It happens every year anew, the moment when the festival of freedom turns for many into a holiday of a bloated stomach, bothersome gas and a feeling of heaviness that is often accompanied by prolonged constipation. These phenomena are not coincidental and they stem directly from the composition of the unique holiday menu, and mainly from the matzah, although it is not the only culprit in the story. Gas has many causes, and despite the great frustration it causes, there are effective ways to treat it and prevent its accumulation in the intestines and its embarrassing release.
An average person produces during the day between half a liter and one and a half liters of gas, which are usually released through the rectum. These gases are formed through several different pathways. Some of them are swallowed together with air during eating, talking or chewing gum, but the vast majority are created due to incomplete breakdown of carbohydrates in the large intestine. When sugars and starches that were not fully digested in the small intestine reach the large intestine, the bacteria found there break them down in a process of fermentation. This process produces gaseous byproducts, including hydrogen, carbon dioxide and sometimes methane. These gases accumulate in the system and lead to a feeling of bloating, physical pressure and sometimes even sharp pain. In certain cases the gases are reabsorbed into the bloodstream and are released through the lungs during exhalation, but most of the time they find their way out in the familiar way.
The unpleasant odor that accompanies gas is mainly due to the presence of sulfur compounds, which are a product of protein breakdown by bacteria in the large intestine. Among the compounds responsible for the odor are gases such as hydrogen sulfide, methyl mercaptan and dimethyl sulfide. The breakdown of amino acids originating from meat, eggs and dairy products may also create gases with a particularly strong smell. The composition of the gas varies from person to person, and it depends greatly on diet, the unique composition of gut bacteria and the rate of carbohydrate fermentation. A study published in the journal Gut Microbes found that patients with a gut flora richer in sulfur-producing bacteria suffered significantly from gas with a stronger odor. This is also one of the reasons why probiotic supplements may help not only in reducing the quantity but also in improving the quality of the odor.
Matzah, which is the clear symbol of Passover, is actually a very dense baked product, low in moisture and dietary fiber and rich in starches that are difficult for the system to digest. It tends to accumulate in the intestine, slow down the motility of the digestive system and cause severe constipation. In a state of constipation, processes of breakdown of stool residues by bacteria are created, which in turn produce gases such as hydrogen and methane that are responsible for the unbearable feeling of bloating. A study published in the journal Gastroenterology explained that during constipation there is an increase in the accumulation of fiber-degrading bacteria that increase the fermentation of food in the intestine, which leads directly to bloating and abdominal pain.
Not only matzah is to blame for the situation. Additional holiday habits join in, such as drinking carbonated beverages in large quantities or chewing gum between meals. Gum, especially those containing sugar substitutes such as sorbitol and xylitol, cause increased swallowing of air during chewing and produce gas themselves. A study conducted at Monash University in Australia showed that consumption of only 5 grams of sorbitol per day may cause diarrhea, gas and abdominal pain in sensitive individuals. Drinking fizzy beverages, including soda or sparkling wine, also introduces carbon dioxide into the digestive system. This gas is released in the abdomen and creates a feeling of excessive fullness. When adding to this the multiple and heavy holiday meals, you get a sure recipe for a constant feeling of fullness.
Another significant factor is hurried eating. When eating too fast, large amounts of air are inhaled with every bite that enters the mouth. The food reaches the stomach when it is not chewed enough, which forces the stomach to work much harder on breaking it down and increases the production of acid and gas. The American Journal of Gastroenterology published a study demonstrating that the rate of eating directly affects the volume of air in the stomach and the amount of gas released afterward.
The mental stress that characterizes the holiday days, including cooking, hosting and intensive organization, also affects our stomach. Anxiety and stress activate the sympathetic nervous system, which suppresses the normal activity of the digestive system and causes irregular motility. This is a vicious cycle in which anxiety worsens digestive symptoms, and these symptoms increase the feeling of distress. Light physical activity or breathing exercises can help calm the system and reduce bloating.
Gut bacteria are central players in this story. An imbalance in gut flora, meaning an overgrowth of harmful bacteria or a lack of beneficial bacteria, causes an improper digestion process of sugars. These break down incompletely and ferment in the intestine while producing gas. Leading medical journals such as Nature Microbiology have in recent years emphasized the connection between irritable bowel syndrome and an unbalanced gut flora, which includes increased production of hydrogen and methane.
To cope with the situation, first of all constipation must be relieved. Drinking plenty of water, a diet rich in fiber in the right amount, such as cooked vegetables or prunes, and moderate physical activity help the system restart. It is important to consume fiber gradually, since too sharp an addition may actually worsen the situation at first. At the same time, it is worth checking sensitivity to foods such as legumes, dairy products, onions and garlic that may trigger bloating. Probiotic supplements can be used to balance the bacterial population. Studies have found that certain strains are very effective in reducing bloating among those suffering from irritable bowel syndrome.
If the feeling of bloating is accompanied by sharp pain, weight loss or blood in the stool, a gastroenterologist should be consulted to rule out serious problems such as celiac disease or inflammatory bowel diseases. In order to get through the holiday safely, it is recommended to reduce matzah consumption, make sure to drink plenty of water and take light walks every day. In the case of persistent constipation, preparations such as Peglax powder or Normalax can be used in consultation with a doctor, until bowel movements return to normal.
In cases where the phenomenon continues for more than 6 weeks, the doctor may refer to stool tests to detect parasites or bacteria such as salmonella and campylobacter. Additional tests may include a blood test for celiac, a pancreatic function test or a calprotectin protein test indicating inflammation in the intestine. There is also a breath test to identify bacterial overgrowth in the small intestine, a condition that causes unusual gas immediately after meals and requires targeted treatment.