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Understanding flatulence is a common question. Where does it come from? And which are the best probiotics for flatulence? If you have ever wondered about this, read on to find out.
Flatulence is a normal by-product of the human digestive process. Gases include methane (CH₃), hydrogen (H₂), hydrogen sulphide (H₂S) and carbon dioxide (CO₂). These are released via the anus, because of bacterial fermentation in the large intestine.1 Fermentation is the microbiome at work, hence gas being normal! This produces short chain fatty acids which fuel our gut cells. Powerhouses of digestion, SCFA’s are anti-inflammatory and help to move food through the colon. The type of fermentation will influence the smell. Normally if it is smelly, this is the digestion of a protein. If it doesn’t, then it will be a carbohydrate. However, people with low stomach acid may find proteins particularly hard to digest. This is because stomach acid is needed to trigger enzymes to break down proteins. Incomplete digestion of protein can cause a more potent smell.
Excessive flatulence can come hand-in-hand with bloating as a result of various causes. It could be as simple as gulping too much air whilst you eat! Or it might require further medical investigations to identify food intolerances such as coeliac disease or even SIBO2,3. Healthcare professionals can read more about SIBO on the Probiotics Professionals site in this article: Probiotics and Small Intestinal Bacterial Overgrowth (SIBO).
As we age, metabolism slows down and there is a lesser need for food. We need enough hydrochloric acid in the stomach to digest our food. But elderly people will naturally produce less stomach acid. Signs & symptoms of low stomach acid vary from reflux, to bloating and gas. It can even lead to Vitamin B12 deficiency, particularly in the elderly.4
Could excessive flatulence be more common in the elderly?
Unfortunately, due to this natural decline in stomach acidity a lot of people suffer from acid reflux later in life. A common way to manage acid reflux is PPI medication (proton pump inhibitors). PPI’s can help reduce unpleasant symptoms when acid reflux is present in the elderly. However, long-term use may lead to consequences such as low magnesium or acid rebound.5 This is when the stomach temporarily excretes excess acid. Another potential negative impact of PPI medication is that they may reduce the number of good gut bacteria in the microbiome, which could lead to an overgrowth of ‘bad’ gas-causing bacteria, hence the increase in flatulence in the elderly.
Low stomach acidity in the elderly can also lead to SIBO.6 This is when bacteria start to grow in the wrong place of the digestive system. A study tested for SIBO in 98 people with IBS and excessive flatulence. The results showed SIBO could be more common in older women with IBS.7 This shows one of the reasons that excess flatulence is present in older people.
Research suggests that the elderly may have less diversity of bacteria in the microbiome. Bifidobacteria, an important beneficial bacteria, has been shown to be reduced in the elderly8. The decrease in this bacteria is associated with increased inflammation9, and even bacterial overgrowth. Many factors such as antibiotics, living conditions, diet and country affect diversity. These will all play a part in a balanced gut flora and ultimately, a lowered diversity leads to a higher chance of experiencing digestive issues such as flatulence.
Most probiotics may be able to help with flatulence. This is because probiotics improve the balance of good bacteria in the gut, outcompeting bad gas-producing bacteria. However, there are specific strains of probiotics for flatulence that have been researched which may provide a more targeted effect.
One study assessed the strain Bifidobacterium lactis HN019 in 88 adults over 14 days. Administration of the higher dose of this strain showed a decrease in flatulence by 45%.10 Bifidobacterium lactis HN019 strain has been shown to improve constipation which is associated with flatulence.
The strain Bifidobacterium lactis BB-12 is considered one of the most clinically researched. It demonstrates significant improvements in constipation as shown in one of the largest clinical trials conducted on a strain of live bacteria. Tested in over 1,200 participants with constipation across several countries in Europe. Over a 4-week trial, Bifidobacterium lactis BB-12 at a strength of 1 billion CFU every day, showed the biggest improvement in constipation.11 This strain is also particularly effective in regulating constipation in the elderly.12 This strain may help to improve flatulence if constipation is associated.
Another strain Bifidobacterium infantis 35624 has shown positive effects in symptoms of gas. A large study involving 362 participants with IBS divided into four groups were given different amounts of Bifidobacterium infantis 35624. At the end of the four-week treatment phase, the dosage of one hundred million CFU lowered flatulence. It also helped bloating, abdominal discomfort and overall IBS symptoms.13
Flatulence can also be a symptom of lactose intolerance.14 Probiotics can enhance lactose digestion by enhancing the activity of the enzyme beta-galactosidase. This is a protein necessary to consume lactose. Specific probiotic strains Lactobaccilus acidophilus Rosell-52 and Lactobaccilus rhamnosus Rosell-11 were tested together and improved tolerance to lactose.15 Both strains Bifidobacterium longum16 and Lactobacillus acidophilus NCFM17 also improve the ingestion of lactose, hence improving symptoms like flatulence.
Probiotics can certainly help with flatulence and excessive gas. The best probiotics for flatulence have been researched and shown to alleviate not only flatulence but a diverse range of digestive symptoms.
We are often asked, ‘can probiotics cause gas?’ Some people may fear that taking a probiotic could make gas worse. It is more likely for a prebiotic to cause gas in sensitive individuals. However, taking a probiotic supplement may cause increased flatulence initially in some people. Like with anything new that is introduced to the body, there is a period of adaptation. These symptoms have been shown to subside within a few days.18 The extent of an initial response may be determined by significant dysbiosis or in conditions like IBS.
Sadly, if our gut is out of balance, there are many foods that can cause us to experience flatulence. Foods that contain fructooligosaccharides (FOS) are known to have this affect in some people. FOS are undigestible carbohydrates that feed our friendly bacteria, however, they can be a double edged sword for some!19 Foods containing FOS include:
In addition, beans, lentils, nuts and seeds contain a type of protein called lectins. These proteins resist breaking down in the gut, which can cause gas production.20 You can reduce the risk of gas by soaking them, which helps to break them down outside of the gut first! You could do this first by cooking your beans and pulses for several hours. Dried fruit and oats may be troublesome for some, due to the high fibre content. However, these are considered on the normal side if you experience gas.
Some people may be more or less sensitive to these foods. Conditions like IBS or SIBO can result in an increased sensitivity. These people may think about working with a qualified healthcare provider to explore a low FODMAP diet or similar. You can read more about this in our article: Natural remedies for IBS.
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