Life is a Gas! When Bloating Causes Discomfort and Pain
STEVEN SANDBERG-LEWIS
N.D., DHANP
I have a tendency to get into too much detail in some of my blog posts, so I will try to contain my desire to expand in all directions (hmm, sounds like gas).
Gas production by bacteria and yeast is a normal part of the digestive process. There are special nerve/muscle reflexes that move gas in the stomach up and out the mouth. Others move intestinal gas down to the rectum. These are distinct from the muscle contractions that move food and liquid. In addition, much of the gas in the small intestine is absorbed into the blood and filtered out by the lungs to be exhaled.
Because of my experience, focus, research and teaching, I am called on to diagnose and treat many IBS and SIBO patients. These people often experience significant pain associated with bloating as well as alterations in stool frequency and consistency. The level of pain, fatigue and other systemic symptoms can be extreme. The pain in some cases may be similar to that experienced with appendicitis or a gallbladder attack. To add insult to injury, emergency room and other healthcare practitioners may be poorly equipped to diagnose or treat this type of pain.
Research has shown that bloating from excessive gas (caused by bacterial overgrowth) can be objectively measured. It often improves after fasting and increases after meals as the day proceeds. Gas can become trapped in certain parts of the intestine causing distention, and in IBS, this often leads to pain. Non-IBS research subjects have no symptoms when up to 2 liters of gas (nitrogen, oxygen and carbon dioxide) is gradually infused into the upper small intestine. The same amount of gas leads to pain and/or bloating in IBS subjects. Research also proves that if the gas infused is methane, it slows down intestinal transit by up to 69%. Clearly the type of gas as well as the intricacies of the intestinal reflexes matter.
The best treatments for IBS and SIBO involve addressing the underlying causes and reducing the overgrowth of organisms that produce gas. The prevention stage often involves a diet that is lower in fermentable carbohydrates (the preferred energy source for these bacteria, archaea and fungi) as well as options for improving nerve reflexes, GI muscle coordination and mucosal healing.
Patients often misunderstand that eliminating these organisms is not our goal. Instead our goal is to restore the normal balance. These organisms belong in the gut, but in lower numbers and in a balance with the various other species.
During the prevention and support phases of treatment, I find it important to remind patients that the production of intestinal gas is a normal phenomenon. The hydrogen producing bacteria not only belong in the gut, but are essential to life and health. Moderate volumes of gas are expected and getting rid of all gas should not be the goal. Health, comfortable digestion and balance, I think, is a better endgame.
Life is a gas!
Hive Mind Medicine blog posts are for educational purposes only and are not intended as medical advice. Please consult with your health care practitioner for personalized guidance.