Merck Manual Essay On Flatulence Underpants

Corsets and crinolines, boxers and bras … the history of underwear is also an intimate history of changing attitudes to gender, sex, hygiene and morality. But the smalls on show in the Victoria and Albert Museum’s new exhibition, Undressed, tell a story of technology as much as social trends.

Underwear goes on show at the Victoria and Albert Museum

From whalebone to wire, state-of-the-art spandex to austerity-era paper, boobs and bums have been progressively enlarged, shaped, squeezed and hoisted by ever more elaborate materials and mechanisms. With the rise of high-performance fabrics and smart materials in the 21st century, here’s a brief survey of what the future is looking like for pants.

Undercover underwear

What do you do when you develop a cunning remote-monitoring system to track soldiers’ performance in the field, but they don’t want to wear a clumsy chest strap, or forget to wear the wristband? You hide it in their pants, of course.

US army researchers have developed smart underwear, with sensors secreted inside elastic waistbands that track heart rate, body temperature and perspiration, and beam the stats back to a central monitor. This “wear-and-forget” sensory system is also designed for stressful training situations, identifying which soldiers remain more balanced, so they can be picked for the harder missions.

As ever, the multibillion-dollar fitness industry has taken lessons from the military-industrial complex and developed underwear that tracks your metrics during exercise. Forget the Fitbit. Meet the OMsignal smart bra, the result of “exhaustive scientific research” into making bras more expensive than ever before. Sensors in the straps send instant feedback to a smartphone app, so you can monitor precisely how few calories you are burning. There’s no escape: it’s not just the NSA – our underwear is watching too.

Genital scaffolding

Our top 10 iconic underwear moments

The term “enhancing underwear” might summon images of go-go-gadget pants that help you run faster and jump higher, but it actually refers to a new breed of briefs that promise you a bigger bulge. Push-up bras and “butt-lifters” have long been a staple of women’s lingerie aisles, but genital scaffolding has now spread to menswear. Featured in the V&A exhibition, the “Wonderjock” is the work of Australian company AussieBum and aims to do for men’s bits what the Wonderbra did for women’s busts – hoisting them up and thrusting them out.

Is “pouch-enhancing technology”, which basically consists of a separate pocket for your bits at the front of the pants, the logical evolution of the “manspreading” urge to take up more space? “It will literally pick you up and push you forward,” growls the video, showing a pair of pants swelling up with a big bulge, ready to burst.

Pants for pill-poppers

Underwear is already a common place for smuggling drugs of the illegal variety, but a recent pharmaceutical innovation could soon make putting pills in your pants a legitimate activity. Swiss textile giant Schoeller has developed a fabric that administers drugs to the surface of your skin over time, and thinks the best place to put it is in your undies – as those are the garments you’re least likely to forget to put on.

The iLoad uses the principle of a nicotine patch, with a “donor layer” over a base fabric, which can be charged with the required substance, like a sponge. Release of the substance is triggered by warmth, vibration, moisture and perspiration, with the “desorption” time adaptable to specific applications. Designed for treating dermatitis, sleep disorders and bedsores, the medicinal underwear could be rolled out to tackle all manner of ailments. Wake up with a cold? In future you might be reaching for your Lemsip-infused pants.

The company sees cosmetics as a big growth market for its “chargeable underwear” technology. Sit down and you could get an unexpected shot of moisturiser, perfume or cellulite cream, giving the idea of “slimming underwear” a whole new cachet.

Oh, for a bacon-scented bottom

If you love waking up to the smell of a cooked breakfast, but don’t have anyone to cook for you, help is at hand in the form of bacon-scented boxers. “Marrying the ultimate in comfort and cured meat, J&D’s Bacon Scented Underwear represents the gold standard of meat-scented luxury undergarments,” says the Seattle-based food company behind the porky pants. “Each pair is hand crafted in the US to offer the support of briefs, the freedom of boxers and the smell of breakfast cooking in your pants. You really can have it all.”

A more practical innovation comes from British manufacturer Shreddies, which has developed flatulence-filtering underwear, allowing you to “fart with confidence”. Their magic farty pants incorporate a layer of Zorflex, a microporous carbon-based material more commonly used in chemical warfare. Research by De Montfort University found the fabric “removes sulphide and ethyl mercaptan so effectively it can filter odours 200 times the strength of the average flatus emission”, guaranteeing wind protection after even the fiercest lentil curry.

No, I’m really not pleased to see you

“Thunderwear” might sound like more fart-suppressers, but it is the brand name of “the original and most widely worn concealed holster available anywhere in the world! “Is the old ankle holster just a ‘little’ awkward?” asks the promotional website. Well, now you can simulate the gangsta feeling of putting your firearm straight in your boxers, only with the added comfort of a double-walled denim pouch for abrasion resistance.

The design also has a patented three-layer moisture barrier, to prevent mishaps if you get a bit excited by the thought of having a big steel barrel shoved in your kegs. A holster that leaves the gun pointing directly at the family jewels, what could possibly go wrong? The website features a page of glowing, somewhat alarming, testimonials: “Tried it out at dinnertime in jeans & a t-shirt,” says AP of Los Angeles, CA. “Neither wife nor kids were the wiser. Thanks.”

• Undressed: A Brief History of Underwear is at the Victoria and Albert Museum, London, until 12 March 2017.


There is great variability in the quantity and frequency of rectal gas passage. As with stool frequency, people who complain of flatulence often have a misconception of what is normal. The average number of gas passages is about 13 to 21/day. Objectively recording flatus frequency (using a diary kept by the patient) is a first step in evaluation.

Flatus is a metabolic byproduct of intestinal bacteria; almost none originates from swallowed air or back-diffusion of gases (primarily nitrogen) from the bloodstream. Bacterial metabolism yields significant volumes of hydrogen, methane, and carbon dioxide.

Hydrogen is produced in large quantities in patients with malabsorption syndromes and after ingestion of certain fruits and vegetables containing indigestible carbohydrates (eg, baked beans), sugars (eg, fructose), or sugar alcohols (eg, sorbitol). In patients with disaccharidase deficiencies (most commonly lactase deficiency), large amounts of disaccharides pass into the colon and are fermented to hydrogen. Celiac disease, tropical sprue, pancreatic insufficiency, and other causes of carbohydrate malabsorption should also be considered in cases of excess colonic gas.

Methane is also produced by colonic bacterial metabolism of the same foods (eg, dietary fiber). However, about 10% of people have bacteria that produce methane but not hydrogen.

Carbon dioxide is also produced by bacterial metabolism and generated in the reaction of bicarbonate and hydrogen ions. Hydrogen ions may come from gastric hydrochloric acid or from fatty acids released during digestion of fats—the latter sometimes produces several hundred mEq of hydrogen ions. The acid products released by bacterial fermentation of unabsorbed carbohydrates in the colon may also react with bicarbonate to produce carbon dioxide. Although bloating may occasionally occur, the rapid diffusion of carbon dioxide into the blood generally prevents distention.

Diet accounts for much of the variation in flatus production among individuals, but poorly understood factors (eg, differences in colonic flora and motility) may also play a role.

Despite the flammable nature of the hydrogen and methane in flatulence, working near open flames is not hazardous. However, gas explosion, even with fatal outcome, has been reported during jejunal and colonic surgery and colonoscopy, when diathermy was used during procedures in patients with incomplete bowel cleaning.

Some Causes of Gas-Related Complaints

Aerophagia (swallowing air)

With or without awareness of swallowing air

Sometimes in patients who smoke or chew gum excessively

Sometimes in patients who have esophageal reflux or ill-fitting dentures

Gas from carbonated beverages

Beverage consumption usually obvious based on history

Patient usually admits when questioned

Chronic, recurrent bloating or distention associated with a change in frequency of bowel movements or consistency of stool

Typically beginning during the teens and 20s

Nausea, abdominal pain, sometimes vomiting

Sometimes in patients known to have a causative disorder

Upper endoscopy and/or nuclear scanning that evaluates stomach emptying

In patients who are thin but still very concerned about excess body weight, particularly young women

A long history of hard, infrequent bowel movements

Non-GI disorders (eg, ovarian or colon cancer)

New, persistent bloating in middle-aged or older patients

For colon cancer, sometimes blood in stool (blood may be visible or detected during a doctor's examination)

For ovarian cancer, pelvic ultrasonography

For colon cancer, colonoscopy

Dietary substances, including beans, dairy products, vegetables, onions, celery, carrots, Brussels sprouts, fruits (eg, raisins, bananas, apricots, prune juice), and complex carbohydrates (eg, pretzels, bagels, wheat germ)

Symptoms that develop mainly after consuming food that can cause gas

Disaccharidase deficiency

Bloating, cramps, and diarrhea after consuming milk products

Celiac disease, tropical sprue

Symptoms of anemia, steatorrhea, loss of appetite, diarrhea

For celiac disease, weakness, symptoms that often begin during childhood

For tropical sprue, nausea, abdominal cramps, weight loss

Biopsy of the small intestine

Usually a known history of pancreatic disease

Sometimes MRCP, endoscopic ultrasonography, or ERCP

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