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Flatulence is defined in the medical literature as "flatus expelled through the anus" or the "quality or state of being flatulent",[1] which is defined in turn as "marked by or affected with gases generated in the intestine or stomach; likely to cause digestive flatulence".[2] The root of these words is from the Latin flatus – "a blowing, a breaking wind".[3] Flatus is also the medical word for gas generated in the stomach or bowels.[4] Despite these standard definitions, a proportion of intestinal gas may be swallowed environmental air, and hence flatus is not totally generated in the stomach or bowels. The scientific study of this area of medicine is termed flatology.[5]

Flatus is brought to the rectum and pressurized by muscles in the intestines. It is normal to pass flatus, though volume and frequency vary greatly among individuals. It is also normal for intestinal gas to have a feculent odor, which may be intense. The noise commonly associated with flatulence ("blowing a raspberry") is produced by the anus and buttocks, which act together in a manner similar to that of an embouchure. Both the sound and the smell are sources of embarrassment, annoyance or comedy.

There are five general symptoms related to intestinal gas: pain, bloating and abdominal distension, excessive flatus volume, excessive flatus smell and gas incontinence. Furthermore, eructation ("an act or instance of belching", colloquially known as "burping") is sometimes included under the topic of flatulence.[6] When excessive or malodorous, flatus can be a sign of a health disorder, such as irritable bowel syndrome, celiac disease or lactose intolerance.[7

Non-medical definitions of the term include "the uncomfortable condition of having gas in the stomach and bowels", or "a state of excessive gas in the alimentary canal". These definitions highlight that many people consider "bloating", abdominal distension or increased volume of intestinal gas, to be synonymous with the term flatulence (although this is technically inaccurate). Colloquially, flatulence may be referred to as "farting", "trumping",[8] "blowing off", "tooting", "pooting", "passing gas", "breaking wind" or simply (in American English) "gas" or (British English) "wind". Derived terms include vaginal flatulence, otherwise known as a queef.

Bloating and pain
Patients may complain of bloating as abdominal distension, discomfort and pain from "trapped wind". In the past, functional bowel disorders such as irritable bowel syndrome that produced symptoms of bloating were attributed to increased production of intestinal gas. However, three significant pieces of evidence refute this theory. First, in normal subjects, even very high rates of gas infusion into the small intestine (30 mL/min) is tolerated without complaints of pain or bloating and harmlessly passed as flatus per rectum.[9] Secondly, studies aiming to quantify the total volume of gas produced by patients with irritable bowel syndrome (some including gas emitted from the mouth by eructation) have consistently failed to demonstrate increased volumes compared to healthy subjects. The proportion of hydrogen produced may be increased in some patients with irritable bowel syndrome, but this does not affect the total volume.[10] Thirdly, the volume of flatus produced by patients with irritable bowel syndrome who have pain and abdominal distension would be tolerated in normal subjects without any complaints of pain.

Patients who complain of bloating frequently can be shown to have objective increases in abdominal girth, often increased throughout the day and then resolving during sleep. The increase in girth combined with the fact that the total volume of flatus is not increased led to studies aiming to image the distribution of intestinal gas in patients with bloating. They found that gas was not distributed normally in these patients: there was segmental gas pooling and focal distension.[9] In conclusion, abdominal distension, pain and bloating symptoms are the result of abnormal intestinal gas dynamics rather than increased flatus production.

Excessive volume
As mentioned above, the normal range of volumes of flatus in normal individuals varies hugely (476–1,491 mL/24 h).[5] All intestinal gas is either swallowed environmental air, present intrinsically in foods and beverages, or the result of gut fermentation. Swallowing small amounts of air occurs while eating and drinking. This is emitted from the mouth by eructation (burping) and is normal. Excessive swallowing of environmental air is called aerophagia, and has been shown in a few case reports to be responsible for increased flatus volume. This is, however, considered a rare cause of increased flatus volume. Gases contained in food and beverages are likewise emitted largely through eructation, e.g., carbonated beverages. Endogenously produced intestinal gases make up 74 percent of flatus in normal subjects. The volume of gas produced is partially dependent upon the composition of the intestinal microbiota, which is normally very resistant to change, but is also very different in different individuals. Some patients are predisposed to increased endogenous gas production by virtue of their gut microbiota composition.[9] The greatest concentration of gut bacteria is in the colon, while the small intestine is normally nearly sterile. Fermentation occurs when unabsorbed food residues may arrive in the colon. Therefore, even more than the composition of the microbiota, diet is the primary factor that dictates the volume of flatus produced.[9] Diets that aim to reduce the amount of undigested fermentable food residues arriving in the colon have been shown to significantly reduce the volume of flatus produced. Again, increased volume of intestinal gas will not cause bloating and pain in normal subjects. Abnormal intestinal gas dynamics will create pain, distension, and bloating, regardless of whether there is high or low total flatus volume.

example:

Smell
Although flatus possesses physiological smell, this may be abnormally increased in some patients and cause social distress to the patient. Increased smell of flatus presents a distinct clinical issue from other complaints related to intestinal gas.[11] Some patients may exhibit over-sensitivity to bad flatus smell, and in extreme forms, olfactory reference syndrome may be diagnosed.

Incontinence of flatus
"Gas incontinence" could be defined as loss of voluntary control over the passage of flatus. It is a recognised subtype of faecal incontinence, and is usually related to minor disruptions of the continence mechanisms. Some consider gas incontinence to be the first, sometimes only, symptom of faecal incontinence.[12]

[Endertub3]

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[poobum]

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[Sirsploit]

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