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I have often thought that the common or garden fart was misnamed as being the result of enteric fermentation, when the result was exitic. However, this explains all!
What a Gas
by Jeffrey Kluger
There are worse places to be than Dr. Michael Levitt's waiting room.
Chernobyl, for instance. Or Love Canal.
It's not that there's anything wrong with Levitt's facilities
themselves, you understand. Indeed, as doctor's offices go, they're
better than most. There are no millennia-old copies of Travel & Leisure
on the coffee table (A Weekend in Pangaea!), no sour balls from the
mid-1950s in the receptionist's candy dish, no relentless Muzak
repetitions of The Girl From Ipanema. No, the problem with Dr. Levitt's
waiting room is Dr. Levitt's patients.
Michael Levitt is a gastroen-terologist working at the Veterans Affairs
Medical Center in Minneapolis. The term gastroenterology, of course,
refers to the branch of medicine that treats ailments of the stomach and
bowels and comes from the Greek gaster, for belly, and enterology, for
someone who really ought to wash his hands before making you a sandwich.
For a medical specialty high in heroism and low in glamour, you can't do
much better than gastroenterology, but in Levitt's practice the stakes
have been raised. For the past 15 years, Levitt has been roundly
recognized as one of the world's leading authorities on the science of
flatulence.
Flatulence is the means by which the body rids the colon of unwanted
gases, the intestines of unwanted pressure, and crowded theater rows of
unwanted strangers. Its familiarity notwithstanding, it has generally
ranked near the bottom of most people's lists of Impressive Things the
Body Can Do--just a notch above the ability to flatten Coors cans
against our foreheads. Despite the low esteem in which nature's joy
buzzer has been held, however, a handful of researchers have made it the
chief object of their study. What, they have asked themselves, can it
tell us about the functioning of the body? How, they have challenged one
another, can it be alleviated when it becomes excessive? Why, their
families have asked them, couldn't they at least have considered a nice
podiatry practice? Levitt is one of the rare scientists who have been
willing to tackle these questions, and after 19 years in the flatus
game, he does not regret his choice.
An enormous amount of lore has grown up around the phenomenon of
flatulence, he says, much of it untrue. Debunking these myths and
uncovering the truth is like investigating any poorly understood area of
medicine. The answers are all there--if you're willing to go after them.
Levitt came by his interest in eruptive science in a somewhat dramatic
way. In 1976 a patient approached him with what Levitt later decorously
described in a New England Journal of Medicine paper as a five- year
history of passing excessive flatus. The demure phrasing in Levitt's
writing did nothing to capture the problems his patient faced. Since
1971, the prudently unnamed 28-year-old male confessed, he had been
passing intestinal gas far more than he ever had before in his life, and
certainly more than any of his understandably put-upon friends and
family members. For the previous two years, he had been keeping a
scrupulous record of his personal greenhouse emissions, and when he
revealed these so-called flatugraphic recordings to Levitt, the doctor
was taken aback. On an average day the patient recorded 34 episodes of
flatulence, with some days cresting into the low 40s. Levitt did not
have any data on how this compared with the output of the ordinary
person, but even in a globally warmed, ozone-shredded,
chlorofluorocarboned world, this sounded bad. Before his unhappy patient
detonated at a mooring mast in Lakehurst, New Jersey, Levitt decided to
take his case.
In treating a man complaining of flatulence, there are many things a
doctor must consider--not the least being that the patient is a man.
>From toddlerhood to dotage, there are few skills more highly prized by
the average male than a facility with flatulence. Why men should seem
more open about their gastric volatility than women is a mystery, but
from a sex whose inventiveness gave the world the noogie and the wedgie,
a fascination with all things intestinal should not come as a surprise.
While most men do what they can to curb this natural impulse, limiting
themselves to such flatus surrogates as whoopee cushions and fireworks,
an affinity for flatulence remains.
To study a problem of extraordinary flatus, Levitt needed data on what
ordinary flatus is. Recruiting seven highly cooperative volunteers, he
requested that they spend at least a week keeping flatugraphic logs of
their own, recording how frequently they stirred intestinally and when
these events occurred. While taking the time to note such events would
not make for an especially social week, it would make for a
scientifically enlightening one, providing Levitt with what was almost
certainly science's first flatulence control group. When the results
were in, it was clear that control was just what his seven volunteers
did have and what his troubled patient didn't.
In the group I chose, Levitt says, the mean flatus frequency turned out
to be 13.6 episodes per day, with no statistically significant
differences attributable to age, gender, or other discernible variables.
The upper limit for even the most gaseous of these subjects was less
than 20. In all cases the daily output was considerably lower than my
patient's 34, indicating that his problem was quite real.
More disturbing than the frequency of flatus from the afflicted man was
the quantity of effluence produced by each event. It's well known that a
flatulent episode can range from a barely detectable rumble to a
propulsive burst sufficient to attain low Earth orbit, depending on
general health and recent visits to all-you-can-eat salad bars. With the
help of internally worn rectal tubes and 100-milliliter collection
syringes, an earlier study had determined just what the standard output
of all these eruptions is.
The average person appears to release between 500 and 2,000 milliliters
of gas per day rectally, Levitt says, with the average volume of what
passes at once varying between 35 and 90 milliliters. The young man I
was treating released an average of 5,520 milliliters per day, or 162
milliliters per event.
By any measure, it was clear that Levitt had discovered the Joltin' Joe
of digestive distress, but before consigning the unfortunate man to a
private wing in gastroenterology's Hall of Fame, Levitt knew he'd have
to investigate further. The next step, he decided, was to study not just
the quantity of the patient's gaseous output but its makeup. Given the
power of intestinal exhaust to turn heads, clear rooms, and in extreme
cases fell whole swaths of old-growth forest in the Pacific Northwest,
this least fragrant vapor would seem to be made of only the most pungent
stuff. Yet according to analyses Levitt--and later others--conducted on
captured flatulence, intestinal gas can be surprisingly benign.
When you analyze rectal gas, Levitt says, you find that it is about 99
percent carbon dioxide, hydrogen, nitrogen, oxygen, and methane. Most of
these gases are either swallowed inadvertently when food is eaten or
released from the food as it is digested. What makes this remarkable to
most people is not just that these gases are so common but that they are
also utterly odorless.
For flatus to attain its singular bouquet, it must rely on the remaining
1 percent of the gas that makes it up--a percent composed of very
different stuff, which comes from a very different source. Like all
complex organisms, the human body is home to millions of microorganisms
that live in our hair, pores, and even our internal organs. The part of
the body that is apparently zoned for the most residential
development--at least by house-hunting one-celled organisms without much
of an eye for resale values--is the digestive tract. Among the better
known microbes that receive their E-mail and E! channel in your
intestines is the prolific E. coli. Among the lesser known are
Klebsiella and Clostridium. All these organisms live for the most part
in the colon, where they attack and consume undigested food and in turn
generate their own waste products. In the case of microorganisms, waste
usually means gas, and in the case of these microorganisms, that gas can
be pretty ripe stuff--usually molecules containing sulfur, such as
dimethyl sulfide and methanethiol. When these waste products build up to
a sufficient level, they are released with the rest of the gas in the
bowels, announcing their presence--and too often yours--to the world.
The odoriferous gases present in flatus are present in extremely small
concentrations, Levitt says. It is a testament both to the pungency of
the gases and to the sensitivity of the nose that we can detect them so
readily.
Of course, not all episodes of flatulence carry an olfactory price tag.
Some people, it seems, can release all the intestinal gas they want with
no one the wiser, while other people seem to be unable to enter a room
without first having to file an environmental impact statement. While
it's tempting to conclude that individual quirks of individual
metabolisms account for these differences, the answer usually has less
to do with our bodies than with what we put into them--particularly when
what we put into them are carbohydrates.
...
by Jeffrey Kluger
There are worse places to be than Dr. Michael Levitt's waiting room.
Chernobyl, for instance. Or Love Canal.
It's not that there's anything wrong with Levitt's facilities
themselves, you understand. Indeed, as doctor's offices go, they're
better than most. There are no millennia-old copies of Travel & Leisure
on the coffee table (A Weekend in Pangaea!), no sour balls from the
mid-1950s in the receptionist's candy dish, no relentless Muzak
repetitions of The Girl From Ipanema. No, the problem with Dr. Levitt's
waiting room is Dr. Levitt's patients.
Michael Levitt is a gastroen-terologist working at the Veterans Affairs
Medical Center in Minneapolis. The term gastroenterology, of course,
refers to the branch of medicine that treats ailments of the stomach and
bowels and comes from the Greek gaster, for belly, and enterology, for
someone who really ought to wash his hands before making you a sandwich.
For a medical specialty high in heroism and low in glamour, you can't do
much better than gastroenterology, but in Levitt's practice the stakes
have been raised. For the past 15 years, Levitt has been roundly
recognized as one of the world's leading authorities on the science of
flatulence.
Flatulence is the means by which the body rids the colon of unwanted
gases, the intestines of unwanted pressure, and crowded theater rows of
unwanted strangers. Its familiarity notwithstanding, it has generally
ranked near the bottom of most people's lists of Impressive Things the
Body Can Do--just a notch above the ability to flatten Coors cans
against our foreheads. Despite the low esteem in which nature's joy
buzzer has been held, however, a handful of researchers have made it the
chief object of their study. What, they have asked themselves, can it
tell us about the functioning of the body? How, they have challenged one
another, can it be alleviated when it becomes excessive? Why, their
families have asked them, couldn't they at least have considered a nice
podiatry practice? Levitt is one of the rare scientists who have been
willing to tackle these questions, and after 19 years in the flatus
game, he does not regret his choice.
An enormous amount of lore has grown up around the phenomenon of
flatulence, he says, much of it untrue. Debunking these myths and
uncovering the truth is like investigating any poorly understood area of
medicine. The answers are all there--if you're willing to go after them.
Levitt came by his interest in eruptive science in a somewhat dramatic
way. In 1976 a patient approached him with what Levitt later decorously
described in a New England Journal of Medicine paper as a five- year
history of passing excessive flatus. The demure phrasing in Levitt's
writing did nothing to capture the problems his patient faced. Since
1971, the prudently unnamed 28-year-old male confessed, he had been
passing intestinal gas far more than he ever had before in his life, and
certainly more than any of his understandably put-upon friends and
family members. For the previous two years, he had been keeping a
scrupulous record of his personal greenhouse emissions, and when he
revealed these so-called flatugraphic recordings to Levitt, the doctor
was taken aback. On an average day the patient recorded 34 episodes of
flatulence, with some days cresting into the low 40s. Levitt did not
have any data on how this compared with the output of the ordinary
person, but even in a globally warmed, ozone-shredded,
chlorofluorocarboned world, this sounded bad. Before his unhappy patient
detonated at a mooring mast in Lakehurst, New Jersey, Levitt decided to
take his case.
In treating a man complaining of flatulence, there are many things a
doctor must consider--not the least being that the patient is a man.
>From toddlerhood to dotage, there are few skills more highly prized by
the average male than a facility with flatulence. Why men should seem
more open about their gastric volatility than women is a mystery, but
from a sex whose inventiveness gave the world the noogie and the wedgie,
a fascination with all things intestinal should not come as a surprise.
While most men do what they can to curb this natural impulse, limiting
themselves to such flatus surrogates as whoopee cushions and fireworks,
an affinity for flatulence remains.
To study a problem of extraordinary flatus, Levitt needed data on what
ordinary flatus is. Recruiting seven highly cooperative volunteers, he
requested that they spend at least a week keeping flatugraphic logs of
their own, recording how frequently they stirred intestinally and when
these events occurred. While taking the time to note such events would
not make for an especially social week, it would make for a
scientifically enlightening one, providing Levitt with what was almost
certainly science's first flatulence control group. When the results
were in, it was clear that control was just what his seven volunteers
did have and what his troubled patient didn't.
In the group I chose, Levitt says, the mean flatus frequency turned out
to be 13.6 episodes per day, with no statistically significant
differences attributable to age, gender, or other discernible variables.
The upper limit for even the most gaseous of these subjects was less
than 20. In all cases the daily output was considerably lower than my
patient's 34, indicating that his problem was quite real.
More disturbing than the frequency of flatus from the afflicted man was
the quantity of effluence produced by each event. It's well known that a
flatulent episode can range from a barely detectable rumble to a
propulsive burst sufficient to attain low Earth orbit, depending on
general health and recent visits to all-you-can-eat salad bars. With the
help of internally worn rectal tubes and 100-milliliter collection
syringes, an earlier study had determined just what the standard output
of all these eruptions is.
The average person appears to release between 500 and 2,000 milliliters
of gas per day rectally, Levitt says, with the average volume of what
passes at once varying between 35 and 90 milliliters. The young man I
was treating released an average of 5,520 milliliters per day, or 162
milliliters per event.
By any measure, it was clear that Levitt had discovered the Joltin' Joe
of digestive distress, but before consigning the unfortunate man to a
private wing in gastroenterology's Hall of Fame, Levitt knew he'd have
to investigate further. The next step, he decided, was to study not just
the quantity of the patient's gaseous output but its makeup. Given the
power of intestinal exhaust to turn heads, clear rooms, and in extreme
cases fell whole swaths of old-growth forest in the Pacific Northwest,
this least fragrant vapor would seem to be made of only the most pungent
stuff. Yet according to analyses Levitt--and later others--conducted on
captured flatulence, intestinal gas can be surprisingly benign.
When you analyze rectal gas, Levitt says, you find that it is about 99
percent carbon dioxide, hydrogen, nitrogen, oxygen, and methane. Most of
these gases are either swallowed inadvertently when food is eaten or
released from the food as it is digested. What makes this remarkable to
most people is not just that these gases are so common but that they are
also utterly odorless.
For flatus to attain its singular bouquet, it must rely on the remaining
1 percent of the gas that makes it up--a percent composed of very
different stuff, which comes from a very different source. Like all
complex organisms, the human body is home to millions of microorganisms
that live in our hair, pores, and even our internal organs. The part of
the body that is apparently zoned for the most residential
development--at least by house-hunting one-celled organisms without much
of an eye for resale values--is the digestive tract. Among the better
known microbes that receive their E-mail and E! channel in your
intestines is the prolific E. coli. Among the lesser known are
Klebsiella and Clostridium. All these organisms live for the most part
in the colon, where they attack and consume undigested food and in turn
generate their own waste products. In the case of microorganisms, waste
usually means gas, and in the case of these microorganisms, that gas can
be pretty ripe stuff--usually molecules containing sulfur, such as
dimethyl sulfide and methanethiol. When these waste products build up to
a sufficient level, they are released with the rest of the gas in the
bowels, announcing their presence--and too often yours--to the world.
The odoriferous gases present in flatus are present in extremely small
concentrations, Levitt says. It is a testament both to the pungency of
the gases and to the sensitivity of the nose that we can detect them so
readily.
Of course, not all episodes of flatulence carry an olfactory price tag.
Some people, it seems, can release all the intestinal gas they want with
no one the wiser, while other people seem to be unable to enter a room
without first having to file an environmental impact statement. While
it's tempting to conclude that individual quirks of individual
metabolisms account for these differences, the answer usually has less
to do with our bodies than with what we put into them--particularly when
what we put into them are carbohydrates.
...
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