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Q: Excessive gas 5 months after lap.cholecystectomy (kevinmd-ga) ( Answered,   0 Comments )
Subject: Excessive gas 5 months after lap.cholecystectomy (kevinmd-ga)
Category: Health > Conditions and Diseases
Asked by: d_pen-ga
List Price: $20.00
Posted: 07 Jun 2003 00:11 PDT
Expires: 07 Jul 2003 00:11 PDT
Question ID: 214275
I am an Indian working in Hong Kong. I had laproscopic cholecystecomy
done in Dec 2002. From the time I recovered till date (Jun 03) I am
facing the following problems
1) Excessive gas that does not get easily expelled and moves about in
the abdomen.
2) Urgency to defecate (atleast 2 times a day)
3) Irregular consistency of stools (very small pieces)

Following questions
1) What can I do to reduce gas? Keeping control of oil in my diet is
not easy as I am travelling very often and cant eat home cooked food.
2) Is there any over the counter medication for gas that will
effectively neutralise the problem and doesnt have side effects?
3) Can I go to the gym and do strenuous abdominal excercises to reduce
my abdomen flab?

Subject: Re: Excessive gas 5 months after lap.cholecystectomy (kevinmd-ga)
Answered By: kevinmd-ga on 07 Jun 2003 05:37 PDT
Hello - thanks for asking your question.      
Although I am an internal medicine physician, please see your primary
care physician for specific questions regarding any individual cases –
please do not use Google Answers as a substitute for medical advice. 
I will be happy to answer factual medical questions. 

To answer your questions:

1) There are several conditions that are associated with increased
intestinal gas.  One of the most common examples is a disorder known
as irritable bowel syndrome (IBS). Its cardinal symptoms are abdominal
pain and altered bowel habits, but these symptoms have no identifiable
cause. Many patients also complain of visible abdominal distension
although they do not have increased amounts of gas in the intestine.
Many researchers believe that some of the symptoms of IBS may be
caused by heightened sensitivity of the intestines to normal events
that occur within them.

A second condition is known as dyspepsia.  Dyspepsia describes
recurrent or persistent pain or discomfort that is primarily located
in the upper abdomen.  Dyspepsia can arise from various underlying
conditions. However, the most common type of dyspepsia seen by
physicians is known as "functional" (or "nonulcer") dyspepsia. This
refers to dyspepsia that occurs without an identifiable cause. People
with functional dyspepsia tend to have increased sensitivity to
distension in the upper intestines.

Certain foods are associated with increased gas.  Those that contain
the carbohydrate raffinose, which is poorly digested, leads to gas
production by the action of colonic bacteria. Common foods containing
raffinose include beans, cabbage, cauliflower, Brussels sprouts,
broccoli, and asparagus.

Lactose intolerance is caused by an impaired ability to digest
lactose, the principle sugar in dairy products. Clinical symptoms of
lactose intolerance include diarrhea, abdominal pain, and flatulence
after ingestion of milk or milk-containing products.

Finally, carbohydrate malabsorption can occur in patients with celiac
disease (a disease caused by intolerance to a protein contained in
wheat) and short bowel syndrome are other disease associated with
increased gas.

As for the next step, I would suggest an evaluation by your personal
physician.  The solution may be simply to modify your diet (i.e.
eliminating lactose or raffinose-containing foods).  If that doesn't
help, you may want to consider further testing such as endoscopy,
testing of your stool for fecal fat (suggesting of malabsorption),
testing for lactose or other carbohydrate malabsorption, or blood
tests for celiac disease.

2) Over-the-counter products that contain simethicone, such as certain
antacids (e.g. Maalox Anti-Gas, Mylanta Gas, Gas-X, Phazyme),
activated charcoal (e.g. Charcocaps, CharcoAid) or Beano (an
over-the-counter preparation that contains an enzyme involved in
metabolizing certain complex carbohydrates) are all used to help
reduce the amount of intestinal gas.

3) There should be no reason that the intestinal gas should preclude
you from performing abdominal exercises.  You may want to note that
posture affects where the gas goes.  An upright position tends to lead
gas through the mouth, a lying position leads gas through the

This answer is not intended as and does not substitute for medical  
advice - the information presented is for patient education only. 
Please see your personal physician for further evaluation of your 
individual case.       
Please use any answer clarification before rating this answer. I will
be happy to explain or expand on any issue you may have.             
Kevin, M.D.     

Search strategy: 
No internet search engine was used in this answer.  All sources are 
from physician-written and peer-reviewed sources.   

Goldfinger.  Patient information: Gas and Bloating.  UptoDate, 2003.

NIDDK - Why do I have gas?

American Gastroenterological Association - Gas in the digestive tract
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