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Minimising Flatulence

Roybn Nagel MB BS, FRACP

How do you deal with the patient who presents complaining of excessive flatulence? Here, Dr Nagel outlines her approach to this difficult management problem.

• There is a wide variation in the amount of flatus passed by normal individuals. On average, an adult passes 500ml to 2000ml of gas daily.
  This gas is passed in 50ml to 200ml aliquots, 10 to 20 times a daily.
  Most patients who complain of excessive flatulence are passing quantities of flatus within the normal range.
• Anxiety and irregular bowel habit often contribute to a perception of increased flatulence and/or abdominal bloating and pain. Pathological flatulence needs to be distinguished from physiological wind.
• If excessive flatulence is accompanied by 'alarm' symptoms such as a change in bowel habit, loss of weight, abdominal pain or change in continence then organic pathology is more likely to be found. Lactase deficiency and coeliac disease are common 'windy' conditions in our community.

One in ten people

In the community aged over 40 years suffer incontinence of faeces and/or flatus. This presentation may be an opportunity for the patient to discuss malodour or in continence.