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Non-medical definitions of the term include "the uncomfortable condition of having gas in the stomach and bowels", or "a state of excessive gas in the alimentary canal".

These definitions highlight that many people consider "bloating", abdominal distension or increased volume of intestinal gas, to be synonymous with the term flatulence although this is technically inaccurate.

Colloquially, flatulence may be referred to as "farting", "pumping", "trumping", [8] "blowing off", "tooting", "pooting", "passing gas", "breaking wind" or simply in American English "gas" or British English "wind".

Derived terms include vaginal flatulence , otherwise known as a queef. Generally speaking, there are four different types of complaints that relate to intestinal gas, which may present individually or in combination.

Patients may complain of bloating as abdominal distension, discomfort and pain from "trapped wind".

In the past, functional bowel disorders such as irritable bowel syndrome that produced symptoms of bloating were attributed to increased production of intestinal gas.

However, three significant pieces of evidence refute this theory. The proportion of hydrogen produced may be increased in some patients with irritable bowel syndrome, but this does not affect the total volume.

Patients who complain of bloating frequently can be shown to have objective increases in abdominal girth, often increased throughout the day and then resolving during sleep.

The increase in girth combined with the fact that the total volume of flatus is not increased led to studies aiming to image the distribution of intestinal gas in patients with bloating.

They found that gas was not distributed normally in these patients: there was segmental gas pooling and focal distension. Swallowing small amounts of air occurs while eating and drinking.

This is emitted from the mouth by eructation burping and is normal. Excessive swallowing of environmental air is called aerophagia , and has been shown in a few case reports to be responsible for increased flatus volume.

This is, however, considered a rare cause of increased flatus volume. Gases contained in food and beverages are likewise emitted largely through eructation, e.

Endogenously produced intestinal gases make up 74 percent of flatus in normal subjects. The volume of gas produced is partially dependent upon the composition of the intestinal microbiota, which is normally very resistant to change, but is also very different in different individuals.

Some patients are predisposed to increased endogenous gas production by virtue of their gut microbiota composition. Fermentation occurs when unabsorbed food residues may arrive in the colon.

Therefore, even more than the composition of the microbiota, diet is the primary factor that dictates the volume of flatus produced. Again, increased volume of intestinal gas will not cause bloating and pain in normal subjects.

Abnormal intestinal gas dynamics will create pain, distension, and bloating, regardless of whether there is high or low total flatus volume. Although flatus possesses physiological smell, this may be abnormally increased in some patients and cause social distress to the patient.

Increased smell of flatus presents a distinct clinical issue from other complaints related to intestinal gas.

It is a recognised subtype of faecal incontinence , and is usually related to minor disruptions of the continence mechanisms.

Some consider gas incontinence to be the first, sometimes only, symptom of faecal incontinence. Intestinal gas is composed of varying quantities of exogenous sources and endogenous sources.

The endogenous gases are produced either as a by-product of digesting certain types of food, or of incomplete digestion , as is the case during steatorrhea.

Anything that causes food to be incompletely digested by the stomach or small intestine may cause flatulence when the material arrives in the large intestine, due to fermentation by yeast or prokaryotes normally or abnormally present in the gastrointestinal tract.

Flatulence-producing foods are typically high in certain polysaccharides , especially oligosaccharides such as inulin. Those foods include beans , lentils , dairy products , onions , garlic , spring onions , leeks , turnips , swedes , radishes , sweet potatoes , potatoes , cashews , Jerusalem artichokes , oats , wheat , and yeast in breads.

Cauliflower , broccoli , cabbage , Brussels sprouts and other cruciferous vegetables that belong to the genus Brassica are commonly reputed to not only increase flatulence, but to increase the pungency of the flatus.

In beans, endogenous gases seem to arise from complex oligosaccharides carbohydrates that are particularly resistant to digestion by mammals, but are readily digestible by gut flora — microorganisms methane-producing archaea; Methanobrevibacter smithii that inhabit the digestive tract.

These oligosaccharides pass through the upper intestine largely unchanged, and when they reach the lower intestine, bacteria feed on them, producing copious amounts of flatus.

When excessive or malodorous, flatus can be a sign of a health disorder, such as irritable bowel syndrome , celiac disease , non-celiac gluten sensitivity or lactose intolerance.

It can also be caused by certain medicines, such as ibuprofen , laxatives , antifungal medicines or statins. Interest in the causes of flatulence was spurred by high-altitude flight and human spaceflight ; the low atmospheric pressure , confined conditions, and stresses peculiar to those endeavours were cause for concern.

Flatus intestinal gas is mostly produced as a byproduct of bacterial fermentation in the gastrointestinal GI tract, especially the colon.

Nitrogen is not produced in the gut, but a component of environmental air. Patients who have excessive intestinal gas that is mostly composed of nitrogen have aerophagia.

For example, in one study of the faeces of nine adults, only five of the samples contained archaea capable of producing methane. Historically, compounds such as indole , skatole , ammonia and short chain fatty acids were thought to cause the smell of flatus.

More recent evidence proves that the major contribution to the smell of flatus comes from a combination of volatile sulfur compounds.

The benzopyrrole volatiles indole and skatole have a mothball smell, and therefore probably do not contribute greatly to the characteristic smell of flatus.

In one study, hydrogen sulfide concentration was shown to correlate convincingly with perceived bad smell of flatus, followed by methyl mercaptan and dimethyl sulfide.

These results were generated from subjects who were eating a diet high in pinto beans to stimulate flatus production. Others report that methyl mercaptan was the greatest contributor to the smell of flatus in patients not under any specific dietary alterations.

It is therefore likely that the smell of flatus is created by a combination of volatile sulfur compounds, with minimal contribution from non-sulfur volatiles.

Diets high in protein, especially sulfur-containing amino acids, have been demonstrated to significantly increase the smell of flatus.

Normal flatus volume is to mL per 24 hours. Similarly, the number of flatus episodes per day is variable; the normal range is given as 8—20 per day.

This process is thought not to affect solid and liquid intra-lumenal contents. Researchers investigating the role of sensory nerve endings in the anal canal did not find them to be essential for retaining fluids in the anus, and instead speculate that their role may be to distinguish between flatus and faeces, thereby helping detect a need to defecate or to signal the end of defecation.

The sound varies depending on the tightness of the sphincter muscle and velocity of the gas being propelled, as well as other factors, such as water and body fat.

The auditory pitch sound of the flatulence outburst can also be affected by the anal embouchure. Among humans, flatulence occasionally happens accidentally, such as incidentally to coughing or sneezing or during orgasm ; on other occasions, flatulence can be voluntarily elicited by tensing the rectum or "bearing down" on stomach or bowel muscles and subsequently relaxing the anal sphincter, resulting in the expulsion of flatus.

Since problems involving intestinal gas present as different but sometimes combined complaints, the management is cause-related.

While not affecting the production of the gases themselves, surfactants agents that lower surface tension can reduce the disagreeable sensations associated with flatulence, by aiding the dissolution of the gases into liquid and solid faecal matter.

Such preparations do not decrease the total amount of gas generated in or passed from the colon, but make the bubbles larger and thereby allowing them to be passed more easily.

Other drugs including prokinetics , lubiprostone , antibiotics and probiotics are also used to treat bloating in patients with functional bowel disorders such as irritable bowel syndrome, and there is some evidence that these measures may reduce symptoms.

A flexible tube, inserted into the rectum , can be used to collect intestinal gas in a flatus bag. This method is occasionally needed in a hospital setting, when the patient is unable to pass gas normally.

One method of reducing the volume of flatus produced is dietary modification, reducing the amount of fermentable carbohydrates.

This is the theory behind diets such as the low-FODMAP diet low fermentable oligosaccharide, disacharide, monosaccharide and polyols.

Certain spices have been reported to counteract the production of intestinal gas, most notably the closely related cumin , coriander , caraway , fennel and others such as ajwain , turmeric , asafoetida hing , epazote , and kombu kelp a Japanese seaweed.

For example, the fermented bean product miso is less likely to produce as much intestinal gas.

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