Liberation of noxious volatiles per rectum;1 borborygmi are associated with legumes, nonabsorbable carbohydrates–e.g., fruits, vegetables, lactose, wheat, cryptococcal infection, and iron and vitamin E deficiencies; in most subjects, CH4 production is low, but increases dramatically in colorectal cancer, reflecting a change in flora2
1Physicians rarely regard excess flatus rationally; one flatulist with numerous noisy and noisome events NEJM 1976; 295:261 meticulously recorded a production of 35 off-gassings/day–control population, 13 events/day; despite use of antibiotics, simethicone, charcoal, and Lactobacillus acidophilus, the fanfare of the flatteur’s faecal flora continued unabated; gas chromatography revealed: CO2 44%, H2 38%, N2 17%, O2 1.3% and CH4 0.3%, a production that partially responded to lactose elimination 2Flatulographic screening assays are likely to have a lower yield than occult blood testing
World record Bernard Clemmens, London, UK, sustained a toot from his flute for 2 minutes, 42 seconds geocities.com/snowyssilly facts/worldrec1.html
Management A fabis abstinentis–i.e., hold the beans; gastric gas may respond to simethicone, intestinal gas to activated charcoal. Chick-peas, lentils, navy, string and soy beans, which contain indigestible polysaccharides with raffinose, stachyose and verbascose side chains, rendered digestible by soaking in water
Note: H2 and CH4 are explosive gases, and detonation may occur Am J Surg 1952; 84:514 during electrocauterisation or colonoscopic polypectomies, disasters are prevented by using bowel preps containing nonfermentable agents.
Synonyms Farting, flatulation
Reference Western J Med 1986; 145:502