By Garth A. Rattray
I had reason to travel abroad a few weeks ago, but as soon as we buckled up, someone 'bombed' the plane. So traumatic was the experience that I hurriedly penned a short poem on the matter.
At first I didn't realise it,
because it happened very fast
But the effect was devastating,
and it certainly did last
It blew up and down and
and then between my seat
It sent all my senses reeling,
from my head down to my feet
There was no way to escape it,
we were all trapped inside
The craft was encapsulated,
there was nowhere to hide
This cruel individual
must have had a very bad day.
To unleash such a conflagration
on us all, innocent prey
I saw my Saviour smiling,
this world I might depart
I feared my life was ending,
because of that terrible fart
When I eventually recovered from that silent but deadly expulsion of nitrogen, carbon dioxide, oxygen, methane, and smelly hydrogen sulphide, I thought about how many Jamaicans know very little about bowel gas.
They don't know how it gets there and what makes it troublesome for some. People blame it for pain in diverse places and some even blame 'gas' for their missing menses and concomitantly expanding lower abdomen.
I always have a hard time trying to explain to some patients that it is impossible for gas to travel to the head, neck, limbs or anywhere outside the gastrointestinal tract.
Some patients insist on demonstrating gas by rubbing the offending body part - like a shoulder, knee, wrist or ankle - before letting out a loud guttural or trumpeting, sometimes attenuated, crescendo or decrescendo belch. This is usually followed by a satisfied look of relief and perhaps a heaving sigh segueing into a relaxed slump.
Convinced that they have proven their point, they then ask that I rid them of the gas in their knee, for instance, which is obviously the source of their pain and discomfort.
But, if one looks closely at the victim riddled with gas, just before expelling the offending substance from their mouths, some patients take in a sharp gulp of air. This is aerophagia - the swallowing of air (of which the patient is often unaware).
Swallowed air contributes to gas within the bowels. Some gas is belched out, some is absorbed, but some goes on to be expelled through the anus.
Diet and composition
The amount of gas formed within us depends on our diet and composition of our personal resident colonic bacteria. They ferment unabsorbed food residues from undigested starches and sugars.
Among the gas-producing things in our diet are: cauliflower, broccoli, Brussels sprouts, beans, peas, cabbage, onions, celery, carrots, milk products, eggs, cucumber, raisins, bananas, prunes, dried fruit, foods high in bran, and green salads. It's not that these are bad for us; it's just that we should expect a lot of gas from them.
Gas retained at the start of the small intestine (jejunum) causes tightening of the bowel muscles there and produces more symptoms than gas retained at the end of the large intestine (rectum), where it causes relaxation of the bowel muscles there. Some people are gas retainers - they have inherent motility problems.
Gas is not dangerous. However, excessive and/or smelly flatulence can be reduced by minimising gas-producing products, dedicating time to eating/drinking, and emptying the bowels of faeces. If that fails, individuals may want to seek medical advice.
Garth A. Rattray is a medical doctor with a family practice. Email feedback to firstname.lastname@example.org and email@example.com.