of the wall of the gut due to the gas may cause a reflex contraction and spasm of the smooth muscle in the gut wall.
• Stomach ache or abdominal pain – distension of the gut wall may elicit pain especially if gas pockets build up and trapped gas accumulates between solid matter in the gut or as a result of stomach/intestinal contractions.
• Stomach noises or abdominal rumbling as gas moves through the gut and motility contractions mixes and moves the solid, liquid and gas contents in the gut.

Causes of Excessive Gas in the Upper Gut

The most common cause of gas in the esophagus, stomach, and duodenum is due to air swallowing (aerophagia) and the consumption of carbonated beverages.

Certain ‘gassy’ foods may increase gas in the gut but generally contributes to excessive flatus often as a result of the action of coliform bacteria. This is discussed further under Gassy Stomach.

Aerophagia

• Air swallowing (aerophagia) occurs for various reasons including eating or drinking too quickly, mouth breathing, hyperventilation (anxiety), excessive gum or tobacco chewing and poorly fitted dentures.
• Air is trapped usually in the upper esophagus but may pass down into the stomach and duodenum. It is usually passed out as a belch but can extend further down into the lower gut where it is passed out with flatus.

H.pylori Infection

• Invasion of the gastric and duodenal mucosa by Helicobacter pylori bacteria does produce moderate amounts of gas due to the chemical process that occurs when the bacteria protects itself from the stomach acid.
• While the amounts of gas produced in this case is very small, it may partly contribute to excessive gas in the stomach.

Hiatal Hernia

• Protrusion of a portion of the stomach through the diaphragmatic opening into the chest cavity can cause a host of upper GI symptoms.
• A hiatal hernia does not cause gas production but decreases the stomach volume and may affect digestion and cause a stomach bloating with additional symptoms like excessive belching.

Delayed Gastric Emptying

• This may be due to muscle and/or nerve dysfunction like gastroparesis, hormonal disturbance (digestive hormones) or a physical obstruction like in pyloric stenosis, stomach polyp or other stomach and duodenal tumors.
• Food stays in the stomach for a longer period than normal and this increases the gas production as a result of gas digestion plus any bacteria, like with H.pylori infection, have a longer time span to consume the food.

Food Intolerances

• Food intolerance or malabsoption may cause gas production as intestinal bacteria consume the undigested and unabsorbed nutrients.
• This is seen in conditions like lactose intolerance, gluten intolerance, sorbitol and fructose malabsorption.

Small Intestinal Bacterial Overgrowth

• Overgrowth of normal intestinal flora (normal gut bacteria) in the small intestine consumes nutrients in the ingested food thereby releasing gas as a byproduct.
• Small intestinal bacterial overgrowth (SIBO) ‘robs’ the body of essential nutrients and impairs digestion and absorption thereby leading to malabsorption syndromes.

How to Stop Excessive Gas

Eat And Drink Slowly

Air swallowing (aerophagia) is one of the main reasons for gas that you belch or flatus. Therefore it is important to reduce air intake in the course of daily life. Eating or drinking too fast can increase the amount of air you swallow. Sometimes we all eat faster when we are on the go. But some people have a habit of eating and drinking fast. If you are suffering with excessive gas, you can reduce the degree of air swallowing by eating and drinking slower. Take the time off to have a meal and eat properly. Pace yourself accordingly.

Do Not Chew Gum

Gum chewing is another major cause of air swallowing. If you occasionally chew gum then it should not be too much of a problem. But if gum chewing is a habit and you are suffering with excessive gas, then now is the time to kick the habit. The same applies for tobacco chewing. It is largely due to the excessive salivation that occurs with chewing which leads to frequent swallowing. Although you may make a conscious effort not to chew with your mouth open, even the air taken in through the nose is swallowed.

Stop Cigarette Smoking

Cigarette smoking is another way of taking in too much air. Although smokers inhale the smoke, a large amount of air accompanies it. As a result some air (as well as smoke) enters the gastrointestinal tract. Smoking too fast or heavy smoking makes the situation worse. Quitting smoking is an obvious choice due to its health risks. If you are suffering with excessive gas then quitting is an obvious choice. Switching to nicotine gum as part of nicotine replacement therapy (NRT) should be avoided for obvious reasons.

Stay Away From Gassy Foods and Dinks

Certain foods and drinks are more likely to increase digestive gas. Carbonated beverages will obviously contribute to gas. Gassy foods tend to have high contents of sulfur and fiber but even spicy foods can be a problem. Some of the common gassy foods are asparagus, beans, broccoli, cabbage, cauliflower, garlic, lentils, onions and wholewheat foods. Another possibility is that a person may have an intolerance to certain foods, either because their gut cannot digest or absorb it. As a result undigested nutrients may serve as a food source by the intestinal bacteria which in turn produce more gas.

Eat In Moderation

Whether gas is linked to air swallowing during eating or from food itself, by overeating you are more likely to contribute to air intake o gas formation. Research has shown that obese people tend to suffer with more gastrointestinal complaints that are not related to any disease. Often these symptoms are attributed to functional bowel disorders. Although not as yet established, overeating which is known to contribute to obesity could also be a reason for some of these symptoms like excessive gas. Try to eat smaller meals more frequently and control your daily food intake to see if it does help with reducing gas production.

Stop Mouth Breathing

Another major cause of air swallowing is breathing through your mouth. It is unavoidable for people with conditions that lead to a blocked nose. However, some people are mouth breathers by habit and this practice can be consciously rectified. If a blocked nose is a problem then you should speak to a doctor about the proper treatment for the underlying cause, such as allergic rhinitis. Many people who snore are also mouth breathers when sleeping. Losing weight and using an ergonomic pillow can help remedy snoring and therefore mouth breathing during sleep to some extent.

Use A Probiotic Regularly

There are hundreds of millions of microbes living in your bowels. Most are bacteria that assist with several functions in the human body and are referred to as the normal intestinal flora. These bacteria have to be kept in check as an overgrowth or eradication can disturb normal bowel functions and cause excessive flatulence. A probiotic can help restore the normal intestinal flora and keep the populations of these microbes in balance. Live culture yogurt is one option but probiotic supplements with the spores of these ‘good bowel bacteria’ are also available.

Avoid Eating Before Sleeping

Some people find that their gas problem is worse at night or upon waking in the morning. There could be various possible reasons for these symptoms. Movement through the bowels slows down during sleeping while stomach acid production increases. This may increase decomposition of food in the gut which in turn contributes to gas formation. Eating should be avoided before bedtime. Ideally there should be a gap of about 3 hours before meal time and bedtime. Midnight snacking is not advisable, irrespective of how small the snack is.

Light Activity After Meals

Physical activity can assist with digestion. It may be helpful for minimizing symptoms like excessive belching and flatulence. Strenuous physical activity is not advisable immediately after eating, especially if it was a large meal. A slow stroll for a few blocks is sufficient but if you do not have the time to walk around leisurely, you can try other physical activity. Standing up and walking around the house will suffice. However, you should avoid lying down or sitting idly on the couch after eating.

Keep Bowel Movements Regular

Having regular bowel movements can be helpful in relieving excessive flatus. As stool remains in the colon and decomposes, more gas is produced. Expelling stool on a regular basis prevents prolonged decomposition and also expels large amounts of bacteria which contribute to gas formation. Having one to two bowel movements daily is ideal. But some people are less regular. If constipation is a problem then a laxative should be used occasionally until normal bowel habit can be restored. Excessive flatulence can also be a problem with frequent bowel movements or diarrhea. Therefore bowel habit needs to be maintained within normal limits.

Last updated on September 6, 2018.