Gas-Related Problems in Those with Hepatitis/Liver Disease

Some people with liver disease complain of increased gas production (flatulence), abdominal bloating, and abdominal distention. These symptoms may stem from malabsorption (impaired absorption) and/or maldigestion (impaired digestion) of certain nutrients by the body. These symptoms are especially likely to occur in people with alcoholic liver disease and cholestatic liver diseases, such as primary biliary cirrhosis. Such symptoms may also be caused by the medications used in the treatment of liver disease. Cholestyramine (Questran) is one example of a medication that is likely to cause increased gas production. Alternatively, flatulence may not be related to a liver disorder at all, but instead may stem from increased consumption of foods that have a tendency to cause gas (see the list on page xx) or from the development of a food intolerance, such as lactose intolerance.

To remedy these symptoms, people can try decreasing their consumption of gas-containing foods and of foods that they are having difficulty digesting. Often, elimination diets are helpful. An elimination diet involves eliminating one food at a time from the diet to determine whether that food is solely responsible for the gas production. It is usually best to begin by eliminating milk and milk products, as they are the foods most commonly not tolerated. One approach that will cut down on the gas-producing potential of fruits is to peel off the skins. Another is to cook fruits and vegetables until they are soft and soggy. Unfortunately, these methods of preparation also significantly reduce the nutritional value of these foods. Finally, taking an anti-gas remedy (typically containing simethicone) can sometimes help.

Foods that can cause gas include:

• Dairy products, such as milk (including skim and low-fat), yogurt, milk chocolate, cheese, and cheese pizza.

• Raw vegetables, especially onions, carrots, cabbage, lettuce, broccoli, cauliflower.

• Beans.

• Bagels.

• Pretzels.

• Soups.

• Fruits with skins.

• Dried fruits, such as raisins and prunes.

• Fatty foods.

• Artificial sweeteners, such as sorbitol.

• Carbonated beverages, such as soda.

• Chewing gum.

All contents of this article are Copyright © Melissa Palmer, MD

Melissa Palmer, MD is the author of " Dr. Melissa Palmer's Guide of Hepatitis and Liver Disease". (Published 2004. Penguin Putnam

Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. Prior to 2012, she maintained perhaps the largest medical practice devoted to liver disease in the United States. Dr. Palmer is Clinical Professor of Medicine at New York University Medical Center. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City.

Dr. Palmer is Board Certified in Gastroenterology and in Internal Medicine.

She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.

She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis. Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis.

Dr. Palmer has performed numerous clinical trials on various experimental medications for the treatment of hepatitis.

Dr. Palmer is currently available for lecturing, investor and hedge-fund consultations, consultations to industry, and media interviews and appearances-- including television. For such matters, she can be contacted through hepatitismedia@gmail.com.

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