Gas (Flatulence): Excessive

What is excessive gas?

A normal but embarrassing part of life is to pass bowel gas on a daily basis. Most people also belch or burp up stomach gas occasionally. In fact, the average adult on a regular diet passes gas 10 to 20 times a day. This amounts to approximately 1 quart of gas per day. Gas should not be considered excessive unless it occurs at more than twice the normal frequency.

What is the cause?

• Swallowed air. The main causes of normal gas are swallowed air, gas-producing foods, and certain diseases that interfere with sugar absorption. Every baby is somewhat "gassy" because of swallowing air during sucking. This process is increased by sucking on a clogged nipple, a nipple with too small an opening, a bottle that does not have milk in it, a pacifier, the thumb, or a blanket. Babies also swallow air during crying.

  Older children swallow air with gum-chewing. Children with nasal allergies swallow air if they sniff a lot. Some children have a nervous habit of frequent swallowing. The carbonation in soft drinks releases gas in the stomach. Stomach gas is more likely to pass into the intestines if a child is lying down.

• Certain foods. Some foods (such as beans) are made up of complex carbohydrates that are not completely digested in the small bowel. These foods are converted into gas by bacteria in the large bowel. Eating beans can increase gas production tenfold.
• Lactose intolerance. The most common medical problem that causes increased gas is milk intolerance. This is when you cannot digest milk very well. The enzyme (lactase) that normally digests milk sugar (lactose) slowly decreases in amount between ages 4 and 20 in many people. The undigested lactose is converted into gas by the bacteria in the large bowel. The amount of gas produced depends upon the amount of milk you drink. The main symptoms are bloating, diarrhea cramping, and passing a lot of gas.
• Diarrhea and constipation. Gas can be temporarily increased with bouts of infectious diarrhea. Gas can also build up behind constipation and can be released in large amounts. Bowel gas is usually odorless.

How can I take care of my child?

In general, passage of gas causes no symptoms. By age 5 or 6 most children can be taught to release gas in a quiet and socially acceptable manner. Gas does not need to be released by inserting anything in the rectum.

Air swallowing can be reduced by getting rid some of the habits listed above (for example, sucking on a pacifier).

Reduced intake of beans and carbonated beverages will decrease gas production in all children.

If you feel your child has a milk intolerance (especially if it runs in the family), only give your child 2 glasses of milk a day. Milk does not need to be completely eliminated in most people with this problem. Your child can keep eating yogurt because it is easy to digest. Supplemental enzyme lactase drops or pills can also be taken with milk products. If the symptoms continue after you've made these minor diet changes, talk to your child's healthcare provider.

When should I call my child's healthcare provider?

Call during office hours if:

• Your child develops loose stools that last over 7 days.
• Your child loses weight.
• You have other questions or concerns.