There can be nothing as embarrassing as gas. It gurgles and squelches through the intestines during pauses in conversations, sometimes squeaking like a rusty door and sometimes roaring like an express train in a tunnel. It gets trapped by spasms causing pain and such gross bloating and distension that you can look as if you’ve acquired a five month pregnancy within the space of half an hour. It can rise up in the mouth and be expelled with a cavernous belch but worst of all, it can escape downwards, silent and deadly at five paces or with a flutter or toot that instantly advertises your shame.


Gassy and other gastrointestinal symptoms are a taboo subject. A survey conducted in 2007 by Tickbox for Yakult revealed that 48% of women (compared to 32% of men) felt too embarrassed to talk to their GP about them. But what is so embarrassing about our guts?  Are they the vulnerable underbelly that we cannot control?  Do our bowels represent the dark, dirty aspects of ourselves that we can’t talk about.  Our guts have a hot line to the emotions.  They are supplied by sympathetic and parasympathetic nerves that translate what happens to us into bodily feelings.  Gut reactions are part of our emotional language.  ‘I can’t stomach this.  He doesn’t have the guts for it.  It gives me the shits.’ 


They can also reveal how people feel about their life situations.  Jane developed faecal incontinence when her teenage daughter became pregnant, repeating the shame of her own narrative, Chris’s rumbling tummy betrayed the guilt of his secret love affair.  And Stephanie was only able to go after she had left her husband.             


But such shameful symptoms might also suggest something wrong with the gut. All intestinal diseases can be associated with alterations in bowel habit and many with increased flatulence. As Dr Paul Cann, consultant gastroenterologist at the James Cook Hospital in Middlesborough said, ‘Bloating or farting can be caused by conditions that impair intestinal absorption, such as coeliac or pancreatic disease.  The pseudonymous, Mr Sutalf, claimed to be the world’s most flatulent patient by expert flatologist, Dr Michael D. Levitt, was scientifically recorded to fart 144 times in a single hour, generating enough gas to launch a weather balloon.  He had lactase deficiency and was easily treated by reducing his milk intake.    


Diet could well be the problem. Many fruits and vegetables contain sugars or starches that defy digestion in the small intestine but are fermented in the colon releasing gas.  The flatulent properties of beans were immortalized in the Hollywood movie, Blazing Saddles, but bananas, apples, pears, reheated potatoes, cereal fibre and Jerusalem artichokes are also very gassy. Unfortunately they are all components of a ‘healthy’ high-fibre diet. The art of medicine is balance. If it’s the offensive odour rather than the volume of gas that is the problem, cutting down the amount of meat in the diet can help.  


There is no simple solution to embarrassment.  All too often, shameful symptoms indicate a bowel that has been wrenched out of kilter by circumstance.  Relaxation, hypnotherapy and other complementary therapies can help restore emotional balance.  Psychotherapy might address the meaning of the symptom – guilt, shame, disapproval, anger or attention seeking, for example.  But the indiscretion might lie with the diet or the symptom might just indicate an undiscovered gut disease.  Gas leaks can be dangerous whatever the cause, so ‘swallow’ your pride and talk to your doctor about them! 

This article was published in The Times this morning. ,