Gott: Flatulence is a natural part of digestion

Q. I am a 61-year-old female who tries to eat healthy and exercise, and sometimes I do better than others. But in the past year, I have been suffering from the increasing embarrassment of noisy flatulence, and it doesn't seem to matter what I eat. No pain, except that of embarrassment. I read that it is usually dietary, but it doesn't seem to make a difference. Beano did nothing.

A friend suggested taking acidophilus. Is this a good idea? If so, how much? I don't want to go through unnecessary testing, but could this be a symptom of some other problem or is it something one should expect as we age? I guess you can't die of embarrassment, but sometimes I avoid going out with others.

I am on what I call the “middle-age pack” of Lipitor, Caduet, a daily aspirin and Nexium for acid reflux, which sometimes mimics angina. The Nexium has stopped this problem completely. I had a heart attack due to statin rebound, but that was five years ago. Could any of these medications be causing the problem?

A. Initially, there are a few possible causes for your noisy flatulence. The first that comes to mind is swallowed air. It is normal to swallow air while eating and/or drinking. That air is composed of nitrogen and oxygen. The oxygen is absorbed appropriately, but nitrogen can pass through into the intestine and cause the problem. Fortunately, a major portion of it is expelled back through the mouth via burping or belching.

Gases such as carbon dioxide can be produced during the normal digestive process because of an interaction between stomach acids and pancreatic juices. Those juices neutralize digestive acids; however, during the process, they may produce carbon dioxide, methane and hydrogen that can cause flatulence.

Then there is always the possibility that you are lactose or gluten intolerant or have irritable bowel syndrome. Foods such as beans, cabbage, broccoli, asparagus, cauliflower and others with a high starch or fiber content cannot be fully digested by enzymes. That undigested portion of the foods you eat passes into the intestine, where they are digested by bacteria — a process that can create gas. Some people may be intolerant of sugars in certain foods, such as dried fruit, honey, onions, artichokes and drinks that contain high-fructose corn syrup, as well as some sugar-free candies.

Lipitor and Nexium have the side effect of flatulence. Caduet can cause gas. I am not aware of aspirin being a potential factor. Therefore, you might wish to speak with your physician regarding your medications and ask for his or her direction on the matter.

Other considerations might be to consume ginger, miso or tempeh. Use cinnamon in your cooking or on toast whenever possible, or try a pinch of baking soda in a four-ounce glass of water whenever flatulence presents. Try over-the-counter activated-charcoal tablets, digestive-enzyme supplements or probiotics such as acidophilus, most easily found in yogurt containing live L. acidophilus.

Again, your physician has your complete medical history and is your best guide in the matter.

© 2011, United Feature Syndicate, Inc.