Flatulence (Passing Gas)

What is it?

Flatulence is passing gas or passing wind. Everyone passes gas a number of times each day. When you are getting cancer treatment you may have an increase in the amount or frequency of gas passed. There are a number of reasons why this may happen:

• Constipation or diarrhea may cause an increase in how much gas your body is making. Some cancers, stress, many medications, and radiation therapy can cause gas, constipation, and diarrhea.
• Chemotherapy medicines can change the speed of digestion, either speeding it up or slowing it down. Even when these changes do not cause constipation or diarrhea, they may cause an increase in how much gas is made. Chemotherapy may also change the bacteria that are present in your digestive system, increasing the production of intestinal gas.
• Other medications that can increase intestinal gas are antacids, antibiotics, nutritional supplements, and non-steroidal anti-inflammatory pain relievers (NSAIDS).

Passing gas is normal, but too much gas can be embarrassing or uncomfortable. It can cause cramping, pain or bloating. Often, the excess gas will resolve when treatment ends. 

How can I manage gas?

Each person’s body can react differently to foods. You may want to start a food diary to write down what you eat each day, how your body reacts to those foods, and how you are feeling. You may be able to determine which foods cause you more gas than others. Activities that may help you control excess gas:

• Exercise can help manage constipation and help with digestion, especially after eating a large meal. Examples of exercise are walking, swimming or gardening.
• Eating smaller meals more often and eating at the same time each day can decrease gas. Spicy and fatty foods can increase gas so it can be best to avoid them. 
• Eat slowly, don’t drink while eating, and don’t talk while eating. This can help minimize the amount of air swallowed when eating. 
• Don't use a straw when drinking and avoid caffeinated (coffee and tea) or carbonated drinks (soda, beer, seltzer water). You should also avoid chewing gum as it can increase the amount of air swallowed. 
• Artificial sweeteners (erythritol, mannitol, sorbitol, and xylitol), found in some gums and sugar-free or low sugar foods, may increase intestinal gas. Limit the use of artificial sweeteners. 
• Limit alcohol and smoking as these can interfere with digestion.
• Gas producing foods you may want to avoid include:
  • Onions, celery, carrots, broccoli, brussels sprouts, cucumbers, cabbage, cauliflower, leeks, radishes, parsnips, green salad, and garlic. 
  • Bananas, apricots, prunes, and dried fruit. 
  • Bagels, wheat germ, pretzels, bran cereal, and brown rice. 
  • Peas and beans. 
  • Sugar alcohols, carbonated drinks, caffeinated drinks, and chewing gum. 
  • Dairy products such as milk, yogurt, and cheese. 
• Moderate gas producing foods include potatoes, eggplant, citrus fruits, apples, pastries, and breads.
• Foods that do not produce excess gas:
  • Meat, poultry, fish, and nuts.
  • Lettuce, peppers, avocado, tomato, asparagus, zucchini, okra, and olives. 
  • Cantaloupe, grapes, and berries.
  • White rice, chips, popcorn, graham crackers, fruit ice, and gelatin. 
  • Eggs.  

When should I contact my care team?

There are over the counter medications, such as simethicone, that can be used to help manage gas. Ask your provider which one is right for you. If intestinal gas is causing you cramping, bloating or pain, or you are having other digestive symptoms, such as new onset of constipation, "pencil-shaped" stools or blood in stool, contact your care provider.