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Out of gas?

GU0001

A "scientific and social breakthrough!" announces the label. "Ends the discomfort and social embarrassment which come from eating beans, chili, cauliflower, chick peas, soy foods, and many others."

Meet Beano, the "Gas Preventer. " For years, researchers have tried-and failed-to find a drug, food, or diet that would curb patients' flatulence. Now the company that developed Lact-aid, which cuts down on the gas caused by milk, is going after the gas caused by other foods. The question is: Does Beano-or anything else-work?

It's rarely what you'd call a life-threatening condition.

True, during the late-1960s research on gas was a (minor) national priority because of concern that it could cause explosions during long-term space flights. And it's also true that the unfortunate patient having his or her intestinal polyps cauterized with a spark-emitting instrument has occasionally produced just enough gas to cause a "frightening blast."(1)

But for most people, gas is a problem because it causes (sometimes painful) bloating and (often mortifying) odors. "Why does it always seem to happen in a crowded elevator?" sighs one sufferer who (not surprisingly) asked to remain anonymous.

Alas, years of research on gas have generated an abundance of fascinating facts ... and a dearth of effective treatments.

ONE IN A BILLION

Scientists know quite a bit about flatulence, considering what it takes to, for starters, measure one's output. (Suffice it to say that a collecting tube is involved.) "You have to have a fairly motivated patient," concedes John Bond, Jr. of the VA Medical Center in Minneapolis. Here are some key findings:

* Everyone has gas. The average person generates 1 to 3 pints a day. But some people produce a lot more than others. For example, in 1979 a medical journal reported a Follow-Up of a Flatulent Patient," identified only as 30-year-old L.O. Sutalf (get it?), who passed flatus (now do you get it?) an average of 34 times a day (we don't know his volume).(2) The average for most 30-year-olds is only 14 times.

* Most gas is odorless. Though proportions vary from person to person, gas is largely composed of hydrogen, nitrogen, and carbon dioxide, with a touch of oxygen. In addition, a third of the adult population produces copious quantities of methane, while the rest emits little or none. Although early reports suggested that methane-makers had a higher risk of colon cancer, that theory has been disproved.

* Less than one percent of gas smells. But boy, does it ever. Researchers at Utah's Salt Lake VA Medical Center recently determined that, contrary to popular opinion, it's not the skatoles and indoles, but several sulfur-containing compounds, that are primarily responsible for fecal odor.(3)

Unfortunately, the human nose can detect hydrogen sulfide in concentrations as low as one-half part per billion. That's like (pardon the analogy) one sheet of toilet paper in a roll stretching more than five times around the earth.

* Certain foods are gassier than others. Small studies have shown that people produce more gas after eating beans, Brussels sprouts, raisins, apple juice, and prune juice.(4-6) But few foods have been tested and people vary

Take our friend L.O. Sutalf, who meticulously recorded each major passage of gas (he excluded those of less than 7 milliliters, which he termed "squeakers"). Surprisingly, he included broccoli and cauliflower, which have a gassy reputation, in his list of "normo-flatugenic foods," a group he defined as producing no more than 19 passages of gas per day.

Bagels, on the other hand, were among his "extremely flatugenic foods" (more than 40 passages per day). So don't assume that what's gassy for others is gassy for you.

* Carbohydrates are largely to blame. At least when you're talking volume. Most gas is the result of sugars, starches, and fiber that reach the large intestine without being digested or absorbed. Once in the bowel, your resident colonies of harmless bacteria eat them, giving off as byproducts hydrogen, carbon dioxide, and, in some people, methane.

One of the most common sources of gas is lactose, a sugar that occurs naturally in milk products. Many people don't have the enzyme (lactase) to digest lactose. Another source is soluble fiber, like the pectins in fruits and the beta-glucans in oat bran.

Recently, researchers have shown that gas-producing bacteria feed off small amounts of starch that escape digestion by enzymes in the stomach and small intestine.(7,8) So far, wheat, oats, potatoes, and corn-virtually every starchy food except rice-have been implicated. "Even seemingly innocuous foods like plain bread and pasta made of white flour can do it," says the VA Medical Center's John Bond.

The fourth-and most infamous-source of gas is the family of raffinose sugars found (in large amounts) in beans and (in much smaller amounts) in many vegetables and grains. No one has the enzyme (alpha-galactosidase) to break them down. When they hit the large intestine, our bacteria have a feast.

That's where Beano comes in. it's liquid drops of the alpha-galactosidase that you add to the first bite of an offending food."

EMISSION CONTROLS

Beano is raising hopes because, frankly, there isn't much else that works.

None of the drugs tested so far is effective. Researchers have tried, among others, simethicone (which breaks up the gas bubbles-great, but the gas is still there), prokinetic agents like metoclopromide (to move things through the gut quicker), activated charcoal (to which the gas is supposed to "stick"), antibiotics (to kill off the gasproducing bacteria), and carminatives like peppermint oil (to induce belching).(9)

So far, they've come up with a big zero. "I try to get patients off medications," says W Grant Thompson of the University of Ottawa School of Medicine, adding that "some drugs, such as metoclopromide, can cause nervous-system abnormalities."

The only treatment that does work is an elimination diet. The trouble is: It isn't easy to do.

Take L.O. Sutalf. This dedicated patient started by fasting (except for water) for entire days. He then introduced one food at a time, keeping careful records of his output over the next 24 hours (see chart).

Once he identified a dozen or so minimal gas producers," he ate those foods for breakfast and dinner. Lunch consisted of the test-food-of-the-day in quantities of at least three times the amount normally eaten at a meal."(2)

Sutalf's productivity eventually dropped to normal. But it took two years of assiduous effort. "The only treatment that always works and the only thing that ever works is an elimination diet," says researcher Bond.

Of course, his comments don't include Beano.

CATCH THAT SULFUR

Bond couldn't comment on Beano because its effectiveness hasn't been fully tested.

Despite the fact that Beano's label is already claiming that it "prevents the gas from beans ... and cabbage, peas, broccoli, eggplant, soy and many others," only two studies have been completed (but not yet published). Four others are being planned at Johns Hopkins, McGill University, New York Medical College, and UCLA.

"The anecdotal response has been overwhelming," says Alan Kligerman, CEO of AkPharma, Beano's manufacturer. "We've never seen anything like this." But he's the first to admit that anecdotes are not proof.

And while those studies should shed some light on Beano's capabilities, they'll probably still leave some questions unanswered. For example, Beano may affect the volume, but not the odor, of gas. By breaking down the raffinose sugars in foods, Beano should theoretically turn off (or at least tone down) those gas-producing devils in your bowels. That should reduce the bloating and distension that trouble many gas-sufferers.

But sugars may have little to do with gas's distinctive fragrance. I think undigested protein is contributing the odiferous compounds," says Sharon Fleming of the University of California at Berkeley. And that's an area no one has pursued, she adds.

"We actually began to look at odor, but ran into sufficient analytical problems that we had to stop," says Fleming. "The sulfur-containing compounds adsorb onto and absorb into so many things that trapping and analyzing them is difficult."

Not to mention unpleasant.

AkPharma hadn't planned to test Beano's effect on odor, but Kligerman says he's willing to consider it.

A THOUSAND POINTS OF LIGHT?

Until more studies are done, you can test Beano yourself. (Call AkPharma at 800-257-8650 weekdays from 8:30 am to 5:30 pm Eastern Time for a free sample.) Here are some other tips:

* If you have trouble digesting milk, try a lactose-reduced brand. (We'll elaborate in an upcoming issue.)

* Cook your beans thoroughly. It makes their starches and proteins more digestible. Discard the liquid the beans are soaked, cooked, or canned in; it's loaded with raffinose sugars. n Some people have excess gas because they swallow too much air. Gum-chewers take note.

* If your pet has "problems" of his or her own, call AkPharma for a sample of its Beano-for-pets, "Curtail," which, according to company literature, is "for those dreadful moments in the living room when you don't know whether to look at each other or the dog."

If all else fails, light a match (no kidding). it creates ozone that dissipates the unwanted odors by oxidizing them.

And there's always the last-gasp approach: Hang around with people who eat the same foods you do.
(1) N. Eng. J. Med. 302: 1474,1980.
(2) Dig. Dis. Sci. 24: 652, 1979.
(3) Gastroenterol 93: 1321, 1987.
(4) Am. J Clin. Nutr. 40: 48, 1984.
(5) Gastroenterol 12: 782, 1949.
(6) Am. J Dig. Dis. 17: 383, 1972.
(7) Gastroenterol. 80: 1209, 1981.
(8) N. Eng. J Med. 304:891, 198).
(9) Can. Med. Assoc. J. 139: 1137, 1988.
COPYRIGHT 1991 Center for Science in the Public Interest
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:research on flatulence, and new product, Beano, designed to reduce gas
Author:Liebman, Bonnie
Publication:Nutrition Action Healthletter
Date:Mar 1, 1991
Words:1592
Previous Article:Let them eat Entenmann's.
Next Article:Beta-carotene: fluke or fate?
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