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What Causes Excessive Flatulence?
Question: I am 34, male, height 5.5 and weight 55kg. Suffering from Very very excessive flatulence since two years (Slow Gas Leak with out knowing). It is affecting my work in confined walls and social life, working as a system engineer. It is totally disabling me and very depressed(Shifted my work station to an isolated place in office). Additionally last three months loose and watery bowl movements twice a day. But in this two years, some two to three months, I lived very happily with out any flatulence. Endoscopy with biopsy, Colonoscopy, CT scan, Blood test are normal.
High Flatulence: After 1-2 hours of food, increases in afternoon and night.
Stool: Soft and watery
Bowl movement : Twice (Urge after food)
Diet: Hotel Food (Idly, dosa, Meals)
Restriction: Diary, Caffeine, Spicy, and Gassy foods
Better: Very little significant betterment with home made food and complete rest (for a Month)
Past Food habit: Excessive Tea and smoking. No Alcohol.
Other complaints: Frequent belching, Mild Burning sensation in upper Stomach, Skin Itchiness, nervousness, emotional.
Surgery: Inguinal hernia at age 33.
Past Treatment: Chest Tuber closis at age 16, Migraine/Headache treatment for two years at age 25.
Past Medication:
Librax, VSL3, Pan20 for two weeks - No difference (made worse)
Riffagut, Pan20,Nextio5mg for two weeks - No difference
Econorm, Mebeverine and Hifibre ispaghula husk for two weeks - No difference (made worse)
Current Medication:
Riffagut400 1-0-1
Providac (LACTOBACILLUS ACIDOPHILUS) 1-0-1,
Histac 0-0-1
enteric-coated 40 mg pantoprazole 1-0-0,
Mebeverine 1-0-1 - Significant improvement (Volume of gas not reduced, Smell changed and significantly reduced).
Past one week I am under this medication feeling better up to 12.00 p.m and flatulence increases as day progress. Tried and tiered of using ginger, fennel, papaya, Pineapple, cumin, figs and buttermilk just increases no of bowl movements no comparative betterment. But to my XXXXXXX with out any specific medication , for some two to three months I was fully flatulence free.
Kindly help me in diagnosing my problem.
Regards, XXXXXXX
High Flatulence: After 1-2 hours of food, increases in afternoon and night.
Stool: Soft and watery
Bowl movement : Twice (Urge after food)
Diet: Hotel Food (Idly, dosa, Meals)
Restriction: Diary, Caffeine, Spicy, and Gassy foods
Better: Very little significant betterment with home made food and complete rest (for a Month)
Past Food habit: Excessive Tea and smoking. No Alcohol.
Other complaints: Frequent belching, Mild Burning sensation in upper Stomach, Skin Itchiness, nervousness, emotional.
Surgery: Inguinal hernia at age 33.
Past Treatment: Chest Tuber closis at age 16, Migraine/Headache treatment for two years at age 25.
Past Medication:
Librax, VSL3, Pan20 for two weeks - No difference (made worse)
Riffagut, Pan20,Nextio5mg for two weeks - No difference
Econorm, Mebeverine and Hifibre ispaghula husk for two weeks - No difference (made worse)
Current Medication:
Riffagut400 1-0-1
Providac (LACTOBACILLUS ACIDOPHILUS) 1-0-1,
Histac 0-0-1
enteric-coated 40 mg pantoprazole 1-0-0,
Mebeverine 1-0-1 - Significant improvement (Volume of gas not reduced, Smell changed and significantly reduced).
Past one week I am under this medication feeling better up to 12.00 p.m and flatulence increases as day progress. Tried and tiered of using ginger, fennel, papaya, Pineapple, cumin, figs and buttermilk just increases no of bowl movements no comparative betterment. But to my XXXXXXX with out any specific medication , for some two to three months I was fully flatulence free.
Kindly help me in diagnosing my problem.
Regards, XXXXXXX
Brief Answer:
Possibly related to antibiotics
Detailed Answer:
Hello Mr XXXXXXX
I am really sorry that you are experiencing all these symptoms. I can understand the toll it must have taken on your personal life. But I think there is a solution to the problem. And thank you for the sequential medical history and the treatment history. It did help me in coming to a conclusion regarding your condition.
Gas in the intestines is produced from two sources - 1. Digested food, especially from foods like beans and dairy products like cheese. 2, In the normal course of the day we do tend to swallow a lot of air. The gas we swallow tends to cause a lot of burping while the gas produced by digestion of food is expelled as flatulence. Nervous people or anxious people tend to swallow more air than normal people and hence tend to burp more.
Also if the bacterial environment in the intestine is altered due to any reason, then the digestion of food is affected and this leads to abnormality in the stools.
By your long history, I deduce that you are suffering from mild gastritis coupled with alteration of the bacteria in your bowel owing to continued use of rifagut. This is an antibiotic which also kills the helpful bacteria in the intestine. This could be one reason why you are feeling better after stopping all medications.
So my advice to you is, stop all antibiotics. Take a probiotic like you are already on. An over the counter antacid (pantoprazole, etc) should help the gastritis. Beyond this for the flatulence I am happy with the dietary restrictions you are already on.
In addition to this I would advice some activated charcoal tablets (Gasni, Distenil etc) which help absorb the intestinal gas and deceases the flatulence.
Please stop all the ginger, fennel, papaya, Pineapple, cumin, figs and buttermilk as this is used to treat constipation and could very well explain why you are having increased frequency of stools.
Hope this helps and hope you start feeling better.
Please do not hesitate to contact me for any further clarifications
Have a great day
Dr Suresh Raghavaiah
Possibly related to antibiotics
Detailed Answer:
Hello Mr XXXXXXX
I am really sorry that you are experiencing all these symptoms. I can understand the toll it must have taken on your personal life. But I think there is a solution to the problem. And thank you for the sequential medical history and the treatment history. It did help me in coming to a conclusion regarding your condition.
Gas in the intestines is produced from two sources - 1. Digested food, especially from foods like beans and dairy products like cheese. 2, In the normal course of the day we do tend to swallow a lot of air. The gas we swallow tends to cause a lot of burping while the gas produced by digestion of food is expelled as flatulence. Nervous people or anxious people tend to swallow more air than normal people and hence tend to burp more.
Also if the bacterial environment in the intestine is altered due to any reason, then the digestion of food is affected and this leads to abnormality in the stools.
By your long history, I deduce that you are suffering from mild gastritis coupled with alteration of the bacteria in your bowel owing to continued use of rifagut. This is an antibiotic which also kills the helpful bacteria in the intestine. This could be one reason why you are feeling better after stopping all medications.
So my advice to you is, stop all antibiotics. Take a probiotic like you are already on. An over the counter antacid (pantoprazole, etc) should help the gastritis. Beyond this for the flatulence I am happy with the dietary restrictions you are already on.
In addition to this I would advice some activated charcoal tablets (Gasni, Distenil etc) which help absorb the intestinal gas and deceases the flatulence.
Please stop all the ginger, fennel, papaya, Pineapple, cumin, figs and buttermilk as this is used to treat constipation and could very well explain why you are having increased frequency of stools.
Hope this helps and hope you start feeling better.
Please do not hesitate to contact me for any further clarifications
Have a great day
Dr Suresh Raghavaiah
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank you for your detailed answer and reply sir.
I guess, as per my previous try, LACTOBACILLUS ACIDOPHILUS(Providac) is better suits me than VSL3 and Econorm. Can you suggest some good probiotics which may be suitable for me. Also I will try activated charcoal tablets and follow your advice.
Most of times I get mild to moderate skin itching all over body, especially in hands, face, stomach and rashes in face rarely. In mouth looks like thrush and sweating in legs. Is this anything related to flatulence?
Thank you Sir.
I guess, as per my previous try, LACTOBACILLUS ACIDOPHILUS(Providac) is better suits me than VSL3 and Econorm. Can you suggest some good probiotics which may be suitable for me. Also I will try activated charcoal tablets and follow your advice.
Most of times I get mild to moderate skin itching all over body, especially in hands, face, stomach and rashes in face rarely. In mouth looks like thrush and sweating in legs. Is this anything related to flatulence?
Thank you Sir.
Brief Answer:
Continue Lactobacillus
Detailed Answer:
Hello Mr XXXXXXX
Thank you for getting back to me. Hope you are doing better since the last time.
Regarding the probiotics, The one you are on right now should work just fine. I don t think changing the brand of probiotics is going to help you in anyway. Please continue the same for a while and if in two to three weeks you do not have any relief, then we will revisit the issue.
The itching all over the skin could just be dry skin. It happens a lot in dry environment. I would suggest you to apply a moisturising lotion like vaseline, nivea etc after taking a bath everyday, twice a day and see if this brings you any relief. If this does not relieve you of your symptoms in 3-4 days, then I think you need to visit a dermatologist to get the same complaints evaluated to rule pout any fungal infections.
Oral thrush is a very rare condition and only people who are immune suppressed or suffer from diabetes get. If you are practicing regular oral hygiene practices like brushing your teeth everyday, I would be very surprised if you do have thrush. Please visit a physician to get it checked as if it is indeed thrush, it is very easy to treat and It is not related to any of your GI issues.
Please follow the above advise and I do think you will start feeling better soon.
As always please do not hesitate to write back for clarifications.
Dr Suresh Raghavaiah
Continue Lactobacillus
Detailed Answer:
Hello Mr XXXXXXX
Thank you for getting back to me. Hope you are doing better since the last time.
Regarding the probiotics, The one you are on right now should work just fine. I don t think changing the brand of probiotics is going to help you in anyway. Please continue the same for a while and if in two to three weeks you do not have any relief, then we will revisit the issue.
The itching all over the skin could just be dry skin. It happens a lot in dry environment. I would suggest you to apply a moisturising lotion like vaseline, nivea etc after taking a bath everyday, twice a day and see if this brings you any relief. If this does not relieve you of your symptoms in 3-4 days, then I think you need to visit a dermatologist to get the same complaints evaluated to rule pout any fungal infections.
Oral thrush is a very rare condition and only people who are immune suppressed or suffer from diabetes get. If you are practicing regular oral hygiene practices like brushing your teeth everyday, I would be very surprised if you do have thrush. Please visit a physician to get it checked as if it is indeed thrush, it is very easy to treat and It is not related to any of your GI issues.
Please follow the above advise and I do think you will start feeling better soon.
As always please do not hesitate to write back for clarifications.
Dr Suresh Raghavaiah
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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