HEALTH AND MEDICAL PRODUCTS:ANTIFLA TULENCE AGENTS.

ANTIFLA TULENCE AGENTS

Many individuals throughout human history have expressed complaints related to gastrointestinal gas. The most common symptoms of gas are belching, abdominal bloating, abdominal pain, and flatulence. Flatulence is the condition of possessing excessive stomach or intestinal gas. It is a physiological excretory phenomenon caused by the production of gas by bacteria within the colon of the large intestine. The gas is subsequently released from the rectum through the action of abdominal muscles, often resulting in discomfort and social embarrassment for the individual.

Gases are produced by chemical and bacterial or fungal activities in the intestines. The primary components of gas (known as flatus) are odorless gases: including carbon dioxide, hydrogen, methane, and oxygen. The proportions of these gases depend largely on the species of bacteria that reside in the human colon that digest, or ferment, food that has not been absorbed by the gastrointestinal tract through normal digestive processes before reaching the colon. The presence of hydrogen and methane gases contributes to the flammable characteristic of flatus. The characteristic “rotten egg” or ammonia-based odor of flatus may be attributed to the presence of trace gases such as skatole, indole, volatile fatty acids, and sulfur-containing compounds (e.g., hydrogen sulfide ammonia). This is usually the result of putrefaction whereby bacteria have caused proteins to disintegrate.

Compared with foods that contain carbohydrates, foods that contain fats and proteins cause little gas. An estimated 30 to 150 grams of undigested food in the form of carbohydrate may enter the colon of an individual daily. The human body does not easily digest and absorb some types of carbohydrates (e.g., sugars, starches, and fiber) in the small intestine because of a shortage or lack of particular digestive enzymes. Thus, the undigested food passes into the large intestine, where harmless and normal bacteria and fungi break down the food, producing undesirable flatus. During the process of fermentation, yeast fungus (e.g., Candida) within the colon may degrade the carbohydrate, producing alcohol

and a copious amount of gas. Certain types of foods that may elicit this response include broccoli, cabbage, brussel sprouts, beans/legumes, cauliflower, onions, prunes, corn, wheat, dark beer, red wine, complex carbohydrates such as potatoes and noodles, and sugars such as sorbitol (a sweetener found in sugar-free products), lactose (milk sugar), fructose (fruit sugar), and raffinose (legume, vegetable, and whole grain sugar). While the presence of excess intestinal gas may be attributable to simply eating quickly and swallowing excess air, other physiological conditions that may lead to excessive flatulence include lactose intolerance, constipation, poor dietary insoluble fiber intake, parasites, inflammatory bowel disease, intestinal obstruction (e.g., cancerous tumor), diverticulitis, hypothyroidism, and narcotic/drug use.

While dietary modification may be beneficial for some individuals, over-the-counter oral medications for flatulence treatment are often cho- sen, which may include simethicone or digestive enzyme supplements. Although activated charcoal or peppermint spirits are also useful in treat- ing flatulence, they are not well tolerated by many individuals. Simethi- cone, a simple methoxylated siloxane, is a commonly used antiflatulent. This drug acts on the surface of gas bubbles within the intestine, reduces the surface tension, and thereby disrupts (breaks) the bubble film sur- face, allowing air to escape in the form of belching or passing flatus. This mechanism is accomplished through the action of bridging the liquid film by polydimethylsiloxane droplets, assisted by hydrophobic silica particles also present in this antifoaming, antiflatulence agent.

Antiflatulence digestive enzyme supplements include products con- taining the enzyme a-galactosidase. This naturally occurring enzyme hy- drolyzes the galacto-oligosaccharide sugars (e.g., raffinose, stachyose, and/ or verbascose) found in a variety of products ingested by individuals with a high-fiber diet, including grains, cereal, nuts, seeds, soy products, le- gumes, and vegetables. Thus, unlike simethicone, these types of antiflatulence products actually prevent the production of gas resulting from the ingestion of certain foods before the bacterial fermentation of these foods within the intestine.