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Having gas problem with severe constipation. What could be the reason behind this?

Answered by
Dr. Charles S Narasi


Practicing since :1962

Answered : 693 Questions

Posted on Wed, 26 Dec 2012 in Digestion and Bowels
Question: XXXXXXX from india, 31 years old as graphic designer (long sitting job)..started having problems with gas and constipation since last 4 year feel bloated within 2 hrs after meal..burps alot (100 times a day) right after eating or drinking water..burping releves abdominal pressure..sometimes feel breathless due to gas..constipation releives with laxatives but mkaes me nauseated after bowel movement..ususally it lasts for 2-3 hrs untill next meal...sometimes even longer..i lost weight (22 kg in 2 years...) LFT, KFT, blood serum b12, thyroid, endoscopy were fine..stool tests were also fine with some acidic nature of stool..recently i got tested for vit d and i was low on that (7.5 ) i took nexium 3 yrs back with alot of other medicines too for around 3-4 month but no relief..i dont know whats wrong...
i have alot of anxiety due to this.
i started excercising even when everyone was telling me not to do by looking at my weakness..but excercise seemed to help a little..i gained 3-4 kg in last 1 yr but gas and all other symptoms are still same
my major confusion is that if m producing alot of acid or less acid..
plz help
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXXX,
I can understand how frustrating it is with the problems
that you have.
Gas that we have comes from two major sources.
Everytime we eat or drink, we swallow air. Also, gas
is produced from fermentation during digestive process.
Especially starches or carbohydrates produce more gas.
You mention acidity problem and belching or burping.
This certainly indicates that you have GERD. This can
exist with or without a Hiatus Hernia, that is a portion
of the stomach sliding up above your diaphragm, the
abdominal muscle that separates the chest and the
You said that you were on Nexium which is a good drug
and prevents damage to the lining of the esphagus from
the acid. This does not control the amount of gas or
make the gas move down the intestinal tract.
I want you to make sure that you don't have lactose
Intolerance. If you are deficient in lactase, the enzyme
that breaks down lactose that is in dairy products and
lots of other snacks like cookies and crackers, you can
have a lot of gas. There is a breath test available to rule
this out.
Other condition is Celiac disease which can cause poor
digestion and cause you to have excess gas. This requires
special blood tests. Ask your doctor if you were tested for this.
If you are in the habit of chewing gum containing Sorbitol, stop
that. Eat your food slowly and don't drink water till after you
finish eating. Limit the use of Beans (Legumes), urad dhal.
chana dhal.
You can start taking a PEG solution (Polyethylene Glycol)
2 tablespoons a day and gradually increase till you start
having watery stools and then cut back the amount. You
can go up or down on the dosage to have normal stools
daily. If you have not had an upper GI x-ray, get that to rule
out a large Hiatus Hernia.
Hope you can discuss this with your doctor.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Charles S Narasi 31 minutes later
thanks sir for the reply...
would like to mention few more points regarding my issue..
i have got endoscopy done 2-3 yrs showed nothing but a very mild hiatus hernia..which was not to be concerned about as per the doctor there..he only gave me nexium..
i dont have any heartburn coz i take alot of leafy vegetables and almost everyday like spinach, beans etc they even reduce the amount of gas many times i have noticed..

if i eat anything with thin gravy then i feel heartburn mostly , even gheeya can cause me heartburn sometimes if it has watery gravy..

i wasnt taking milk or dairy for atleast 1 didnt help with gas..although it reduced a little but not much...

i wake up fine...if my stomach cleans completely then my breakfast makes me little more relaxed and sleepy for 1 hr..if stomach is constipated then breakfast doesnt effect me much..sometimes i feel sudden weakness/relaxation after 2 hrs of eating specially in mornings at around 12 and i feel like urge to pass stool too..i checked my blood sugar and was all fine many times..

i usually take spinach and XXXXXXX leafy dishes ..chicken constipates me...even a single piece..

i belch more and more when my stomach cleans..but i feel bloated more when constipated..

i m thinking about trying digestive enzymes and XXXXXXX betain u think i should..?
Answered by Dr. Charles S Narasi 1 hour later
I think the best thing for you to do is make a list
of all the things you eat or drink everyday for one or
two weeks.
On one side make a note on how you felt that day along
with how your stool was and how gassy you were.
You can make a scale of 1-5. If you had a good day, give
it a number one on the scale. If that was the worst day
give yourself a five on the scale.
At the end of two weeks, take a good look at the list and
go over all the things you ate or drank and figure out
what you had during very bad days. You will be surprised
if you can detect a common factor.
As for enzyme supplements, if you had problem with
your pancreas, digestive enzymes will help. Also, I
would recommend a probiotic tablet everyday.
Wish you good luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Charles S Narasi 15 hours later
thanks sir...i will start taking velgut capsules along with digestive enzymes...
just curious if i just understand why do i feel nauseaous on the day when i have bowel movement..and wht can i do abt it..
Answered by Dr. Charles S Narasi 3 hours later
To your specific question, I don't have a definitive
answer. But , after I reviewed your history, you state
that you have had vestibular problems. During the act
of bowel movement, especially if someone strains, one
of the nerves called Vagus nerve may get stimulated.
Some people pass out, others may have nausea or
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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