You should first realize that some flatulence is normal. It is a result of swallowing air, especially if you eat or drink quickly. Another cause of gas in the intestines is the digestive process which relies on bacteria to break down food residues.  Some foods produce more intestinal gas than others.  Medicines that cause constipation can make gas more frequent or painful. And as with many things, stress can exacerbate painful gas/bloating.

Recognizing that you are swallowing air is the first step in controlling the habit of swallowing air. Chew your food longer and sip fluids slowly. Try to avoid frequent sighing and chewing gum.

A change in diet can also help you have less intestinal gas. Try to eat a more varied diet and avoid foods that cause flatulence. These foods vary from person to person, but the following foods commonly produce gas in many people:

• dairy products (except yogurt)
• some vegetables, especially brown beans, cauliflower, peas, Brussels sprouts, broccoli, and cabbage. Mushrooms and onions are a problem for some people.
• bran and whole grains
• fruits like pears, apples, and peaches
• carbonated beverages, sparkling drinks, and beer
• dried fruits
• sugar substitutes in sugar-free foods and candies; for example, sorbitol

A change in eating habits and diet usually takes care of most gas problems. Many nonprescription medicines are available to help reduce symptoms such as antacids with simethicone.

If you felt left in suspense from last week's diarrhea article, you may have experienced increased stress just waiting for this week's diagnosis: Irritable Bowel Syndrome (or IBS).  IBS is a disorder in which the intestine overreacts to a variety of signals, such as food, hormonal changes, stress and medications.  This can lead to spasm or stretching of the intestine and enhanced sensitivity of the nerves, causing a person to have abdominal pain, diarrhea and/or constipation, bloating/gas, or any combination of these symptoms. It is a common, non-life-threatening illness. To have Irritable Bowel Syndrome, symptoms must be present for at least 12 weeks, not necessarily consecutively, within the past 12 months.

Buzz words for IBS include:

• Abdominal pain relieved with defecation or passing gas
• Pain onset associated with change in stool frequency
• Pain onset associated with change in stool form or appearance

Other supporting criteria include:

• Abnormal stool frequency
• Abnormal stool form (lumpy or hard, loose or watery)
• Abnormal stool passage (straining, urgency)
• Bloating or feeling distention

What can you do if you suspect IBS?  See your health care provider to eliminate the possibility of serious disorders.  Your provider might suggest you first keep a record of what food/activities trigger your symptoms.  In medicine we don't actually say that there is a "cure" for IBS but there are several ways to "manage" IBS.  See your health care provider for suggestions or use one of the following resources;

International Foundation for Functional Gastrointestinal Disorders - www.iffgd.org
The American College of Gastroenterology - www.acg.gi.org

Don't succumb to medical students' syndrome that is, identifying with whichever disorder we are studying this week.  Many people have intermittent fluctuations in bowel habits over time.  To really have a syndrome (a constellation of symptoms,) signs should occur over a prolonged time period.