|
Volume CXXXIII, Number 6 |
 |
Smelly? Watch the fructose
JEFF BENSON, M.D.
DUDLEY COE HEALTH CENTER
Dear Dr. Jeff: This is really embarassing, but you ARE a doctor. I've always had a lot of problems with gas. Recently, it's gotten worse, and it's starting to drive my roommates crazy! Any recommendations?-F.B.G.
Dear F.B.G.: A certain amount of gas, whether passed from above or below, is as natural as it often seems unavoidable.
Intestinal gas comes from two source: air that we swallow when we eat or drink and gas formed as a chemical by-product by the intestinal bacteria which help us digest our food. In fact, each of us processes up to nine or ten liters of intestinal gas every day!
Intestinal gas consists mainly of hydrogen and methane. Most of it is absorbed into our blood stream and breathed out in unobtrusively small amounts throughout the day. Some, however, collects in our large intestine, and... well, you know the result!
Excessive gas is commonly due to excesses of certain foods (beans are the classic example), alcohol, smoking, or stress. Eating fast, not adequately chewing your food, eating hard candies and chewing gum all lead to swallowing too much air. So does drinking a lot of carbonated beverages. Some people find that dairy products cause gas. For others, whole grains, broccoli, cabbage, or onions have the same effect.
Many intestinal disorders can cause excessive flatulence. Intestinal infections (like giardia), irritable bowel syndromes, inflammatory bowel diseases (like Crohn's), food allergies, and lactose intolerance are just a few examples.
It turns out that fructose intolerance may be responsible for at least some "unexplained" flatulenece and bloating. Fructose is a natural sugar abundant in honey and such fruits as apples, peaches, pears, and oranges.
It is also the key ingredient in "high-fructose corn syrup," the commercial sweetener added in enormous quantities to juices, sodas, snack foods, desserts, and pretty much all processed food and drink. A recent study in the American Journal of Gastroenterology suggested that many people have trouble absorbing fructose, at least quickly, or especially in large volumes or concentrations. Whatever fructose we don't absorb in our small intestine reaches our large intestine. There it is fermented by bacteria. Fermentation produces large amounts of hydrogen and methane gas, causing distention, cramps, and flatulence.
All of us are at least somewhat fructose intolerant. The trick is to avoid consuming fructose-rich foods in large volume over a short period of time. Avoiding over-sized portions and processed foods and drinks can be very helpful. If you're trying to eat more fruits and vegetables (which you should!), build up your diet gradually. Rapid increases in fiber- and fructose-rich foods may cause problems.
You can always try one of the over-the-counter products containing simethicone (an absorbent), like Gas-X or Digel. Beano works pretty well for beans and legumes (but so does soaking and rinsing them before cooking). Health food stores carry activated charcoal capsules, which might prove helpful.
Good luck, F.B.G.!
Jeff Benson, M.D.
Dudley Coe Health Center
|
FastCounter by bCentral |