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Medical Author:

Joseph Maslar, MD

Coauthor:

Lance W Kreplick, MD, MMM

Medical Editor:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Flatulence is most often related to diet, and sometimes to those habits that cause a person to swallow air. Begin by trying to remove problem foods from the diet. For many people, this is a trial-and-error procedure.

• This may take careful observation to notice what foods cause increased gas. Keep a food diary and note excess passage of gas. Any of the gas-producing foods can be removed from the diet one group at a time until the person experiences relief. Sorbitol and fructose are common offenders, so try these first.
• If this method does not work, a more restrictive approach is to start with a very limited number of safe foods, and add one new food every 48 hours in order to determine what food or food group causes difficulty. If the offending food is found, then the affected person can avoid eating that food or be prepared for its consequences.
• If lactose intolerance is suspected to cause the problem, remove all dairy foods from the diet for 10-14 days to assess the effect on flatulence (using a diary). The enzyme lactase, which aids with lactose digestion, is available in liquid and tablet form without a prescription (Lactaid, Lactrase, Dairy Ease). Adding a few drops of liquid lactase to milk before drinking it or chewing lactase tablets just before eating helps digest foods that contain lactose. Also, lactose-reduced milk and other products are available at many grocery stores (Lactaid, Dairy Ease).
• If odor is a concern, there is also some reported success with charcoal filter undergarments.
• If belching is a problem, avoid the behaviors that cause the affected person to swallow air, such as chewing gum or eating hard candy. Eat slowly. Make sure dentures fit properly.
• In general, avoid overeating because this contributes to flatulence as well as obesity. Limit high-fat foods to reduce bloating and discomfort. The stomach will empty faster, allowing gases to move into the small intestine.

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