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What a Gas!

On an average day the patient recorded 34 episodes of flatulence, with some days cresting into the low 40s. Levitt did not have any data on how this compared with the output of the ordinary person, but even in a globally warmed, ozone-shredded, chlorofluorocarboned world, this sounded bad. Before his unhappy patient detonated at a mooring mast in Lakehurst, New Jersey, Levitt decided to take his case. In treating a man complaining of flatulence, there are many things a doctor must consider–not the least being that the patient is a man. From toddlerhood to dotage, there are few skills more highly prized by the average male than a facility with flatulence. Why men should seem more open about their gastric volatility than women is a mystery, but from a sex whose inventiveness gave the world the noogie and the wedgie, a fascination with all things intestinal should not come as a surprise.

While most men do what they can to curb this natural impulse, limiting themselves to such flatus surrogates as whoopee cushions and fireworks, an affinity for flatulence remains. To study a problem of extraordinary flatus, Levitt needed data on what ordinary flatus is. Recruiting seven highly cooperative volunteers, he requested that they spend at least a week keeping flatugraphic logs of their own, recording how frequently they stirred intestinally and when these events occurred. While taking the time to note such events would not make for an especially social week, it would make for a scientifically enlightening one, providing Levitt with what was almost certainly science’s first flatulence control group.

When the results were in, it was clear that control was just what his seven volunteers did have and what his troubled patient didn’t. In the group I chose, Levitt says, the mean flatus frequency turned out to be 13.6 episodes per day, with no statistically significant differences attributable to age, gender, or other discernible variables. The upper limit for even the most gaseous of these subjects was less than 20. In all cases the daily output was considerably lower than my patient’s 34, indicating that his problem was quite real. More disturbing than the frequency of flatus from the afflicted man was the quantity of effluence produced by each event. It’s well known that a flatulent episode can range from a barely detectable rumble to a propulsive burst sufficient to attain low Earth orbit, depending on general health and recent visits to all-you-can-eat salad bars. With the help of internally worn rectal tubes and 100-milliliter collection syringes, an earlier study had determined just what the standard output of all these eruptions is. The average person appears to release between 500 and 2,000 milliliters of gas per day rectally, Levitt says, with the average volume of what passes at once varying between 35 and 90 milliliters.

The young man I was treating released an average of 5,520 milliliters per day, or 162 milliliters per event. By any measure, it was clear that Levitt had discovered the Joltin’ Joe of digestive distress, but before consigning the unfortunate man to a private wing in gastroenterology’s Hall of Fame, Levitt knew he’d have to investigate further. The next step, he decided, was to study not just the quantity of the patient’s gaseous output but its makeup. Given the power of intestinal exhaust to turn heads, clear rooms, and in extreme cases fell whole swaths of old-growth forest in the Pacific Northwest, this least fragrant vapor would seem to be made of only the most pungent stuff. Yet according to analyses Levitt–and later others–conducted on captured flatulence, intestinal gas can be surprisingly benign. When you analyze rectal gas, Levitt says, you find that it is about 99 percent carbon dioxide, hydrogen, nitrogen, oxygen, and methane.

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