Excessive Flatulence is a social nuisance rather than a disease and can be because of :
1) Increased production secondary to malabsorption. This is frequently with carbohydrates and in majority milk. As we age, our ability to digest milk sugar – lactose goes down and the undigested sugar is fermented by colonic bacteria to form “gas”. This is a genetically timed "turning off" event and can become apparent at various ages. Lactose intolerance can also occur secondary to other intestinal illness and vitamin deficiencies. Other diseases affecting intestinal mucosa, blood supply, enzyme availability, Colonic bacterial count and composition can cause malabsorption and hence gas. Vitamin deficiencies and thyroid diseases also cause secondary malabsorption and gas. Rarely protein malabsoption can also cause “gas” which is usually feculent and smelly.
2) Reduced compliance and heightened perception also called visceral hypersensitivity. Here even normal amounts of gas can be perceived as more and frequent small passages lead to distress. This is usually seen with low grade inflammation of intestines or with stress. Addressing the cause of malabsorption relieves the flatulence. In case of milk intolerance a milk free diet (no milk, cheese, cream) will relieve the symptoms. Curd, paneer, ghee, butter can safely be taken. Now you also get lactose free milk, soya milk and lactase enzyme supplements (chewable tab) which can be used by people with lactose intolerance.
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