What is gas pain?
Gas pain is pain caused by gas trapped in a small part of the bowel in the upper abdomen.
What is trapped gas?
Trapped gas or trapped wind refers to a pocket of gas in the bowel, usually in the part of the colon that runs horizontally below the rib cage. Trapped gas can cause spasms in the colon and the distension of the ligaments that hold the colon in the position, which can both cause severe upper abdominal pain.
- Splenic flexure syndrome (the pain on the left side – near the spleen)
- Hepatic flexure syndrome (the pain on the right side – near the liver)
Causes and Triggers
The two main causes of gas pain are probably eating foods that irritate you and psychological stress.
Trapped gas often occurs in individuals with irritable bowel syndrome (IBS) . In these and other individuals, the pain can be triggered by:
- Emotional stress
- Air swallowing during drinking through a straw, fast eating or chewing gum
- Eating foods high in soluble fiber, such as legumes, oatmeal, barley, apples, pears or cabbage
- Artificial sweeteners sorbitol, mannitol, maltitol and xylitol found in chewing gum and some soft drinks
- Drinking carbonated drinks or alcohol
- Drugs: antacids, antibiotics, antidepressants, antihistamines, opiates (morphine, codeine)
- Supplements: psyllium husk
Serious health disorders that can be associated with gas pains:
- Abdominal adhesions, for example, after abdominal surgery or infection or due to endometriosis
- Diverticulosis or diverticulitis
- Ileus–temporary absence of bowel motility, usually after surgery or in severe abdominal infection
- Bowel obstruction by a polyp, for example in Crohn’s disease or ulcerative colitis or by colon cancer
Trapped wind can occur as a single event or as a recurrent or chronic problem. Symptoms may range from mild discomfort to debilitating pain and include:
- Constant pain (except at night) in the upper left or right abdomen or lower chest, on the side of the body or in the middle back; it can be aggravated by sitting and deep breathing and may be–sometimes–eased by lying down, burping, passing gas or having a bowel movement 
- Distension (bloating) and tenderness in the upper left or right abdomen
Other symptoms, which may or may not appear along with abdominal pain: referred pain in the tip of the left or right shoulder blade or down the inside of an arm, excessive belching, constipation, diarrhea, excessive gas (flatulence), nausea or dry heaving .
Trapped gas by itself does not cause fever.
A doctor can often make a diagnosis of trapped gas by a simple physical examination. An X-ray image can–sometimes–show an abnormal pocket of gas in the colon.
To exclude other abdominal conditions, abdominal ultrasound, colonoscopy or MRI may be needed.
If your main symptom is constipation:
- You may have a sedentary life style
- You may drink too little water or consume too little insoluble dietary fiber (from whole grains and vegetables)
- You are under stress
If your main symptoms are abdominal bloating and diarrhea, you may have:
- Fructose malabsorption
- Lactose intolerance
- Food poisoning
- Allergic reaction to food
- Infection of the stomach by the bacterium H. pylori
- Intestinal parasites
- Celiac disease
- Small intestinal bacterial overgrowth (SIBO)
If your main symptoms are abdominal, chest or back pain and nausea, you may have:
- Acid reflux (gastroesophageal reflux disease or GERD)
- Gallbladder attack
- Biliary dyskinesia (either gallbladder dyskinesia or sphincter of Oddi dysfunction)
- Acute pancreatitis
- Stomach or duodenal ulcer
- Gastroparesis (delayed stomach emptying)
- Kidney stones or other kidney disorder
- Disorders with enlarged spleen or liver
- Heart attack
- Hypokalemia (low blood potassium level) with painful cramps in the abdominal wall and calf muscles
- Shingles (Herpes zoster)
NOTE: The information about the treatments presented below comes mainly from anecdotal reports and has not been evaluated by clinical studies.
- Lying down and relaxing or massaging the painful area with a hand right after the onset of pain may help.
- Passing gas or having a bowel movement may–sometimes–results in instant relief of pain.
- Deliberately changing the speed of breathing may result in a temporarily relief.
- Drinking warm water or hot peppermint or chamomile tea may help move the trapped gas.
- Applying heat pads may relieve the spasm.
Medications and Procedures
- Dicyclomine , hyoscyamine, propantheline and chlordiazepoxide/clidinium bromide  (antispasmodics) can relieve the spasms .
- Mild laxatives, such as magnesium citrate, or enemas, can resolve constipation.
- Digestive enzymes (lactase, lipase, amylase) can help in individuals with lack of digestive enzymes but not likely in others.
- Massage (visceral manipulation performed by a physical therapist) may result in prolonged pain relief.
- Colonoscopy can be done in order to release trapped gas.
There is no or insufficient evidence about the effectiveness of the following things in relieving gas pain:
- Simethicone [2,5]
- Nonsteroidal anti-inflammatory drugs (NSAIDs): aspirin, diclofenac, ibuprofen, naproxen
- Bismuth salicylate
- Ginger 
- Activated charcoal [5,7]
- Stool softeners
- Apple cider vinegar
- Gripe water (for infant colic pain)
Antacids (calcium carbonate), prokinetic drugs (domperidone, metoclopramide), prebiotics and raw food diet can aggravate symptoms.
1. Be Active and Avoid Unnecessary Stress
One of the best things that can bring peace in your life is concentrating on work you feel is right for you. You will then automatically feel the need to avoid anything that distract you from your work goals: certain foods, relationships, habits, passions, memories, etc.
Physical activity often helps with bowel regularity. Walking can be fine; no need to go to the gym.
Maintain a regular eating, working and sleeping pattern.
Try to avoid:
- Large amounts of foods high in soluble fiber, such as beans and peas, oats, barley, passion fruit, figs, bananas, broccoli, cabbage, cauliflower, onions, artichokes and sweet potatoes
- Anything you personally believe may trigger pain: alcohol, caffeine, fried foods or other.
If you are constipated:
- Eat more foods high in insoluble fiber, such as whole-grain bread and green vegetables (NOTE: in some individuals with IBS, insoluble fiber may aggravate symptoms).
- Avoid foods that may constipate you: soda, chocolate, deserts, cheese, ice cream, caffeine (coffee, tea, cola), white bread and other foods low in fiber .
- Drink enough water.
If you suffer from abdominal bloating and excessive gas, you may want to try a low-FODMAP diet.
Gluten-free diet helps to individuals with celiac disease but not likely to others.
During or after treatment with antibiotics, probiotics help maintain beneficial bacteria in your bowel (intestinal flora) and thus prevent bloating or constipation. Probiotics might not be helpful in other circumstances.
- Gas pain probably occurs as a reaction to emotional stress and certain foods.
- Changing your life style–avoiding unnecessary stress, being physically active, avoiding certain foods and adopting regular eating, working and sleeping pattern–can help.
- It is easy to confuse gas pain, which comes from the intestine, with pain that comes from the gallbladder, so before considering gallbladder removal, ask for an abdominal ultrasound or other investigations in order to get the exact diagnosis.
- Lehrer JK, Irritable bowel syndrome, clinical presentation Emedicine
- Simethicone Drugs.com
- Dicyclomine Drugs.com
- IBS triggers and how to avoid them WebMD
- Gas and gas pains, treatment and drugs Mayo Clinic
- Shafar J, 1965, The splenic flexure syndrome PubMed Central
- Suarez FL et al, 1999, Failure of activated charcoal to reduce the release of gases produced by the colonic flora PubMed
- Ginger WebMD
- Librax (with clidinium) WebMD