I had a patient come in a few weeks ago with an unusual problem. Overall, he was a generally healthy young man. He was, however, bothered by one problem. In his words...
"I fart a lot."
Of course, with all of the new HIPAA rules about confidentiality I have to be very careful about what I write. I’m not supposed to give you enough specific information so that you can figure out who I’m talking about.... but a GUY who FARTS? I think I'm pretty safe about keeping his identity anonymous. (I can hear it in homes across America, "Honey, did you go to the doctor recently?")
According to the Merriam-Webster dictionary, the definition of a "fart" is, "an expulsion of intestinal gas." They didn’t mention it, but I seem to recall something during my superb medical training that it smells bad. Or so I hear. They forgot to add that about the smell and, of course, that's what was causing his consternation. He had tried Beano, Tums, changing his diet to avoid beans, adding more fiber, avoiding fiber, and everything else his brain could churn out... unfortunately, to no avail. So, he came to see me.
Although there are those who would disagree, I actually know very little about flatus, as it's called by medical folks. (Or at least medical people when they're at work)
I didn't have a clue about how to treat farting, er, I mean flatulence. In fact, a part of me wondered why you would want to treat it. In the part of the South where I was raised, farting is still considered a competitive sport. There are people I grew up with who could actually play a Brandenburg Concerto with their rectum. That is, if they would've known what a Brandenburg Concerto is. Or, if they knew what a rectum is. Or a hole in the ground, for that matter. Regardless, with these guys you could certainly recognize the Dukes of Hazzard theme song after certain types of burritos or chilis.
Anyway, when I'm not sure about something, my go-to source for medical diagnoses and treatment is called Up-to-Date. In each field of medicine the brightest and best sift through the most recent medical journals and determine the most recent recommendations. If you find an adenomatous polyp on a colonoscopy when should your next screening be? Got a problem with antiphospholipid antibody syndrome? How frequently should you phlebotomize someone with hemachromotosis? Up-to-Date has the answers for what ails you.
The main thing I like about it is that it keeps guys like me from having to do much reading, or even much thinking. I like that in a database. If only there were more pictures.
From Up-to-Date I learned, among other things, that the volume of gas passed per rectum varies from about 500 to 1500 mL per day, and that the frequency of flatus released varies between 10 and 20 times per day in healthy subjects.
So, after the stimulating, highly intellectual course of reading about my patient’s problem, several questions come to mind:
What kind of a doctor would even think of doing an experiment like this?
What would an expert in this field of medicine be called? Flatulology? Flatusology?
Do they come up with cool new instruments for their field of study? Like, a Flatusometer?
My second series of questions began with: How do you pitch it to your colleagues?
"Hey guys, I've got this great idea for a research project.... It'll be a gas. Really. It will. Really. No, I'm serious... a gas. Why are you all laughing?"
"Yeah, it's true Mom and Dad... Your son is a published author." "Well, of course you can read the article, but, uhhhh, it's kind of technical and boring. You know how those articles are... mostly just a lot of hot air."
However, my other, larger, question is this: How do you find people who will agree to participate in a study to determine how much and how many times a person passes gas in one day?
"But sir, it's really a very tiny hose."
"Yes, that IS your signature... yes, right there next to the beer stain."
"No, sir, you won't need the kazoo."
So, after doing some research into this health issue (of course, it’s only a true health issue if it’s not your gas), I learned that the most common cause of flatus is aerophagia, or swallowing air. My patient and I talked about chewing slowly and taking small bites, and we talked about what kinds of foods to eat, and what kind to avoid. ("Honey?... you DIDN'T go to the doctor's office? Do you know what aerophagia is? I see.... well, you're about to learn.")
My second series of questions began with: How do you pitch it to your colleagues?
"Hey guys, I've got this great idea for a research project.... It'll be a gas. Really. It will. Really. No, I'm serious... a gas. Why are you all laughing?"
"Yeah, it's true Mom and Dad... Your son is a published author." "Well, of course you can read the article, but, uhhhh, it's kind of technical and boring. You know how those articles are... mostly just a lot of hot air."
However, my other, larger, question is this: How do you find people who will agree to participate in a study to determine how much and how many times a person passes gas in one day?
"But sir, it's really a very tiny hose."
"Yes, that IS your signature... yes, right there next to the beer stain."
"No, sir, you won't need the kazoo."
So, after doing some research into this health issue (of course, it’s only a true health issue if it’s not your gas), I learned that the most common cause of flatus is aerophagia, or swallowing air. My patient and I talked about chewing slowly and taking small bites, and we talked about what kinds of foods to eat, and what kind to avoid. ("Honey?... you DIDN'T go to the doctor's office? Do you know what aerophagia is? I see.... well, you're about to learn.")
Yes, this is what I get paid to do.
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