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Greys Anatomy Farting Episode – It’s True!

Recently, the colorectal cancer community received a ‘nod’ from the widely popular ABC show Grey’s Anatomy. In the episode a young woman who’d survived cancer struggled to control her flatulence and bowel movements – many recaps over the past few weeks have even referred to her as “The Farter.”

jim-waller-colorectal-surgeon

Dr. James Waller, colorectal cancer surgeon

It’s raised many questions within the community – namely, is this true? Do you pass gas a lot more once you’ve had colorectal surgery?

To firm this up, we asked Dr. James Waller, a colorectal surgeon from Evansville, Indiana to talk to us about farting. Dr. Waller provides young adult survivors at The Colon Club with answers to some of these obscure questions on a frequent basis. This week he’s jumped in to help the entire community understand “What is Farting.”

What Is Farting & Why Do Some Survivors Fart MORE?!

by Dr. James Waller

What is farting, passing gas, flatulence? I think we all know! But, why does this happen? And what is normal?

Good question, and one that has an interesting answer.

Passing Gas is Normal

Since we all do it, passing gas is a normal biological process. There is always gas in the intestinal tract.

This comes from air and gasses that we swallow. This can occur with the unnoticed swallowing that we all do throughout the day, as well as with meals. Obviously, carbonated beverages release a large amount of gas into the GI tract. But a large amount of the gas is produced in the colon.

The waste which reaches the colon after we have digested our food is still rich in nutrients which can be used by the bacteria in our colon. It is entirely normal, and in fact healthy, to have a large volume of bacteria in the colon.

A substantial percentage of the weight of the stool consists of normal, healthy bacteria! It is fermentation of the nutrients in the stool that produces a large amount of the gas we pass. And yes, some of it is flammable! (Thus another reason to prep for a colonoscopy; it eliminates the risk for explosion if electrical cautery is used!)

Knowing about this fermentation process explains the variability in the amount of gas passed from day to day, and from person to person.

Certain Foods Cause More Gas

BroccoliWe all know that certain foods cause more gas. Beans, mushrooms, broccoli to name a few. This is because some foods contain nutrients, such as complex carbohydrates, that are not absorbed in the small intestine. The colonic bacteria have a feast with these molecules…and produce a lot of gas!

This can also occur with some sweeteners such as sugar alcohols, or in the case of people who are lactose intolerant. The bottom line, anything that disturbs the normal balance may lead to excessive gas and even diarrhea.

 

Why Surgical Removal of the Colon Can Create Gas

This explains why surgical removal of portions of the colon can cause significant issues for patients. The same can occur with antibiotic use, which will reduce and alter the normal bacterial environment.

Surgical patients are often bothered by excessive gas and changes in the frequency of bowel movements for two reasons.

The most obvious relates to loss of part of the colon or rectum. The other is a result of changes in the bacteria. This can occur for several reasons including the antibiotic use associated with surgery.

The colon is responsible for fluid resorption from the stool, as well as storage until time to have a bowel movement. Loss of some of the colon will impact this function, especially with removal of the right colon, where the bulk of water resorption occurs.

Combine loss of fluid resorption with alterations of sensation associated with rectal surgeries, and the complex relationship with changes in the bacterial content, and what you have is a complex problem of bloating, cramping, excess foul smelling gas, and urgency!

Luckily, the body has an amazing ability to adapt over time. But many patients are left with rather disabling symptoms, despite dietary and medical management.

What To Do If You Experience Excessive Gas

If you experience excessive gas, or frequent loose stools, talk to your doctor. A physician must take into account a detailed medical, surgical and dietary history, as there can be a number of causes.

The cause of excessive gas may be difficult to determine why, but medical teams may be able to give tips on reducing the gas or at least propose some trial-and-error solutions to identify why you may be experiencing excess gas.

Although it’s uncomfortable, it’s not life-threatening.

Dr. Waller is a board-certified colorectal surgeon who practices in Evansville, Indiana. Dr. Waller is a fellow of the American College of Surgeons and the American Society of Colon and Rectal Surgeons. He is a member of the American Medical Association, Ferguson Surgical Society, Indiana State Medical Society, Ohio Valley Society of Colon and Rectal Surgeons, Vanderburgh County Medical Society and United Ostomy Association, Inc.

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