The link between flatulence and ageing

Key points:

• Medications, decreased production of stomach acids and a weakened digestive system can serve as contributing factors to an increased rate of flatulence in people as they age

• Estimates for how often a healthy person expels gas can range from five to 15 or more times per day

• Signs of increased flatulence which cannot be attributed to medications, age, diet or frailty may signify an underlying health condition

As people age, they may experience incontinence or routine pharmacological interventions which induce flatulence. People may be led to believe the basic human need to pass ‘gas,’ is, in fact, unnatural or shameful, due to cultural attitudes regarding custodial humour. However, studies have shown that bloating and gas are not only natural, but need to be dealt with.

What causes flatulence?

Diet

What a person eats will affect how the gastrointestinal system responds, independent of conditions such as irritable bowel syndrome [IBS] or Crohn’s disease.

People who have a diet which is stocked with unhealthy foods, such as fried or carbohydrate and sodium-heavy meals may experience gas and bloating at a higher rate than people who opt for the healthier alternative. In particular, pre-packaged and processed foods tend to contain a lot of sodium or monosodium glutamate [MSG], which retain water. When a person’s body retains water, it prevents the natural disposal of waste — with flatus a symptom of anal incontinence in instances of both constipation and leakage.

Products primarily fermented by lactic acid bacteria, including yoghurt, sausages, cheese, sauerkraut and kimchi can introduce good bacteria to offset inflammation and bloating — commonly known as ‘probiotics.’ However, people who are lactose intolerant may find that dairy products induce rather than reduce flatus.

Those who eat quickly may also be at risk of developing flatus or bloating through consuming air as they dine, much like when a person chews gum. ‘Aerophagia,’ as it is known, can lead to burping and bloating along with gastrointestinal discomfort — possible causes of which can include depression, anxiety, stress and smoking.

Age and gender

Dr Elizabeth Ko and Dr Eve Glazier addressed the topic of age and its relation to flatulence in an University of California, Los Angeles [UCLA] Health article, published mid-2022. The Internal Medicine experts responded to a submission from a man in his 80s, after he had expressed concerns that his increased flatus was not related to his diet.

The response stated that changes — related to ageing — to the digestive process, which include a decrease in the production of stomach acid, can cause familiar foods to gradually become problematic.

“Motility, which is the rate at which food moves through the digestive tract, slows as well,” the physicians shared.

“This can lead to a build-up of gases in the bowel and put additional pressure on the anal sphincters […] The anal sphincters can become thinner and weaker as we age and may no longer be able to prevent gas from spontaneously escaping. Some medications can also contribute to flatulence.”

In addition to age, specific factors related to women — such as hormonal changes during menstruation and physical tears related to childbirth were cited as notable modifiers for flatus incontinence — which is the inability to control when gases are expelled.

When is flatus incontinence an issue?

Many would not consider flatus incontinence to be as life-altering as other conditions which are prevalent in older populations, but a person’s dignity, pride and identity should not be undermined, particularly after a lifetime of hard work.

Older people may feel that their ability to make decisions or the level of respect they have received has diminished over the course of their seniority, so drawing attention to a potentially embarrassing and unmanageable condition may hurt.

However, flatus incontinence may be a sign of something more than simply ageing, including:

• Constipation
• Faecal incontinence
• Coeliac disease
• Small intestinal bacterial overgrowth
• Irritable bowel syndrome
• Inflammatory bowel disease
• Crohn’s disease
• Stress
• Anxiety disorder — ie. post traumatic stress disorder [PTSD], generalised anxiety disorder [GAD], specific phobia or obsessive-compulsive disorder [OCD}
• Haemorrhoids
• Anal fissure
• Food poisoning

If you or someone you care for have concerns over their gut health and its consequences, please visit a local medical professional for a routine check-up.

Related content:

The importance of elderly nutrition

Hydration for elderly people and the dangers of dehydration

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