Managing Flatulence During Menopause

When I was in college, I took a year of physiology courses under a professor whose area of research was flatulence. The causes of flatulence, as we learned all too well, are many and complex, but there's usually a treatment for everyone.

If you happened to listen to Dr. Christine Northrup on Oprah on January 17, 2008, you heard a segment on women's relief from perimenopausal symptoms (flatulence, weight gain, and acid reflux, but flatulence in particular) just by eliminating wheat for a week from the daily diet. For some women getting rid of gluten will help, but if it doesn't work for you, there are more natural alternatives that don't require a trip to the doctor or an expensive prescription.

A study published several years ago in the medical journal Women's Health reported that:

• 9% of women aged 40 to 49 experienced constipation requiring use of laxatives, and weight gain accompanying constipation


• 39% of women aged 40 to 49 suffered acid reflux and


• 48% of women aged 40 to 49 reported excessive flatulence.

Unfortunately, these problems don't usually clear up after menopause. Many women experience symptoms that resemble irritable bowel syndrome (IBS) beginning in the perimenopausal years and continuing throughout their lives.

The consequences of celiac disease, a condition of sensitivity to the gluten not just in wheat but also to a lesser extent in barley and rye, are worse in menopause. "Borderline" gluten sensitivity may not show up until menopause. You can of course just leave the wheat out of your diet for a week to see if you get better, but there's also a saliva test for celiac disease available through your doctor. There's even a home test from ELISA technologies or from Genova Diagnostics.

If you're not wheat sensitive, what do you do? First of all, consider dietary implications for IBS-like symptoms such as flatulence and constipation. Bean-O and Lactaid, available in markets everywhere, help if you are sensitive, as most of us are, to beans or dairy products.

A surprisingly frequent cause of flatulence? The South Beach Diet. You don't really need to modify the diet. The methods of dealing with flatulence listed below are enough to assist you to getting to the maintenance phase of the diet when flatulence should not be as problematic.

The favorite remedy for flatulence is over-the-counter Pepto-Bismol. IBS-like symptoms aren't really controlled by Pepto-Bismol, but the "pink" (bismuth salicylate) in the Pepto-Bismol binds hydrogen sulfide so gas isn't smelly. You shouldn't use Pepto-Bismol if you're sensitive to aspirin. If you can't use Pepto-Bismol, an activated charcoal product may be helpful, but ask your pharmacist if you're taking a drug like Zetia for cholesterol or if you are taking Alli to help lose weight. Either product interacts with charcoal.

Other ways to reduce gassiness include:

• Don't drink liquids through a straw (especially carbonated beverages). The extra air comes out as gas.


• Don't chew chewing gums sweetened with sorbitol or xylitol. These sweeteners don't provide calories to you, but they do feed the fermentative bacteria living on your intestinal wall (and especially the bacteria you get from Activia).


• And, if you don't have acid reflux, start a meal with something bitter, the bitterer, the better. Bitter foods trigger a reflex that releases stomach acid to digest food thoroughly.

Men with IBS tend to get diarrhea. Women with IBS and IBS-like disorders tend to get constipation. Here's where avoiding sugar will really help.

When blood sugar levels are even slightly elevated, the central nervous system sends a signal to the gut to release sugars more slowly. The result is constipation.

If you use bran, keep in mind that coarse bran from cereal works better than fine bran in fiber supplements for relieving constipation, but cereals are more likely to aggravate heartburn than fiber supplements. The soluble fiber in fruits and vegetables is better still.

Prunes provide very little fiber, but they act in the gut the same way Milk of Magnesia does, causing the stool to absorb water, making it easier to move.

Exercise relieves constipation, but not a whole lot. Researchers at the University of California at Irvine measured regularity in 8 exercisers who increased their daily workouts on a stationary bike from 1.8 km to 3.0 km (about a mile a day to almost two miles a day). The effect on constipation was measurable, but very slight. A little exercise may relieve a lot of gassiness, however.