Green Vegan Lifestyle in Hong Kong and Asia
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“Unexplained” Epigastric Distension and Flatulence - Dr. Irene Lo

“Unexplained” Epigastric Distension and Flatulence


By Dr. Irene Lo



A lot of people complain of persistent epigastric distension or flatulence despite normal blood tests, endoscopies and ultrasound examinations. Although there is no pathological change inside the stomach and intestine, the discomfort affects appetite and daily life. I refer to this phenomenon as functional discomfort. To understand why the bowel cannot function normally, we have to look at the food we eat. In particular we need to look at the following types of food:


Food which is difficult to for us to digest:

Fat and protein from meat and deep fried foods of all kinds are all difficult to digest. When food cannot be fully digested, it will become rotten inside the intestine. Rotting of partially digested food will lead to multiplication of bacteria and accumulation of gas inside the bowel. This will irritate the bowel and affect peristalsis, contributing to epigastric distension, flatulence and even passing smelly farts.


Completely cooked vegetables are less readily digestible than raw ones. Therefore if you can, it will be a great advantage to eat vegetables raw.


Food which we are unable to digest:

Milk contains lactose which requires the enzyme lactase to digest. Many of us, especially Asians, do not have the ability to digest lactose simply because we do not have lactase inside the gut. Therefore, when we consume milk or milk products, the ingested lactose provides a rich food supply for the bacteria in the gut. This facilitates an unwanted fermentation process which irritates the bowel, affects peristalsis and contributes to epigastric distension, flatulence or colicky abdominal pain.


Brown rice, whole grains and beans which have not been soaked before cooking:

All whole grains and beans are seeds. They do not sprout in dry condition because of the presence of a growth inhibitor named phytates. Phytates will be dissolved when the seed is in contact with water. Then, the sprouting process begins inside the seeds. If we cook whole grains and beans without soaking them long enough in water to dissolve phytates away and discard the water, we will take in phytates when we eat. However, our intestine lacks the enzymes phytase to digest phytates, but the bacteria in our gut can digest it. This will provide nutrition for the bacteria, enabling it to multiply and to produce gas inside our intestine. This gas irritates the bowel, affects peristalsis and contributes to epigastric distension, flatulence and colicky abdominal pain, etc.

Always remember to soak enough and discard the water before cooking whole grains and beans. This will allow us to get the most out of these healthy foods.


Tobacco, alcohol, coffee and tea:

Tobacco, alcohol, and the caffeine inside both coffee and tea (including all western, Chinese and Japanese teas) have an atrophic effect on our stomach and intestinal mucosa. This will disturb the balance of the mucosa metabolism leading to gastritis, ulcers and even perforation. Caffeine can also loosen the gastro-oesophgeal sphincter which can contribute to stomach reflux.



This includes all processed, packaged food which contain chemicals such as preservatives, colouring agents, hydrogenated fat, etc. which may also irritate the bowel, affect peristalsis and contributes to epigastric distension, flatulence and colicky abdominal pain.



I believe that to eating a vegan diet that features whole grains prepared in the right way, as much raw food as possible, and avoiding tobacco, caffeine and alcohol can offer a great advantage in helping us to fight against the functional discomfort we commonly experience. Do try your best to go through what you usually eat everyday carefully. Changing something in your diet may be the key to get rid of these “unexplained” functional intestinal motility disorders that have been bothering you.