Brief Answer:
Depleted and disturbed gut flora.

Detailed Answer:

Hello,

Let's begin with the most neglected thing, swallowing air while you eat or drink can cause air to collect in the digestive tract causing excessive bloating and belching. Second, as you digest food, digestive gases are formed as a result of fermentation and digestion of food which can also collect. Either method can cause severe bloating.

The pathophysiology of gas and bloating is a bit complicated. The term gut microflora or microbiota means hundreds of species of bacteria which lives in our intestinal tract. These bacterias and yeast are responsible for proper digestion and fermentation of food. Hundreds of species of bacteria and yeast are found in the colon of the human intestine. In the same way, thousands of these species flourish in our gut these bacteria play a vital role in digestion and absorption of food. Even minor disturbances in gut microflora can lead to significant changes in gut function, including gas production. Sometimes even surgical procedures disrupt this flora. If this microbiota is disturbed food is improperly fermented causing the production of a large number of gases in the gut leading to severe flatulence. Hence the most common cause in most of the cases is disturbed microbiota. In old patient mobility of intestines is severely compromised leading to accumulation of a large number of gases in intestines. As peristaltic moments are week gas accumulates in intestines. Severe constipation or incomplete evacuation can also hinder the passage of gases.

-Small Intestinal Bacterial Overgrowth can be a reason of severe flatulence.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine, and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestines causing improper and disturbed food digestion.

Tests suggested-
Small bowel imaging and a gastric-emptying scan.
Add a prokinetic drug like domperidone to your schedule.
Take a probiotic like VSL#3.
Follow up with reports.

Hope I answered your query with detail.

In case you need any other professional advice feel free to ask.

Regards,
Dr. Ramesh Kumar, Gastroenterologist

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Brief Answer:
Any invasive procedure disturbs the internal flora of the body.

Detailed Answer:

Hi,

Any procedure which is invasive on the body destroys the gut flora. So there can be a possible association of surgery with your symptoms.

Secondly, try to take a low-fat diet not more then 35 grams of fat from all sources and see if it helps (then it can be due to lack of bile) however, chances are very low.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ramesh Kumar, Gastroenterologist

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Brief Answer:
Follow up.

Detailed Answer:

Hi,

The best one which suits me is VSL#3 through a bit costly yet very effective and over the counter.

Hope I have answered your query.

Regards,
Dr. Ramesh Kumar, Gastroenterologist

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