Gas – Everyone has it, no matter how small or big we are. We eliminate it by burping or passing it on the other end. Passing gas 14 to 23 times a day is normal for both adults and children. Even though it is entirely natural and unavoidable, it can be embarrassing. Furthermore, when gas does not pass easily, pain often results…upset stomach, bloating and cramping.
Children are particularly susceptible to discomfort caused by gas as their delicate digestive systems develop and learn to move gas through their digestive tracts effectively. Understanding causes, ways to reduce symptoms and treatment will help most find relief. If a child has persistently painful or extreme gassiness, it should be brought to the attention of your doctor, as it could be the sign of a more serious medical problem.
Causes of Gas
Gas in the digestive tract (that is, the esophagus, stomach, small intestine, and large intestine) comes from two main sources:
Normal breakdown of undigested foods
The first common source of gas is intake through the mouth. Air swallowing (aerophagia) is the common cause of air in the stomach. Everyone swallows small amounts of air when eating and drinking, and talking while eating. However, eating or drinking rapidly causes even more air intake. Eating more slowly, in as relaxed a manner as possible (as hard as that may be for children!) and, chewing the food better can significantly reduce the amount of swallowed air. For older children, it’s also helpful to avoid chewing gum and sucking on hard candy.
Crying also introduces more air into the stomach. A certain amount of crying is normal in all children as an important part of communication. Crying is simply how babies communicate a need. Toddlers’ crying may also indicate that they are hungry, lonely, warm, cold, uncomfortable or in need of a diaper change. Or crying could just be a mood as they learn to cope with emotions. Many toddlers go through periods of crying for no apparent reason, as they simply get used to the world. Crying in general causes children to gulp air into their digestive systems. These air bubbles can get trapped in their stomach and/or passed on to the intestine. Gas pain can also be a direct result of air swallowed during crying.
Teething often results in crying and, therefore, more air intake into the stomach. Gums are often sore and the extra saliva production during teething contains enzymes which cause upset stomach. All of this usually results in more crying, which can make children gassier and more irritable, and so the cycle continues.
Symptoms in the Upper Gastrointestinal Tract Caused by Swallowed Air
Burping and Hiccups
The way most swallowed air – which contains nitrogen, oxygen and carbon dioxide – leaves the stomach is through burping or belching. Swallowed air can also result in hiccups. Hiccups occur when the diaphragm, a dome-shaped muscle at the bottom of the chest, becomes irritated. Some things that irritate the diaphragm are eating too quickly or too much, an irritation in the stomach or the throat, or feeling nervous or excited. Usually, hiccups last only a few minutes. Some cases of the hiccups can last for days or weeks, but this is very unusual and it’s usually a sign of another medical problem.
If a child hiccups or burps while eating, it may indicate that too much air is being swallowed during feeding. Again, eating more slowly and calmly (avoid gulping), and chewing well should reduce air intake and aid digestion. Avoid the use of straws, too. All of this will prevent too much gas from entering the digestive system and creating these symptoms or symptoms in the lower digestive tract, because when gas does remain in the stomach, it moves on into the small intestine, where it is only partially absorbed. The rest travels into the large intestine, where it may cause other painful symptoms like cramping and bloating, before being released through the rectum.
Bloating and Upset Stomach
Gas has buoyancy and gas pockets can become trapped in the upper and lower intestines. The gas acts like a cork, impeding or halting the flow of gastric juices and causing pressure to be built up. This pressure causes painful bloating and swelling of the abdomen. When gas pockets form in the stomach, this can cause the stomach to distend, causing discomfort or pain.
Gas build-up in the stomach can also create pressure that results in stomach contents coming back up the esophagus, commonly known as “reflux.” Children can have reflux at any age, though it is more common in infants under 1 year. Reflux can be very painful, as many adults also know firsthand. Often, it comes as a burning feeling in the chest or stomach, which may wake children at night while they are in a horizontal position. If a child is obese, there is a greater chance of reflux occurring, due to the change in the dynamics of the esophageal muscle. Reflux can also be triggered by foods. Common culprits include fatty fast foods, spicy foods, citrus foods, peppermint, chocolate, caffeine, and eating large meals or too close to bedtime.
Symptoms in the Lower Gastrointestinal Tract Caused by Gas during the Breakdown of Undigested Foods
Complex carbohydrates (the sugar, starches and fiber found in many foods) and cellulose are not normally digested in the upper gastrointestinal tract because of a shortage or absence of certain enzymes in the human body. The undigested food then passes from the small intestine to the large intestine, where normal, harmless bacteria break down the food, producing hydrogen, carbon dioxide, and in some people, methane. Trace gases, like hydrogen sulfide, are responsible for the characteristic, unpleasant odor. The amounts of these gases largely depend on the bacteria that live in the colon and digest, or ferment, food that has not been absorbed by the gastrointestinal (GI) tract prior to reaching the colon. The amount of undigested food that reaches the colon in the form of carbohydrate can vary with diet and how well one’s GI tract is functioning.
While gas is a normal by-product of digestion, it may cause bloating and pain, though not everyone has these symptoms. Discomfort can depend on how much gas the body makes and how sensitive a person is to the gas produced in the large intestine.
Make Dietary Changes
Changing what you eat and drink can help prevent or relieve gas. Most foods that contain carbohydrates can cause gas. A starch is a complex carbohydrate, and the more complex a carbohydrate, the higher its propensity for causing gas. Potatoes, corn, wheat and most other starches are broken down mostly in the large intestine, where they usually produce plenty of gas. In contrast, fats and proteins cause little gas (though certain proteins may intensify gas odor). Foods that are commonly known to produce gas can have the same effect in children as they do in adults. They can even be passed from breast-feeding mother to infant. Cutting down on foods that cause gas may make a big difference, though the amount of gas caused by certain foods may vary from person to person. Again, it all depends on the amount and types of bacteria each person has in the large intestine. Gas-producing foods may not need to be eliminated entirely, unless one has food intolerance (or food sensitivity). Sometimes, eating smaller amounts will help to reduce flatulence. Trial and error is often the best way to determine one’s own limits.
As you look at the following list of foods commonly known to contribute to gas, bloating and flatulence, you will notice that many are “good for you” – they offer significant nutritional benefit. That is why it is important to accurately identify which foods present a problem in producing gas and accompanying symptoms, so that you don’t restrict foods that do not.
The Tummy Calm Gas Journal can help you accomplish this. Use it to help pinpoint foods/drinks that seem to cause digestive discomfort. (Log potential gas-producing offenders and amounts. Also keep track of the number of times your child passes gas). It can be helpful to share with your doctor, to help answer questions about eating habits and symptoms.
Gas-producing foods usually contain certain sugars (fructose, lactose, raffinose and sorbitol) and/or soluble fiber. Because these substances are not digested in the stomach, they make their way down to the intestines where bacteria break them down. The end result of this process is the release of gas in the intestines.
Here is a list of foods commonly known to cause gas:
1. Vegetables and Legumes – The following vegetables have made their way onto this list because they contain raffinose and/or fructose: artichokes, asparagus, beans, broccoli, brussels sprouts, cabbage, carrots, cauliflower, celery, cucumbers, lentils, onions, peas, potatoes, radishes, green peppers, turnips.Hint: If you cook with dry beans, soak them in water overnight, then pour off the water and cook the soaked beans in fresh water. This may reduce the amount of natural sugars in the beans after the cooling process and help prevent gas and bloating.
2. Fruits – Especially fruits that contain fructose, sorbitol and/or soluble fiber: apples, apricots, bananas, oranges, peaches, pears, prunes, raisins.
3. Dairy Products – Contain lactose (milk sugar). Even if you have not been diagnosed with lactose intolerance, you may find that eating dairy products results in gas: milk, cheese, ice cream, processed foods containing milk products (many breads, cereals and salad dressings, for example).Hint: If you do have lactose intolerance, lactase enzyme supplements, such as Dairy Ease and LactAid, can be taken with dairy products to help break down lactose in food.
4. Certain Whole Grains – Although whole grains are quite healthy for you, some of them contain soluble fiber and/or raffinose, which can contribute to excess gas: barley, flax seed, oat bran, wheat.
5. Snack Foods – Read the labels of sugar-free candies and gums to ensure that they don’t contain sorbitol. Nuts and seeds (like sunflower and poppy seeds) are often a good source of soluble fiber and thus may be problematic in producing gas.
6. Drinks – Certain beverages may contain fructose, sorbitol and/or carbonation, all of which can contribute to intestinal gas: sodas and other carbonated drinks, fruit drinks, fruit juices.