Article by Dr Raghuram Y.S. MD (Ay)
Fart or flatus is a gaseous excretion from the anal region. When we tend to pass the fart or flatus and when a pressure of that reflex is uncontrollable, we will be put in an embarrassing situation. Pushing it out or allowing it might put us and the people around us in discomfort, especially when it bombs out with high pressure and lot of sound. Foul smell of the gases is an added bonus to the sound.
The million dollar question is to hold it or pass it out?
Fart is a body response to throw something away from the body. Body is intelligent enough to sense what needs to be kept in store and what not! Body always sends you signal when things which could damage the system need to be discharged or expelled at the earliest. Need to fart or reflex to throw away the gases are one such signal. The signal is generated when sufficient amount to toxic gases, not intended to be kept back in the body, create a high pressure in the intestines and indicate that they are ready to pass out.
Pushing it out might be an embarrassment, but holding it forcibly, especially when we put up a compulsive practice to do so, hurts the system. The body in due course of time learns to hold back the flatus which has been created or ‘not to signal you’ to push it down.
So the answer is to ‘respond to the call or urge’ and evacuate the flatus, somehow, somewhere….
There are some things which need to be put out of the body in right time, in right quantities. The body sends signals when these things are impending are ready to be put out. These signals or reflexes or urges are called as Vega in Ayurveda. Vega is body’s expression to ‘discharge something or put some undesired thing out of the body’
These impending reflexes are called ‘Adharaneeya Vegas’ or the urges of the body (natural calls) which should not be avoided or held back forcibly. (Adharaneeya – not to be controlled, Vegas – reflexes or urges)
Vegas are signals of auto-detoxification – The body needs to keep itself in pure and sterile condition so as to keep things going in a smooth way. For this to happen, the body needs to throw some unwanted things regularly out of the system, as and when they are produced. If these unwanted things are held back, they might produce damage to the system in due course of time by contaminating the body elements. Thus vegas or signals to throw these things out are ‘signals of auto-detoxification process of the body’
By doing this, the body conducts a self servicing and self maintenance of itself, monitored by the basic inbuilt intelligence of the ‘body-mind-system’.
What to do when the vegas are manifested?
When these vegas are manifested, we just need to help them out. We should not be holding the urges, instead help the body by allowing it to throw them out. As and when an urge arises we need to attend it.
On the other hand, these reflexes should not be artificially created!!
Fart is one such Vega – natural urge.
Apana Vega Dharana
Fart is a word used for flatulence or flatus expelled through anus. It is marked by generation of gases in the stomach and intestines.
In Ayurveda, the flatus or fart is called apana vayu or adho vayu. The name Apana Vayu comes from the sub-type of vayu which is located in the lower portion of the body and operates all the functions of the lower part of the body like defecation, passing off the flatus, urination, menstruation, parturition, ejaculation etc. Since the fart and its passing out is controlled by apana vayu, the fart bears the same name.
The collection of apana vayu (gases formed in the intestines), beyond proportions in the intestines, leading to discomfort of the abdomen is called flatulence. The same condition is called anaha in Ayurveda. It is associated with distension or bulge of abdomen, which is self-regressing most of the times and is called adhmana.
Apana vata or adho vata is produced on a regular basis. It is produced in everyone and naturally thrown out of the body. This is quite normal when it happens as a result of chemical process taking place during the digestion in the intestines with the involvement of gut flora and is eliminated in normal proportions without ones notice.
But when the stomach or intestines are contaminated with morbid doshas or infection or chronic digestion upsets (errors of metabolism), the gas tends to collect frequently. This also leads to abnormal and frequent release of gases from the anus with foul smell and sound.
Correction of digestion process with suitable medicines like digestants (pachana, deepana), carminatives, laxatives (herbal) etc will take care of the condition.
If flatus is formed due to incompatible foods which we might have consumed with or without our knowledge, the condition will subside by taking light digestible foods or by fasting or by taking home remedies like cumin seed processed water or with some medicines like Hingwashtaka churna etc. These situations are temporary.
If the flatulence doesn’t clear in quick time or if there is habitual or pathological accumulation of gases in the abdomen for longer periods of time it causes flatulence and distension in due course of time. This in turn imparts severe pressure on the abdominal viscera and chest organs (heart and lungs). Gradually pressure symptoms are manifested in the tissues and organs of the body leading to functional deterioration or failure.
All the above said conditions related to formation of gases in the abdomen, its frequent elimination or non-elimination depends on various causes. They are:
- Apathya – intake of incompatible foods or unwholesome foods and erratic lifestyle activities
- Vitiation of Apana Vayu
- Ajeerna (indigestion)
- Formation of ama (immature essence of digested food, in circulation, tends to clog the channels of the body due to their sticky nature)
- Mala sanga (obstruction of excreta, other waste substances and toxins in the body, mainly intestines)
- Avarana – obstruction of functions of apana vayu by pitta or kapha or other sub-types of vitiated vayus.
- Apana vega dharana – forcible obstruction of flatus or urge to fart (making a practice of the same)
From the above said description it is clear that the flatus should be discharged regularly, as and when it occurs and it should not be habitually controlled.
What happens if the apana vayu vega is forcible obstructed?
When apana vayu is forcibly withheld, the vayu gets disturbed. The vitiated vayu changes its direction and starts moving haphazardly, especially in an upward direction. This movement of vayu is pathological and is not normal of apana vayu which otherwise should naturally flow downwards.
This abnormal, haphazard and upward movement of vayu is called ‘Udavarta’.
Udavarta causes severe pressure symptoms in all parts of the body and functional disturbances. When the vega dharana is done for a longer period of time as a habit or practice, the udavarta gets worse. Many times it gets so stubborn that it doesn’t respond to any line of treatment or medication. This is common for all the vegas. Udavarta is a causative factor for many systemic disorders.
Symptoms of apana vata vega dharana (forcibly controlling or holding back the impending fart reflex)
Jathare vaatajaaha cha anye rogaaha syuhi vaata nigrahaat (Ref – Charaka Sutra 7/12)
Aadhmaana shoolau hrudaya uparodham shiro rujam shwaasam ateeva hikkaam
Kaasa pratishyaaya gala graham cha balaasa pitta prasaram cha ghoram
Kuryaat apano abhihataha hanyaat pureeshahamukhataha kshipet vaa (Ref – Sushruta Uttara 55)
Below mentioned are the symptoms of forcible obstruction of flatus –
- Adhmana – distension of abdomen, flatulence, bloating
- Shula – colic, pain in the abdomen mainly in the region of urinary bladder and along the line of intestine
- Hrudaya uparodha – feeling of obstruction or tightness in the chest
- Shiro ruja – head ache
- Teevra shwasa – severe breathlessness, dyspnoea, short of breath
- Teevra hikka – severe hiccough
- Purisha avarodha – obstruction to passage of stools (constipation)
- Mutra avarodha or mutraghata – obstruction to the passage of urine
- Vata avarodha – obstruction to passage of flatus
- Klama – tiredness
- Vata roga – various types of diseases caused by vata occur in the abdominal viscera like pain abdomen, gurgling sounds in the abdomen, gaseous distension, errors in metabolism and digestion
- Kasa – cough
- Pratishyaya – cold, congestion, running nose, sneeze, nasal discharges
- Galagraha – feeling of choking in the throat
- Ghora balasa prasara – severe vitiation and spread of morbid kapha in the body
- Ghora pitta prasara – severe vitiation and spread of morbid pitta in the body
- Pureeshaha mukhataha kshipet – stools coming upwards towards the mouth, sense of stools moving upwards (in severe obstruction of intestines)
Almost all the symptoms explained above are due to the retrograde movement of vitiated Vata, leading to increased pressure on abdominal viscera and consequent pressure over the chest, head and neck.
Treatment principles in Apana Vayu Avarodha Janya Vikara (diseases caused due to the forcible control of flatus or fart reflux)
Nidana parivarjana – Avoiding the causative factors (mentioned above) is the key in tackling the health issues arising from forcible obstruction of flatus. Mainly in this condition one should avoid holding on to the urge. He or she should learn to address the urge as and when it develops.
Line of treatment –
Sneha sweda vidhihi tatra vartayo bhojanaani cha
Paanaani vastayaha cha eva shastam vaata anulomanam (Ref – Charaka Sutra 7/13)
Snehana – administration of sneha (medicated ghee and or oil) both externally and internally will address the issues. Sneha, especially taila (medicated oil) is highly beneficial for Vayu, in fact it is antagonistic to morbid vata and pacifies it when judiciously administered. Similarly, the external procedures of administration of sneha like abhyanga (massage), dhara (stream pouring of medicated oils over the body) etc will be helpful.
Swedana – fomentation (steaming, sudation, sweating treatment) is another beneficial treatment in udavarta. It is also antagonistic to vayu and forms a perfect combo with snehana.
Varti – suppositories made up of herbs which eliminate faeces and flatus are inserted in the anal canal and left in place for few hours. The medicines in the varti stimulate the bowel and cause the expulsion of gases. This produces lightness of the abdomen.
Vatanulomana bhojana – foods which push the vitiated vata and blocked gases downwards should be administered. The foods beneficial for controlling and expelling vata are generally predominant in sneha (oil or ghee), hot and heavy in nature (so as to push the stools and flatus towards gravity. Here heavy foods do not mean the foods which are heavy to digest, they only comprise of guru guna (heaviness as quality) which is antagonistic to vata. These foods should be having one or the other of the madhura (sweet), amla (sour) and lavana (salt) tastes, which are opposite to the quality of vata and help in controlling vata.
Vatanulomana paanani – drinks which push the gases downwards and take control of apana vata should be administered. Their role is just like vata anulomana ahara or bhojana.
Vasti – medicated enemas are unparalleled treatments in combating morbid vata. Their role is highly praised in apana vata disorders. Enemas with herbal decoctions (niruha vasti) and medicated oils and ghee (sneha vasti or anuvasana vasti) should be administered skilfully to combat apana vata dysfunctions.
Other options –
Virechana – therapeutic purgation with vata alleviating medicines
Nitya virechana – virechana on daily basis
- Avoid viruddha ahara – i.e. mutually incompatible foods, unwholesome food choices
- Avoid viruddha vihara – i.e. avoid untoward life style activities
- Following good dinacharya – planned protocol of ‘healthy management of a day’
- Follow good Ritucharya – planned protocol and adaptation of ‘healthy seasonal management’
- Not controlling the vegas forcibly
- Not creating the vegas artificially
- Keep up the stomach health and gut health in proper norms, don’t neglect symptoms like flatulence, indigestion, distension of abdomen, constipation etc especially when they persist for longer duration
Modern view of flatulence –
Flatulence is defined as ‘flatus expelled through the anus’ or ‘quality or state of being flatulent’. It is marked by excessive gases generated in the intestine or stomach (digestive flatulence). (In Latin – flatus=a blowing, a breaking wind).
Flatus – is a medical word for gas generated in the stomach or bowels. A proportion of intestinal gas may be composed of swallowed environmental air; hence flatus is not totally generated in the stomach or bowels.
It is also called Flatus incontinence
Non-medical definitions –
– Uncomfortable condition of having gas in the stomach and bowels
– State of excessive gas in the alimentary canal
Bloating, abdominal distension or increased volume of intestinal gas are considered to be synonymous with the term flatulence, but it is technically inaccurate.
Is it normal to fart?
Yes, most of the times it is normal to pass the flatus through the rectum. The volume and frequency varies with different individuals. The feculent smell of the flatus too varies.
Flatus is brought to the rectum by specialised contractions of the muscles in the intestines and colon. The noise of flatulence (blowing a raspberry) is caused by vibration of anal sphincters and occasionally by the closed buttocks.
- Bloating and Abdominal distension
- Excessive Flatus volume
- Excessive flatus smell
- Gas incontinence
Intestinal gases are composed of varying quantities of –
Exogenous gases – swallowed (aerophagia) while eating or drinking or increased swallowing
Endogenous gases – produced as a by-product of digestion of certain types of food or incomplete digestion. Anything which causes incomplete digestion of food may cause flatulence. When the material arrives in colon, gases are produced due to fermentation by yeast or prokaryotes present in gastrointestinal tract.
Flatulence producing foods are typically high in certain polysaccharides, especially oligosaccharides such as inulin. Below listed are some of the foods –
- Spring Onions
- Sweet potato
- Dairy Products
- Wheat Yeast in bread etc
Some infections – giardiasis etc
Mechanism of farting:
- Flatus is mostly produced as a by product of bacterial fermentation in the gastrointestinal (GI) tract, especially in colon.
- 99% is composed of non-smelling gases (oxygen, carbon dioxide, nitrogen, hydrogen and methane)
- Excessive intestinal gas mostly composed of nitrogen is due to aerophagia
- Hydrogen, carbon dioxide and methane are all produced in the gut contribute to 74% of volume of flatus in normal people
- Methane over hydrogen in farts correlates with obesity, constipation and IBS (irritable bowel syndrome)
- The smell is due to the remaining 1% of trace compounds, mainly coming from a combination of VSC (volatile sulphur compounds)
- Studies have shown that MM (Methyl mercaptan), DMS (demethyl sulphide) and H2S (described as decomposing vegetables, unpleasantly sweet / wild radish and rotten eggs respectively) are all present in human flatus
- Increased dietary sulphur containing amino acids increases the smell of flatus significantly
- Foul smell is also caused by the presence of large numbers of micro-flora bacteria and or the presence of faeces in the rectum
Since problems involving intestinal gas present as different set of complaints, the management is usually cause related.
Pain and bloating – are treated by
- Surfactants (agents that lower surface tension and can reduce disagreeable sensations),
- Simethicone preparations (make bubbles larger and allow them to be passed easily),
- Flatus bag – intestinal gas is collected in a flatus bag by inserting a flexible tube into the rectum.
Volume – volume of flatus is reduced by
- Dietary modifications,
- Reducing the amount of fermentable carbohydrates,
- Low FODMAP diet (low fermentable oligosaccharide, disaccharide, monosaccharide and polyols)
- Spices like cumin, coriander, caraway, fennel, ajawain, asafoetida, etc will help
- Avoiding potatoes, corn, noodles, wheat and starches,
- Taking fermented beans (miso),
- Prolonged cooking,
- Fermentative lactic acid bacteria,
- Probiotics (live yogurt etc),
- Lactobacillus acidophilus (supplement),
- Digestive enzyme supplements,
- Alpha-galactosidase enzymes in combination with lactase, amylase, lipase, protease, cellulose etc, Antibiotic Rifaximin
Smell – from flatulence is treated with –
- Bismuth subgallate
- Bismuth subsalicylate
- Bismuth subnitrate
- Activated charcoal
- Undergarments that contained a replaceable charcoal filter
- Insert like a pantiliner that contains activated charcoal
Just before finish –
‘Rogan utpadaniya’ is the name of the chapter in Ashtanga Hridaya in which Vagbhata has explained the vegas and the consequences of forcibly holding them. Rogan utpadaniya translates to ‘those factors which causes diseases’. This shows that the vegas or urges are not just the body signals, but are in fact dangerous to health when held back forcibly. They are responsible for causation of many psycho-somatic illnesses when their normal exit is forcibly chocked.
Our duty is to allow the body to perform its functions normally, without meddling into any of the proceedings. The vegas will help us maintain our health and prevent many diseases when we let them go.
So kindly don’t artificially create or stop the body expressions…Let go and live healthy!!!
Click to Consult Dr Raghuram Y.S. MD (Ayu)