Flatulence is the act of passing gas through the anus which is a normal part of human physiology. It is not usually reported as a symptom unless it is excessive resulting in frequent passing of flatus. The term flatulent is therefore accepted as excessive flatulence or frequent flatulence, in excess of the 15 to 20 times a day that flatus is normally expelled.
A person who is flatulent experiences significant emotional distress as the passing of flatus may be uncontrollable and occur in social settings, often at the most inopportune times. This is exacerbated if the flatus is unusually foul in odor and passing of the gas is loud.
What Causes A Person To Be Flatulent?
A person may be flatulent due to physiological or functional causes or it may be a sign of some underlying disease (pathological causes). Some of the physiological causes of frequent or excessive flatulence includes :
- Excessive air swallowing (aerophagia)
- Very high carbohydrate, fat and/or fiber intake.
- Large intake of carbonated beverages.
- Premenstrual (before period in women)
Diseases That Cause Flatulence
Diarrhea and constipation are two bowel disturbances where flatulence often occurs. It may therefore be due to any of the causes associated with flatulence and may be a concomitant feature in the disease.
Allergies and Intolerances
Symptoms usually start or exacerbate almost immediately after eating and may be accompanied by indigestion, abdominal pain or discomfort, excessive belching, nausea, loud stomach noises or diarrhea.
- Celiac disease (gluten intolerance)
- Lactose intolerance
- Sucrose intolerance
- Intestinal angioedema
An obstruction may be partial or complete and occur anywhere in the gut. Flatulence may be more prominent with an obstruction in the small or large intestine. Abdominal pain, severe nausea, projectile vomiting, constipation and malaise may also be present.
- Gallstone ileus
- Fecal impaction
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Symptoms may arise suddenly, especially in acute infections like gastroenteritis, with pronounced nausea, vomiting, fever and watery diarrhea, especially after eating. With intestinal parasites, symptoms may be milder and develop gradually, often with no fever present. Unintentional weight loss is a key feature in these cases.
- Infectious colitis
- Intestinal parasites
- Tropical sprue
- Small intestinal bacterial overgrowth
- Eating disorders
Maldigestion and Malabsorption
Unintentional weight loss, abnormalities with stool like steatorrhea, failure to thrive and signs and symptoms of nutrient deficiencies (macro- and micronutrients) may be seen.
- Malabsorption syndromes
- Deficiency of digestive enzymes – pancreatic exocrine insufficiency, achlorhydria
- Bile duct blockage
- Bowel resection or gastric bypass surgery
- Slow or rapid transit time as is seen with gastroparesis, irritable bowel syndrome
- Dumping syndrome
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