Excessive uncomfortable Flatulence. Tried elimination.

Hello, I had a look through the archives but couldn't see an answer to my problem.

I'm a UK resident [read: medical investigations take up public funds and GP time] and I have a problem with  flatulence which started just over a couple of years ago and it is getting progressively worse. It is very loud and very uncomfortable, sometimes bordering on the painful, causing my my whole abdomial (abdominal) cavity to resonate, thus the flatulence appears to be emanating from further up my digestive system. Frequency is initially every minute dropping to every fifteen minutes over a few hours.
  
I keep a healthy diet (1), take time over my meals, chew my food properly, get enough fluids, exercise and sleep. I breath through my nose. I don't drink alcohol.

Over the last couple of years based around fast days I've iteratively tried a scientific approach of elimination of everything and subsequent introduction of foods to find out what doesn't agree with me. It seems nothing is agreeing with me.

Starting off from 24 hour fasted (all food eliminated) I've introduced a food at a time. During the fast days the flatulence is gone. Whatever I eat, soon after I produce excessive flatus. Even a post-fast glass of water or fruit juice starts it off.

I've tried eliminnating the usual suspects (beans, onions, brassicas) gluten, dairy, common allergens, commonly poorly digested foods like soya, tried varying the acidity /alkalinity of my diet.
I've tried introducing probiotics and prebiotics in both yogurt and raw form (in case of lactose intolerance).
I've tried eating smaller meals more frequently, still no avail.

This may seem a minor problem (yes I would agree it is in the grand scale of pathophysiologies), but I can't function in polite society like this. I can't work all day on an empty stomach to avoid the embarrassment to me and others of me pumping all day and there are only so many times I can get up and leave the room to let one go. My social life is restricted in that I can't go to the theatre, cinema or anywhere where I have to stay put for 5 minutes. I imagine dating woud be a disaster, if I''d the confidence to go on a date.

I've just recently had acid reflux to add to these problems.

So any suggestions?

(Doc said the fasting wouldn't be a problem, rather an opportunity to work out that works for me and what doesn't. I absolutely trust his medical opinion but I'm anable to contact him).

(1) My regular diet is low fat, plenty of wholegrains, pulses, cereals, fruit and veg of various colours, a variety of fresh herbs and spices. Oily pelagic fish once or twice a week and lean chicken on a Friday otherwise my diet is quite plant based. I don't take much dairy.I daren't eat eggs too often. The beverages I drink should be easy on my stomach eg ginger tea.

(2)  No family history of any GI problems  (Chron's, Ulcerative Colitis, IBD, bowel cancers, ulcers etc) in family

(3) Bloods are fine. Unknown if I have Helicobacter Pylori.

[JohnnyFartpants]

Any suggestions?

[JohnnyFartpants]

Anyone?

[ggreg]

I've been wanting to reply to this for several days, but had to look up a few things.  Either you have a bacteria in your digestive tract, so EVERY possible bacteria has to be tested for, or the various enzymes that break down food are not functioning properly, maybe because of a pancreas problem, bile problem, lack of enzymes to break down sugars (very common reason for gas odor), an immune system problem, the list goes on.  You need to have a thorough workup done to find out why you have too much bad-smelling gas, because it means SOMEthing is out of kilter.  I have given you what I know about what the causes might be, so you'll need to hook up with a good gastroenterologist who is willing and able to investigate the situation from many different angles.  I hope this helps you a little bit.  In the meantime, you can consume charcoal designed just for this kind of thing, and while it won't stop the gas, it'll keep it from smelling so badly.

[JohnnyFartpants]

Thanks very much for replying and for taking the time to look things up.
I had full blood count, liver function and kidney function blood tests done last year. The GP said my bloods were fine.

Gall bladder: plasma Uric Acid is a little high 7.2 (Range  3.4 -7)

Pancreas: I don't know my blood glucose levels but it isn't high enough that there is glucose in my urine (all dip tests OK).
The only other factor which was not average was in kidney function test: serum chloride 107 (Range 96-106) but sodium lower end of normal 138, so not due to high salt.

Perhaps high uric acid probably does put me at risk for gallstones, though since having that done (2008)  I've vastly improved my diet ( I ate a lot more red meat before). The kidney function test might indicate I'm at risk of renal disease and my father did have a kidney removed due to a peppercorn sized stone 35 years ago, though he's still fit and active at 84. That's another matter though.

I've a blood glucose meter, like those used by diabetics. I'll check my blood glucose over a couple of days pre and postprandial, keep taking the probiotics meantime to try and populate my GI tract with 'good' bacteria, then see the pharmacist about charcoal: Actidose, Carbomix or Chardocote.

Thinking back to the onset, I wasn't eating too well, running late for shift every morning and often no breakfast, often a few bags of crisps and a chololate bar for lunch, too tired to cook a dinner at night. My job didn't enable me to get a decent lunch and my daytime diet left me without the enegy to cook.

I'll discuss the gas with my GP when I see him next for something else, as I think he's getting a bit fed up with me as I've had more than my fair share of GP appointments the last couple of years. I think with a publicly funded health system it's responsible to try everything possible myself before recourse to the GP.

Thanks again.