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Community Forum

Fifi's Problem

September/October 2004

A wealthy, young man received a party invitation from an elderly socialite at his country club. When he arrived at the party he did not recognize any of the guests. He tried to introduce himself to several people and join in their conversations, but most of the guests were rather snobbish and ignored him; so, he sat by himself on a couch at the far end of the hostess's living room. The hostess's perfectly groomed white poodle, wearing a diamond-encrusted collar, hopped up on the couch and sat beside him.

Suddenly, the man felt a tightening in his stomach; and, before he could do anything about it, he let out a loud fart. Everyone in the room turned and looked at him. The man was completely embarrassed and did not know how to respond to his social faux pas.

The prim and proper hostess was aghast, and she blurted out at the dog, "Fifi!"

The young man suddenly felt relieved, since the hostess thought it was the poodle that had farted. Conversations among the other guests resumed, but the man farted again. Again, everyone turned his direction; and, in a loud whisper the hostess said, "Fifi!"

Relieved that the dog seemed to have assumed the blame for his gas, the man continued to sit on the couch. But, for the third time, he felt a sudden tightening in his stomach and let out another loud fart.

With shear exasperation in her voice, the little old lady turned sharply and shouted, "Fifi! Get away from that horrible man!"

Everyone has had an embarrassing experience with flatulence (intestinal gas); and, people with HIV tend to complain about it -- or, at least, talk about it -- more than others. Two things directly related to HIV may contribute to this problem.

First, HIV itself can contribute to intestinal gas. HIV naturally gravitates towards the gut, which provides a hospitable environment for the virus. A high viral load in the gut will disrupt normal functions and can result in gastrointestinal distress -- a polite way of referring to diarrhea, nausea, vomiting, and gas.

Second, HIV medications as well as opportunistic infection and prophylactic medications can disrupt normal gastrointestinal functions. HIV medications -- particularly Norvir and Kaletra -- can cause gas. They can alter the acidity level in the stomach, which normally regulates the absorption of food and medications. Altered acidity causes malabsorption of food and medications and may result in gas.

Pancreatic enzymes, or digestive enzymes, will help with malabsorption problems. Activated charcoal "captures" or "binds" gas in its small cavities, or chambers, and carries it safely through the digestive system, thus reducing gas.

Antibiotics and other medications can also alter the bacterial fermentation of food in the intestines, which will increase intestinal gas. Taking probiotics such as acidophilus will replenish good bacterial flora destroyed by antibiotics and will restore the balance of healthy bacteria in the gut. This should reduce gas. Saccharomyces Boulardii, Bifidus, and FructoOligoSaccharides (FOS) are also helpful probiotics for combating gas.

Medications that must be taken on an empty stomach (without food) can also "burn" or damage the intestinal lining, resulting in stomach ulcers and gas. L-Glutamine, an amino acid, can be taken to repair and maintain the intestinal lining and, therefore, decrease intestinal gas.

Simethicone is the active ingredient in several over-the-counter antigas medications (Phazyme, Flatulex, Mylicon, Gas-X). Simethicone chewable tablets will help reduce gas; but, keep in mind that they address the symptom (gas) and not the underlying problem or cause. They should not be taken for an extended period of time unless as directed by a physician.

While flatulence may be a fact of life, that does not mean it is something you "just have to live with." In most cases, gas is manageable. You may not be able to completely eradicate it; but you can, at least, reduce it. And when it does happen, try blaming it on the dog!

Guy Pujol, D.Min., is with AIDS Treatment Initiatives, HIV/AIDS Buyers Club, 139 Ralph McGill Boulevard NE, Suite 305, Atlanta, Georgia 30308-3311, Phone: (404) 659-AIDS; Toll-Free: (888) 874-4845.

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This article was provided by AIDS Survival Project. It is a part of the publication Survival News.
See Also
HIV & You: Managing Gut Symptoms
More on Gastrointestinal Problems and HIV