Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet

Conclusions Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.[1]

Significance of this study

What is already known on this subject?

• Some patients specifically complain of excessive evacuation of gas per anus.
• Intestinal gas content depends by-and-large on gas production by bacterial fermentation of unabsorbed substrates.
• Diet influences anal gas evacuation and gut microbial composition.
• A proportion of patients complaining of flatulence have increased number of gas evacuations, but the net volume of gas evacuated is within the normal range.
• Flatulence is associated with abdominal symptoms.
• Patients’ microbiota present dysbiotic traits and characteristically respond with instability in microbial composition when consuming a flatulogenic diet.
• A number of gut bacterial taxa correlate with anal gas evacuations and volume of gas evacuated.
• Diet influences flatulence, abdominal symptoms, digestive comfort and stability of the gut microbial ecosystem in patients complaining of flatulence.
• Microbial biomarkers may predict symptoms associated with flatulence.

What are the new findings?

• A proportion of patients complaining of flatulence have increased number of gas evacuations, but the net volume of gas evacuated is within the normal range.
• Flatulence is associated with abdominal symptoms.
• Patients’ microbiota present dysbiotic traits and characteristically respond with instability in microbial composition when consuming a flatulogenic diet.
• A number of gut bacterial taxa correlate with anal gas evacuations and volume of gas evacuated.

How might it impact on clinical practice in the foreseeable future?

• Diet influences flatulence, abdominal symptoms, digestive comfort and stability of the gut microbial ecosystem in patients complaining of flatulence.
• Microbial biomarkers may predict symptoms associated with flatulence.

Comment

A flatulogenic diet! That should be a conversation starter, but of more interest is the recognition of a dysbiotic state contributing to inappropriate methane and associated flatulence, and this may account for some of the gas reactivity to oligo fructose foods.

Colonic microflora metabolise oligfructose and utilise it for food and mucin production, yet some people find it hard to maintain intake and record distension and discomfort, as such modifying composition of bacteria may rely on competitively inhibiting Bilophila wadsworthia and Bacteroides fragilis through the ingestion of competing commensal organisms, or a different fork of fibre, such as stewed apples.

Reference