


                +----------------------------------------------+
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                |   Don't turn up your nose at rectal flatus   |
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                +----------------------------------------------+


                    The Gazette, Sunday, December 5, 1993, page B-6
                    Dr. Gifford-Jones column


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             Why would anyone spend time studying rectal flatus ?  Hell
             would have to freeze over before this research would win the
             Nobel prize for medicine. But none of us should turn up our
             nose at this unique study. Or get careless at a Christmas
             party.


             Dr. Albert Tangerman is a Dutch gastroenterologist at the
             University Hospital Nijmegen.


             Tangerman persuaded six adults to collect their flatus. I
             must admit, I would have relished being a fly on the wall
             watching this experiment.


             The subjects were asked to follow their regular diets. Then
             as they felt the need to pass flatus their task began. But I
             doubt that any of them said to friends, "Pardon me while I
             go and collect my flatus !"


             How did they proceed ?  Tangerman provided each person with
             a 60-milliliter syringe. They were advised to press this
             tightly against the anus during the passage of gas. The
             syringe was then sealed securely for later examination by
             gas chromatology.


             So what makes the odor ?  Tangerman detected four volatile
             sulfur compounds in the flatus emissions:  hydrogen sulfide
             (H2S), methanethiol (MT), dimethylsulfide (DMS) and
             dimethyldisulfide (DMDS).


             It's been a popular assumption that H2S was the offensive
             ingredient of flatus. But this was found in only 75 per
             cent of emissions and DMDS in 25 per cent, while MT and DMS
             were present in all emissions.


             Tangerman concluded that MT and DMS were responsible for the


                                                                   1... /3








             odor. Their threshold odor concentrations were well above
             the other gases.



             Penetrating odor
             ----------------

             But why does rectal flatus have such a penetrating odor ?
             Tangerman says, "of all compounds known in the world, these
             smell most at the lowest concentrations."


             Tangerman discovered another sulfur compound (propanethiol)
             after one subject consumed Greek food. Propanethiol has an
             extremely pungent and repulsive odor and may be due to the
             onions in the Greek food.


             This research is hardly suitable for dinner-table
             conversation. But just in case Trivial Pursuit enthusiasts
             are looking for interesting facts here are some additional
             particulars:


             Flatus can reach mind-boggling amounts in patients who
             cannot metabolize lactose, the sugar present in cow's milk.
             One man suffering from this condition deserves to be in the
             Guinness Book of Records. He had 141 rectal emissions in
             four hours after drinking two liters of milk !  I fervently
             hope he wasn't attending a dinner party.


             Here's another piece of trivia you might not know:  rectal
             gas is potentially explosive. One patient was undergoing
             sigmoidoscopic examination for removal of a polyp in the
             large bowel. When the base of the polyp was cauterized to
             control bleeding the collection of gas in the bowel caused
             an explosion.


             The result was a 15-centimeter tear in the patient's
             intestine. The doctor was blown across the room and the
             patient's head struck the table. The patient had ignored the
             doctor's advice to take an enema before the procedure which
             would have reduced these gases to safer concentrations.


             Can holding on to flatus cause any harm to the bowel ?  I
             never thought so until I read an article written by
             Dr. Wynne-Jones, a New Zealand physician.






                                                                   2... /3








             Increased pressure
             ------------------

             Wynne-Jones claims we should all pass gas whenever
             necessary. He claims that holding on to flatus results in
             small herniations (diverticulosis) in the large bowel due to
             increased pressure. He may be right. But I assume he's not a
             popular dinner guest in New Zealand.


             So what can we do to decrease the chance of being the most
             uninvited person in town ?  Some old-fashioned advice is
             still sound. Avoid baked beans. They contain several sugars
             that can't be broken down by enzymes. The result ?  Baked
             beans increase flatus by up to 10 times the normal amount.


             Corn, cauliflower, onions, brussel sprouts, cabbage and
             prune juice are also labelled as "flatogenic". Don't drink
             milk if you lack the enzyme needed to digest lactose. If
             that's the case substitute yogurt which contains the enzyme.


             A few years ago a computer search could not find one
             effective drug that would control flatus. One final tidbit:
             never forget that some flatus is so powerful that it can be
             detected by smell in levels as low as one part in a million.


             So practice restraint during this holiday season.




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