Everyone has gas. This is normal. But not everyone has excessive gas… gas that is painful, gas that smells like you ate old eggs, and gas that makes you look 9 months pregnant. If this is happening to you, as they like to say at NASA, ‘Houston, we have a problem.’
Typically, gas is nonspecific. And because of this, most people will hear from their GI doctor to 1) do nothing, 2) take an acid-blocker, or 3) try the FODMAP (which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet. Tip number 3 actually can be useful for some people, but only because it is helping the underlying cause, not because you have a FODMAP allergy. So the takeaway here is – we need to find the cause. And typically you don’t have to dig to far to find it.
Let’s dive into possible causes of gas and bloating, and then explore how we would test, and then treat.
1) Hydrochloric Acid -HCL- (aka, Stomach acid) Deficiency
In a country where people eat antacids like candy, it’s no wonder that a large part of the American population has stomach acid deficiency. We need stomach acid to help to prevent our bacteria and yeast from overgrowing in our intestines, and to kill possible pathogens and parasites. Without healthy levels of acid, these are free to overgrow, and release more and more hydrogen and methane. Not good! Causes of acid deficiency include, but are not limited to: overuse of acid-blockers, overuse of antibiotics, and an inflammatory diet composed of low fiber and processed foods.
2) SIBO (Small Intestinal Bowel Overgrowth)
This is where a plethora of bacteria have made it’s way into your small intestine, where they should not be, and are replicating themselves much to their delight. Unfortunately not to yours. Symptoms of SIBO include gas, bloating, acid reflux, constipation, diarrhea, fatigue, and abdominal pain. Why is this happening, you might ask? For starters, see #1. Many times SIBO is a result of long-term dysfunction in the gut, which could have begun with a processed diet, or beginning acid-blockers. Luckily there is a way to treat it, and begin to heal the gut. A common diet recommendation for SIBO is the FODMAP diet, which can be helpful while you are undergoing treatment.
3) Parasitic infection
Believe it or not, this is more common than you might think. Many people who live in cities think they are immune to catching a parasite, but this is so not true. Because we do a comprehensive look at stool, common parasites such as blastocystis, giardia and tapeworms are often found, and are in addition to an overgrowth of bacteria. Parasites can be difficult to find, so using a lab which also screens for parasitic DNA is helpful.
4) Fungal Overgrowth in Intestines
Yeast and bacteria typically coexist in the intestines, but due to many of the same factors that cause HCL deficiency and Leaky Gut, they become imbalanced.Yeast love to feed on the high sugar and processed carbs found in a typical American diet. Like bacterial overgrowth, fungal/yeast overgrowth can release toxins which damage the gut. In addition to gas and bloating, people also experience symptoms of fatigue, constipation or diarrhea, brain fog, difficulty concentrating, skin issues, and at its worse, neurological symptoms.
5) Food Allergy
Often people are familiar with the foods that will cause them trouble, and know to avoid them when company is present. Ha! Although sometimes the symptoms will appear 48-72 hours later after the offending food group was ingested, known as a delayed hypersensitivity response. If this happens, it can make it difficult to pin down the food that was the issue. The most common foods that cause issues tend to be: gluten, dairy, corn, soy, egg, citrus and nuts. Luckily testing can be done to help narrow down the offending food.
Luckily there are comprehensive digestive tests that can be done to identify and narrow down bacterial, fungal, parasitic and food allergy contributors to gas and bloating. One that we order often is the Genova Labs GI Effects Comprehensive Stool panel. Food allergy testing can be done through elimination and challenge, or via blood or stool. Testing for HCL deficiency is typically done with an HCL challenge test. This can be tricky for those who are on acid-blockers, as we want to work on healing the gut first, before introducing acid. Please come see us for guidance or your local functional medicine or naturopathic medicine provider.
Treatment typically goes in two stages: 1) begin to heal the gut, and 2) find and treat the cause.
Gentle healing can begin with a soothing blend of GI herbs, such as a combination of DGL, Slippery Elm, Aloe vera, and Marshmallow. These herbs help to create a healing mucous barrier in which the intestinal cells can pull from to begin healing themselves. L-glutamine is also a gentle amino-acid that the intestinal cells can eat to begin repair. Many people begin with probiotics, but this can be tricky. If you have SIBO, this can be like putting gas on a fire. If your gas and bloating feel worse with probiotics, please stop and consult your provider. We also really love the healing of the gut with good, organic food. Organic bone and veggie broth can be healing and soothing, and a great addition to a whole foods, unprocessed diet.
The takeaway here is that while ‘having gas’ may seem simple and benign, there can be many underlying contributors that can affect your long-term health.
For a personalized approach to your health, we would love to see you! Please visit www.sagemedclinic.com for more information or to schedule a visit with one of our holistic, integrative physicians.
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