Pharmacy Times

FACTS FROM YOUR PHARMACIST: A Handout for Patients: Healthy Diets and Unexpected Gas

Author: Stefanie Ferreri, PharmD, CDE

This patient education is brought to you by the makers of beano food enzyme dietary supplement

Many Americans use dietary changes as part of trying to live a healthy lifestyle. Some people must change their diets to protect their health?for example, people with diabetes or heart disease, or even women undergoing menopause. As a result, many people place a priority on healthy eating and include more complex carbohydrates?such as vegetables, legumes (beans), and whole grains?in every meal.

Effect of Healthy Foods on the Body

Complex carbohydrates are an essential part of a healthy diet. However, 79 million Americans avoid eating these nutritious foods because these foods can lead to uncomfortable and embarrassing digestive distress (gas). Gas in the lower digestive tract, the large intestine, is produced through the normal breakdown of certain foods. The discomfort people feel is based both on how much gas the body produces and on how the large intestine processes gas.

Healthy foods high in complex carbohydrates can cause gas because the body cannot digest and absorb carbohydrates in the small intestine. The undigested food passes to the large intestine, where harmless bacteria break it down. This process produces hydrogen, carbon dioxide, and?in about one third of all people?methane, or gas. The most common symptoms of gas are flatulence, abdominal pain, bloating, and cramping. However, not everyone experiences these symptoms, and not all gas-producing foods cause gas in all people.

The inability to fully digest these healthy complex carbohydrates has recently been identified as a food intolerance called Complex Carbohydrate Intolerance, or CCI. CCI affects millions of Americans and is caused by a shortage of the intestinal enzyme alpha-galactosidase, which helps in the digestion of these healthy foods. Current evidence supports a diet low in saturated fat and high in complex carbohydrates from fruit, vegetables, and whole grains to decrease the risk of hypertension, diabetes, cancer, heart disease, and high cholesterol. In fact, fibers found in complex carbohydrates help to lower cholesterol and insulin levels. Avoiding these foods may actually hurt your dieting and health goals.

The best way to reduce the discomfort of lower gastrointestinal (GI) gas is to take an over-the-counter product to prevent the gas from occurring.

Preventing Gas Before It Starts

Because symptoms of digestive distress are caused by a shortage of an important enzyme in the intestines, replacing this enzyme is the most effective way to prevent the symptoms. To work best, the enzyme, alpha-galactosidase, must be taken just before meals. The only over-the-counter brand that contains this enzyme is Beano. Beano breaks down large sugars, making them easier to digest before they reach the colon. It stops the formation of gas before it starts.

The amount you must take to prevent gas is very important. If you do not take enough, you may not have enough of the enzyme in your digestive system to fully break down the complex sugars. You should take at least 1 tablet or 5 drops of liquid per 1.2-cup serving of gassy food. Because a typical meal consists of about 2 to 3 servings of food, experts recommend that you take 2 to 3 tablets or 10 to 15 drops right before each meal. Some people still experience gas from certain foods, so it may be necessary to increase the dose the next time you eat a particular food.

It is important to take Beano just before the first bite of gas-causing food. If it is taken during or after a meal, some of the gas-causing complex sugars will find their way to the colon before they have had a chance to be broken down. Also, if it is taken too early, the acids in the stomach will destroy the enzyme before it has had a chance to do its job.

Beano is recommended for people 12 years old and older. It can be used by people who are changing their eating habits and including more healthy food?eg, cardiac patients, individuals trying to lose weight, and people previously on low-carbohydrate diets who are introducing more vegetables into their diet.

Reducing Gas Symptoms

Beano helps the digestion of healthy foods to prevent gas in the lower GI tract. Other foods, however, can cause discomfort associated with gas and bloating in the stomach. For people who have stomach gas, many nonprescription products to reduce the symptoms are available. These products contain the active ingredient simethicone, which helps relieve the discomfort or painful pressure and the fullness and bloating many people feel. Simethicone products such as Phazyme act on the surface of the gas bubbles by reducing the tension and thereby disrupting or breaking the bubble. Simethicone allows gas bubbles in the stomach and intestines to come together more easily, which allows for easier passage of gas. It is available in many dosage forms, such as regular tablets, chewable tablets, capsules, and liquid. It is usually taken 4 times a day, after meals and at bedtime.

Additional information on CCI is available at www.preventcci.com.

Dr. Ferreri is a clinical assistant professor at the University of North Carolina at Chapel Hill School of Pharmacy.