Help! I have excessive gas and nothing I do works.

Dr Flo, I've experienced stomach problems for many years. Symptoms include excessive gas accompanied by loss of breath, irregular heartbeats, chest pains and body weakness. I've gone to hospitals and last year I was diagnosed with severe ulcers and given a H-pylori kit. My situation improved a little bit. After the medication I started having the same issues and early this year I went for another check-up and tested negative for ulcers. Since then, I take my ulcer medicine daily but the symptoms keep coming back. Could there be other hidden problems since I follow a diet recommended by my doctor. Thanks. Kings

Dear Kings,

What you are experiencing is referred to as bloating. There is characterised by excessive gas, which may cause a feeling of swelling, fullness or tightness of the abdomen, and there may also be pain, rumbling, and belching.

The gas build up in your gastrointestinal tract might be caused by swallowing air as you eat or drink, and the breakdown of undigested food in the intestines. It can also be because of hyperacidity, peptic ulcer disease and/or h.pylori infection. Other causes include constipation; intestinal infections (e.g. amoebiasis), irritable bowel syndrome, indigestion, food allergies; poor absorption of food; inflammation of the lining of the intestines, intestinal obstruction, problems with the movement of the intestinal muscles, excessive weight gain; hormonal changes (e.g. in pregnancy); stress, anxiety and depression. Other more serious, but rare causes include heart failure, kidney disease, liver disease, problems with the spleen and pancreas, and some abdominal and pelvic cancers.

SEE A SPECIALIST

Since you have had this problem for a while, it would be advisable to visit a gastroenterologist (specialist in the digestive system). The specialist will possibly recommend some procedures like stool tests, endoscopy tests like OGD (oesophagogastroduodenoscopy) and colonoscopy, and if necessary, an abdominopelvic ultrasound scan. These will ensure you get an accurate diagnosis and appropriate treatment.

In addition, it is prudent that you lose weight if you are overweight, avoid chewing gum, carbonated drinks (like sodas), fatty foods, “gassy” foods like the cabbage family and legumes. Don’t overeat, eat small portions, eat slowly, chew with your mouth closed, don’t talk and eat at the same time, eat while seated upright, and avoid drinking using a straw. If you have problems digesting certain foods e.g. wheat or milk and milk products, then avoid them. For some people, massaging the abdomen provides relief. Also avoid artificial sweeteners like sorbitol. If you have constipation (very hard stool, or rarely passing stool), then take a lot of fibre and roughage in your diet, take 8-10 glasses of water per day and exercise regularly.

FOOD DIARY

You can keep a food diary — record what you eat each day and monitor your symptoms to see which foods may be worsening the symptoms. You can also take simethicone tablets to reduce the gas. Medicine with alpha-D-galactosidase helps to break down sugars in beans and vegetables and reduce the excess gas.    

Dear Flo.

I read your article about penis size and I just wondered … were those dimensions or areas. A circumference of 16cm and length of 16cm!!!

Kimm

My penis is 3" when erect I have been looking for help since 2008. Also, during sex, I can’t last more than two minutes. I can continue two hours later, but the result is still the same. J.M

Dear Kimm and J.M.,

The average penis size is 7 to 10cm length and 9 to 10cm circumference when flaccid (not erect) and 12 to 16cm length and 12cm circumference when erect. This is an average, which means many people will fall above or below these figures. Also many men who feel that they have a small penis usually have a size that is within the normal range. Nevertheless, there is need for concern if the flaccid penis is less than 4cm in length or if erect, the penis is less than 7.5cm in length, in which case increase of the penis size is considered.

Three inches converts to 7.62cm (multiply by 2.54), which is above the threshold for increasing penis size. However, this decision should be made after consultation with a psychologist and a urologist. The only medical ways of enlarging penis size are through surgery, use of a prosthetic or vacuum devices, which should be done by a urologist.

CAUTION

You should be careful with medications, pills and other treatment methods that are usually advertised as they do not have proper scientific backing. The normal male sexual response cycle involves desire, arousal, plateau, ejaculation, and resolution. The average time from beginning of intercourse to ejaculation is five minutes. This means for many men it could be above or below this. If ejaculation occurs sooner than you or your partner would like, it is called premature ejaculation.

If it happens once in a while, then it is not a cause of concern. If it is frequent and is causing frustration, then it needs to be addressed. It can occur due to psychological and physical factors. Psychological issues include early sexual experiences, worry about sexual performance, anxiety, depression, guilt, poor self-image or relationship problems. Physical factors include abnormal levels of hormones or brain messengers (neurotransmitters), or inflammation of the urethra or the prostate.

ROOT CAUSE

To manage it, any physical problems need to be treated and psychological issues have to be addressed, if necessary, by visiting a mental health professional. You also need to have a supportive partner. There are medications that can be prescribed and topical creams that can be used that have a numbing agent. Other ways of managing it include: Avoiding sexual intercourse for some time and focusing on other forms of touch to reduce the pressure to perform.

Strengthen the pelvic muscles using kegel’s exercises — tightening the muscles that you would use to stop urine flow. Contract these muscles 10 times and repeat at least three times a day. Stop-start technique — during intercourse, when you feel the urge to ejaculate, stop all activity until the urge passes, then start again. By repeating as necessary and some practice, holding off ejaculation can become a habit. Pause and squeeze technique — during intercourse, when you are about to ejaculate, have your partner squeeze the penis where the head joins the shaft for several seconds, until the urge passes, then continue. Using a condom to reduce sensitivity.

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