way gonna get this thing started. We're gonna do this. Yeah. Yeah, we're gonna do it. You know why we're gonna do it? Because this this this this viscous

We've talked about a lot of really important things on this Won't hurt a bit like how to save someone's life, how to do CPR, what to do if someone is drowning. And today we're gonna talk about something equally important

and mysterious. I would say Maur important. Yeah, in

many ways. And that is farting, Mel, you just you still the wind right out of me? Uh, you're

full of thing. Absolutely stinks. Just just gonna breeze by.

We're also gonna talk about burping in

hiccups. So we really are talking about

farting. Yeah, OK, well, it's about time. I can't believe we made it this long without talking

about farting. You've got some questions about fighting. I know. You're I d'oh!

Okay, we're gonna get to that. Were we gotta build up to the fart. We're gonna start with hiccups.

OK, Pickups, boring

hiccups.

They're not They're not boring. If you have them, they're super annoying. I hate them like there's some things in life that I can't stand and hiccups is one of you know, I'd rather have a paper cut than a hick up. I'd rather be poked in the eye with shelf

object. What if someone said Dave piece paper when it cut you right now? Or or you could have the hiccups

for five minutes. Cut me. Just do it. Just get it

over with real quick, but it's not gonna be quick. I'm gonna

give you a really so paper cut.

Okay? So what is a hiccup?

It's some sort of nerve. Not nervous. So sort of like reflects You can't stop, huh? Like some sort of spasm.

Yeah. And your gut? Yeah, that's a really good description. That's what it feels like. Right? So you get this sudden like inspiration, right? Not like you inspired, like, you

know, like like sometimes when you're sitting there and like, your biceps jiggle in and you can't stop it and then you tell people like, Hey, look, look, look, look, I'm not doing anything, and it's like I like to do it with my pectorals. Check this out. This happening totally by itself. Look at them chicks love that tournament. Yeah, to music. Okay, let me just start dancing.

Okay, so it's sort of like that. But it's, um It's been ah, whole different set of nerves. And it causes this reflex arc where you have the sudden breathing inward. And then you're Gladys, You know where the air comes in out that closes. And that makes it the sound. Yeah, yeah.

And what is contracting? What is the muscle that's doing this contracting toe diaphragm? Very good. It's your diaphragm. And you know what's interesting? Your diaphragms in two parts. There's a left side on the right side. 80% of the time. It's on the left side. You know how I know that now? Because in the show notes Wait there are shown. I should be looking at these so much information.

Okay, so there's a medical word for hiccups. Dave, do you know what it is?

Is like Latin sounding like hip? A CAS.

That's from us. That's a good one. That's not it. But it's really good. Dave. Um, no. The medical term. You know the smell. Singleton. Yes.

Single tickets from the Greek hiccup for the creek for hiccup. Different comes from

a single

tests from the Latin meaning a speech broken by sobs.

So sometimes we get people who come into the E. R. And they're there because they have intractable hiccups. They're like, really bother. Imagine, that'd be really frustrating. You know, How long does it have to be before you, to the point where I'm like I'm gonna go to the e. R and wait in the e R

reported like, What's the longest? Someone's had hiccups. It's years, No, and using a camera. It's like 60 something years that this dude had hiccups. What does it break it all like he had and having some time? And that started again. Or it was like like the way we have hiccups at the chick. But I think it's in, like in the Guinness Book of Records of Some Dude have hiccups for like sixties. In 1922 Charles Osborne was trying to weigh a pig before slaughtering it when he fell shortly after he came down with the hiccups which lasted for the next 68 years, they started at a rate of about 40 per minute and later slowed to about 20 per minute. They finally stopped mysteriously in 1990 a year before his death His doctor blamed it on a tiny burst blood vessel in his brain the size of a pin, which he claims to stray the area and his brain stem. That inhibits the hiccup response.

So we use the term intractable hiccups. But what does that really need? Actually, as a medical definition, you know, if you have hiccups or five hours Republic, I've got intractable hiccups. It's horrible. Now you haven't really met the definition. You really

five hours of hiccups is not a problem.

It's I mean, it's probably very irritating, but it doesn't meet the medical term of quote unquote intractable hiccups. You got to be hiccupping for over. Yes, 48 hours. Dave. Good job. Wow. Good job. Yeah, anything less than that would be a hiccup about. Have you been hiccupping for five hours?

You got about How do you sleep? It's got hiccups of footage for five minutes. If I had the hiccups, that would be go to the E r.

Please do that. Yeah, that is awful.

Two days just Eddie sleeping. How do you sleep? I don't think you do.

So if you have a short duration of hiccups sick about it Last for like a day, up to 48 hours. It's persistent hiccups. And then over 48 hours is intractable.

Hiccups. What do you do for that? One of its 60 years. What do they call that? Horrible. Seven counts, but that's what it is.

So what do you do? You think? What do you do for you? Well, you know what? This has been extensively studied

in. I can get rid of hiccups. I've got a better way than you don't know how to get rid of you. Think of what I d'oh is. I find something impossible to do, Like count how many pieces of stucco is on a wall or how many fibers of rug there are or or how many lines there are on a, um, TV screen something you just can't possibly do and try really hard. Did not lose your place and just sit there and really try to count him and they usually go away. That sounds lame.

I going attest to this technique that it does not work. What? I think it goes away. You'll be hiccuping and I'll be like a David like No, I'm concentrating.

Everybody knows that the way you get rid of hiccups. It's been proven in multiple studies. Randomized trials, multi center across the world is that you take a cup of water and you bend over at the waist and you drink out of the cup on the opposite side. So and never understood that every 50% of the time it works every time. I cannot visualize that. I do not understand how that works. Okay, here we go.

Mel is gonna do it. And

And if you also do that while pressing firmly into your ears almost to the point, whether it's significant pain, that increases the probability of the hiccups stopping by another 12% and doesn't what about the you saying that I just made that up? Yeah, you'd

be correct. It also proves that the cup is levitating. If you're using your hands

to plug your ears a special. What about blowing in the bag like a paper bag like hyperventilating into a bag?

Well, these air, all described techniques in the literature doesn't mean that they're science behind them, But they're all described drinking from the other side of the glass, breathing into a bag, gargling water, sipping ice

water holding your breath, getting scared, getting punched? Oh, yeah, Getting scared. That's

a good one. Yeah, these are all described as as possible techniques. And And I think the concept with some of them is to try to interrupt the the hiccup reflex arcs of certain nerves that go into the process of hiccupping, the frantic nerve and the vagus nerve and a bunch of nerve roots coming off of your C spine. Um and so if you could do something to stimulate those nerves or sort of disturbed those nerves than instead of like, continuing to Hiccup, they're like, Oh, we're gonna do something else now And they and they focus on that. I think that's I think that's the general concept that's not really scientifically

based. Yeah, I think it's like squirrel. So you're got hiccups and you suck on a really sell lemon and your friend move goes. 11 forgets that it's part of this reflex loop stops. I believe that's the scientific explanation. My master made me this collar. He is a good and smart master, and he made me this collar so that I may talk squirrel.

Now let's talk about real science and legitimate data on this subject.

Okay, Got it.

Boring. So there's this very robust, sort of, like group that does these massive reviews of the literature to basically say, Hey, we've looked at everything and this is what the data says. It's called the Cochran Library. Okay, So the Cochran Group reviewed this in 2013 and they found a drumroll. Zero studies that met inclusion criteria to even be included. Azriel scientific evidence.

So in layman's

terms, there's no evidence for anything.

So, you know, to get into the Cochran database has a good study, you have to fulfill certain criteria, has to be blinded or randomized and really well done scientifically. And they're basically saying there is no studies that are well done for the treatment of hiccups. Despite that, we treat hiccups every day. If you think something works, then just do

it. Yeah, why not try it? I mean, what's the harm inviting

a lemon right within reach? If you think the cure for hiccups is jumping up, told buildings, it's probably not a good Yeah, that's the

way you would stop

hiccuping. Would you stop a lot of things? Would you?

And the medications that we give just so you know, if you come in asking for one of these just so you know, they're nausea medicines. But they're also anti psychotic medicines. She's yes,

and often they're given by injection. And I think it's just that you just stuck me with a needle in the the front, ignoble in your little. And then it forgets to hiccup.

Not that it's dangerous to give someone an anti psychotic, don't want to give that impression. But yeah, that is, that is like the medicine that we're giving

you. Just so you know, the layman, it seems a little like overkill because I don't know what a psychotic anti psychotic medication is. So it's like I'm gonna give you anti psychotic medication for hiccups. That seems a little like I don't know

if I need that. I'm going to go do this bend over

ginger tea. The beautiful thing about medicine is when you're psychotic and we give you a medicine. It's an antipsychotic to stop the psychosis, but if you're nauseated, we give you an anti nausea medicine. It's the same medicine, and if you got hiccups, we're gonna give you an anti hiccup minute thing science we're gonna cover.

So naturally, after talking about hiccups, you're also probably worried about farts.

Can we get to the phone? I want to get to the farting Freudian slip.

Yeah, let's talk about gas

coming out of place and let's do it. I feel like I got far right now. I won't, though, because we're in a very close. All right, it's a little warm.

Burping and farting have a lot of things in common,

right? It Sure, Yes. It's coming out of an end

of G I End of you. Is

there a medical term for burping?

There is. And it's not belching its called

purpose expectation

of France. Eric Rotation. What did the Ayer rotation there? Rook Titian, e r u C T A t Ioan Irritation

can use it in a sentence. Please.

I am irritated that you're

I was gonna go spilling.

Okay, So, um so why did this happen? Well, you've got guess in you in your intestines and it's got to come out from somewhere. How much gas do you think that you have in your G I tract at any given time

between like, you're you're burping gas and you're farting

Dad's like right now, let's say just from your mouth all the way down there's gas that's living in your intestines, right? Okay. How much do you think is in

you? I know how much is in May? 870 litres floating. Continuously leaking out A ttle Tubbs. I think you're supposed to burp right toe like sink to the bottom. Something like that?

Yes. Really? Wonka's Chocolate factory. About

1500

million. Oh, that's a lot.

Yeah. I just think there's a lot of spaces and crevices. I could probably Philip a lot of gas before it starts like it's got to come out.

Well, okay, So first I need to preface this by saying this is not based on excellent data. There was a study in the 19 seventies where they took some argon gas and put it in someone. And then they saw how much gas came out and what that gas consisted of are trying to determine how much it was not are gone, right? And so then therefore, that's how much gas is in you. And this is not awesome data, but. But in that study they said that it was about 30 to 200 mill liters or C C's of gas at any given time.

Less than a dog Kirk full of air. Wow, I don't believe it. It's a bad 800 letters. It's particularly after cabbage. Come on, it's gotta be more than that, right? That's not enough. I grew. This is thinking medicine or in science called face Validity. So somebody comes out with a new study that says, You know, stabbing people in the heart. Turns out there is really good for people. Face validity is like common sense like that doesn't make sense. I think we should do another study.

I agree with that. Yeah, this doesn't have face validity. I'm sure it's 800 ladies of gas. That's my experience. I'm just saying, What is the structure of the gas? What are the ingredients? What made up? It's flammable, right? Because there's a lot of YouTube videos where this stuff happened, so there's a lot of different guesses most. It's just sort of the same guess you find in the because a lot of this might be you swallowed the gas. Some of its this bacteria in your gut that creating Guess there's lots of nitrogen. Results of auction exhaustive Hodgins.

But there's also may thing, which is a byproduct of the bacteria eating various things. So there's May thing in there. That's probably the thing that is lighting up when you light your farts so you have to have a mortar methane than other gases. If it's gonna light right, we've gotta have some method in there for dear life. Theme mix of gases and smells You produce is unique to you. It all depends on the foods you eat and the specific flora and your digestive tract. The majority of most people's gas is composed of nitrogen and oxygen from swallowed air and hydrogen and carbon dioxide produced by gut bacteria. On Lee, about 1/3 of people produce methane and, just to be clear, both methane and hydrogen are flammable. The only methane will produce a blue flame win. Let people know we're even talking because I believe that this is predictable, a thing that males in Australia Nobel so sure that

teenage boys in America know about it Definitely universal. I think. I think old cultures, I think third attempt to light a fart

on that makes me feel better because It was my brother's favorite past time. Growing up in Australia in the Outback was delight his fat. And in fact, one day he was doing it on the catch to gross out and he let the catch on fire.

Did he like the couch on fire Because of the expulsion of the fart or her from loose a lighter?

Quickly, nobody does. But I know that he lit his fart. And then a few seconds later, they were screaming, Oh, my God! The catches on fire! True story. I remember it like it was yesterday and that we told him to stop doing it because I don't know if this is true, but we were very concerned that what would happen if the flame went up his rectum. Oh, yeah, like a back draft.

Because this has actually happened. This has happened in

people in the operating. It happens in the houses. They tell you not to open the door because the backdraft the fire comes. Don't open that rectum. It feels very warm. That could be a 500

once you fart. You close that close the sphincter

because you do not want a backdraft. Okay, I need to go back and explain that. So this has happened in the operating room. There's good reports of this. And so this can happen two ways. One way is you're the surgeon and you're working on somebody's Colin, for example, and they use these electric quarterly devices that are very hot. And if you put a little hole in the Ballon, there's a big gas pocket in there. Proof that can happen. And it has actually been described. And I just found another one. Reported from Japan, where they were lazy. Ring a woman's cervix for cancer at the same time she broke wind boom started a fire.

Now I don't want you to get scared. This is incredibly rare, and there's things that are being put in place to prevent that happening. But yes, this has happened in the operating room. Those faults, they're dangerous. And kids Public service announcement Don't light your farts. You can get really badly burned. It's a bad idea. It's a living thing. Brian breathes eight.

So we were talking about where do the farts come from? And what are they made of? Bacteria. Yeah, bacteria is probably the biggest one, so they're digesting your food. He thought you were digesting your food, but bacteria are helping you. But also a lot of things that we eat our lot of gas. We eat things that are gaseous. Like I bet you didn't know that an apple is 20% gas.

No, I didn't know that. But I know there's like the cabbage. Thank you. Gassy? Yes. Beans, for some reason or super gassy. Just has a table. She's got a table of the most gay c'est

produce thistles called classifications of food according to their flat. A genic potential potential splatter

genic. So if leitess fart fart potential fart potential foods. Okay,

What's the matter? Jenise iti

What is the most farty food?

Okay. The farty ist foods Extremely flattered genic, um and that is defined as greater than 40 passages of gas per day. So what are the What makes you fart more than 40 times a day. They say milk and milk products. But I would argue that that's probably for someone who's right. I mean, this is an old school article, so I don't I don't know how real this is. Ah, they say things like onions, carrots, beans, bananas and wheat germ. Those air Their examples for the farty ist foods. Carrots?

Yeah. Carrie and I think of

funniness and carrots. No, I don't either.

Beans for sure, Rick, Of course. Right. The magical fruit. The more you eat, the more you too.

And why is that?

Yeah, why is

that? It's because the stuff that forms like the outer layer of the vegetables, These are some sort of complex carbohydrate and you may not have the ability to break everything down on your own. Like if you don't have the enzymes to do that, then you rely on intestinal flora to have enzymes to help you break that down. And what do they do? What is the byproduct when they use their enzymes to break that down? Yes. Yeah, they give up

the layer so that gas can be like carbon dioxide or can be me thing. So their concept is, if you have a lot of these sugars, you can absorb some of them. But if there's a lot left over, then the bacterium just eat them and then they start fighting. And that makes you so lactose. And Torrance is Some people just don't have enough or the ends on to breakdown Lecter's and absorb. So the better I do it for you and you fight a lot. You get Billy playing your diary, Smith.

And even if you're not lactose intolerant, the ones that commonly do it so, he said, like the outer layer of the beans. That's a complex sugar that's in there. It's called Rafa Knows, but also fruit does have all heard of fruit does common sugar. That's another one that can cause increased gas and then sorbitol, which is basically in every type of gum. It's an artificial sweetener, silly all sugar free gums. Most of them have sorbitol in them, and that's, you know one thing that can give you

a lot of words. So this revenues this thing. It's in beans, but it's also a cabbage. Yeah, to Brussels sprouts, broccoli alot of those things. It's the same problem, so I don't anything good for me. Don't do it. A chicken doesn't like me. Guess he, speaking of beans. What's up with Beano? How does that work? Because you know you take and it, like, alleviates your gas.

Well, that's what it's supposed to dio, doesn't it? I mean, probably it probably does help. Basically, that's just an enzyme. It's this oral form of an enzyme called Alfa Galactus side Ace. And the idea is that as soon as you're gonna eat that gas form and food, so before you eat your cabbage in your broccoli melon which now the world is open to you, you Sprinkle Labinot on and you can have it, and it helps break that down. So that way, it's You're not relying on the bacterial Florida break down and farting and make you fart.

Sabino doesn't make fart bacteria make thoughts. Bono helps break the circuit down so I can absorb it. Okay, I before this now I was under the impression that Beano eight farts e thought it was like charcoal it, like, sorted. And then you put it out as a break. Exactly. Okay, Mel, I'm not gonna ask justice questions farting, Ever sign of a problem like a medical

problem? And you're not asking? No, Because you're gonna say you don't want diagnosis.

Say yes. It is a problem. Uh, I guess it could be mostly, it's telling you, like if you were excessively funding and some people like fighting all the time. It's probably that you do have sort of an enzyme insufficiency. Or it could be that you have an enzyme insufficiently like you're lactose intolerant. For example, if every time you eat a certain food you get abdominal pain and you fucking like guess what? Probably shouldn't eat that food. Your body is not digesting it very well. So from that point of view, maybe that's true. But is sort of a symptom that people would present with to make us think Oh, my gosh, this person could have something really bad.

Lots of guests is not something that we think that we don't go. Oh, my gosh, That's grads Cancer. Your date. Okay, I think so. So, really, gas is your your flora your own personal floors way of yelling at you at the end of the day, like I didn't like

Like I love

Come on, let's have some more of that.

And if you come in and you're only complaint is lots and lots of gas, you're probably fine. Like when these patients have follow up studies and they see the G I doctor, they get scopes. They're fine. Like most of time. Nothing is discovered about them. There may be just a little bit more sensitive to their own body farting, and they think it's a problem. It's when the farting is associated with other things like, Hey, I got lots of gas and belly pain and I'm losing weight. Then you're like Who

you mentally kind of put far off

the list? Yeah, Other other things like, Oh, maybe this person needs a workup for something like celiac disease. But it's not because of the farting. It's because of all the other symptoms that went along with it for that individual

effect, but and can be the son of good things, right? Just so we're have surgery, I have appendicitis, for example, that Senator and then on rounds you're rounding. I used to be a surgery isn't around on the patient, and you'd ask them a passing any guests, you having any farts? And there'd be like No, no, no, it's not a bad. There's good thing because that means your colon is working again. They Yeah, I had a little too thi this morning.

I remember, though. Remember that getting colonoscopies and they would ask you like, did you fart? Did you pass gas and you're like, Yeah, I just did. And they were so happy. They're like, Oh, so wonderful a year. It's like I don't think I'll ever hear anyone ever say that ever again.

Yeah, you really get that comment when you're a baby and you fart Go t o and Post op. So cute, silly it's on him way

should talk about what's normal. Fighting is normal. It's just part of being a human being. You may not like it. It's just part of being alive. After digest things, one of the byproducts of digestion is firing. If you have an excessive amount of Flavius, though, a lot of people like I must have cancer. I get something that's terrible. So if you have an excessive amount, you can do some things to reduce that. You can look at this list of foods, and maybe you're eating photogenic foods. Maybe you're lactose intolerant. Maybe you need to drink a little less milk and ate a few less beans.

Perhaps so there are some things that you can do. Maybe when you get anxious, you swallow a lot of air. Maybe you need to work on breathing techniques, they says. draws like don't drink from straws because you'll suck down too much air. And certainly carbonated beverages swallow whole carbonated beverage. If you don't bump it up, it's gonna command the other Well, really? Yeah.

Yeah. So if I'm

holding a fart will come out as a bird. It goes north to south. It doesn't go south and north only under severe pathological conditions, which quite terrible when you have this thing called a balle obstruction were bells don't work. Things come back up to the point where they come out your mouth. Wow, it's terrible. But no. If you holding a fuck, it will not make its way all the way back up in until just hurt until it and eventually will come in. But normally they say that most people fart 20 times a day.

That's a lot, I think. I think it's enough

that number sounds way underestimated.

I think that what? Yeah, I think

more maybe for guys in Is this like a gender thing? Like women versus men who do that study. Do you have a faw tomato? You're attached to Your Highness.

Maybe there's like a little counter

counter walk around the counter next week

we should do a study on Let's get some real data. How many times do you fart a day? You mentioned what? What's normal and what could be pathological. But we don't talk about that for hiccups. I mean, hiccups are generally like normal. We all get hiccups, but people who are getting lots and lots and lots of hiccups or sudden bout of them with other symptoms, that could be a sign that something else is going on. So there are reports of hiccups occurring when someone's having a heart attack or when someone's having, ah, tumor or various things. So it's not like you, you know, should panic like Oh my God, have the hiccups. Seven. Probably having a heart attack, but you're having other symptoms to go along with it. Then maybe you should come get checked out.

Have you seen anyone in the E. R. For like excessive farting?

I've seen excessive farting

in the e r. You know, like they came in for that reason. Yeah, I've seen it. Yeah, it's mostly I've never seen somebody coming specifically for that, but I've certainly had people who as part of the history taking saying and I'm really concerned. I pass a lot of gas. I think something's rotting inside my Billy. You're human. You have a hollow tube. It goes from your mouth. Your Highness, that hollow tube has bacteria in it. It has food in it and it has gas in it. And that guest has to go out.

Because if it doesn't, you're going to explode. What? You're gonna float away like Veruca Salt. So it has to come out for yourself. Did not float away.

They were Olderberry, and

she didn't

float. Oh, who floated away? Charlie, Charlie and his grandfather. And they had to burp. They had to burp to

come back down after the fizzy water in the 1971 film Willy Wonka and the Chocolate Factory. Veruca Salt does not blow up into a giant blueberry that happens to Violet Beauregard. Brooke Assault ends up falling through a shoot in the egg sorting room. Farouk

assault! I will say I admit that I sometimes make restaurant reservations under that name.

Make it under Augustus Glue. Thanks, Dave Mason. Just mason. My

name and a special thanks to our research assistance for this episode, medical students and need Picard

and Dr Jesse Werner. This one hood a bit is a production of fool Abou Incorporated produced by CC habit Bill Connor The information you here on this one hood of it should not be taken as actual medical advice. If you have actual medical questions about actual medical things, you should see an actual medical practitioner even though we are actually doctors were not your actual doctor. So be sensible and keep it real. And this Oh, this this, this, this this viscous. I'm just looking at just who's literally in tears about the

issue. Is the backdraft that got me. That's when I really lost it. Yes, yeah.