Flatulence is the passage of excessive amounts of intestinal gas.
Upper gastrointestinal flatulence
is due to swallowed air. It is more common in people who are anxious, eat quickly, or smoke. Behavioral modifications are usually successful; other treatments include peppermint water, aerated drinks, or simethicone, a defoaming agent that facilitates bringing up wind.
is due to swallowed air and the chemical and bacterial degradation of food. Gas production will be increased by the ingestion of high fiber foods and non-absorbable carbohydrates, or with bacterial overgrowth in the small intestine. Increased intestinal gas production may cause distension, bloating, audible bowel sounds (borborygmi), painful colic, and embarrassment at the noise and smell of wind passed.
- Dietary modifications or the use of an alternative laxative usually alleviate symptoms.
- Physical exercise, which aids the passage of flatus, should be encouraged.
- Abdominal massage may help frail and bedbound patients.
- Activated charcoal can reduce both the amount of flatus passed and the odor.
- Antispasmodic anticholinergic drugs are useful in the treatment of intestinal colic.
- Patients with small bowel bacterial overgrowth are treated with antibiotics.
Woodruff R. Palliative medicine evidence-based symptomatic and supportive care for patients with advanced cancer. 4th ed. Oxford University Press, 2004. p. 257.