Gulp: Adventures on the Alimentary Canal (27 page)

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Authors: Mary Roach

Tags: #Science, #Life Sciences, #Anatomy & Physiology

BOOK: Gulp: Adventures on the Alimentary Canal
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*
But one example of the sly marketing genius of AkPharma. Beano was also the sponsor of a team of hot air balloonists in a prominent race.

*
?ti teG


I brought Levitt a scrap of notebook paper covered with hash marks, the score card of an anonymous family member who kept track for two days, totaling thirty-five and thirty-nine. “Yeah,” Levitt said, “every time I give a talk someone comes up and tells me twenty-two is way too low.”

14

Smelling a Rat

DOES NOXIOUS FLATUS DO MORE THAN CLEAR A ROOM?

M
ICHAEL
L
EVITT DID
not set out to make his mark on the world by parsing the secrets of noxious flatus. His fellowship advisor had the idea. The gas chromatograph had just come into use as a laboratory tool, and no one had yet had the ingenuity—or nerve—to apply the technology to human emissions. “He called me into his office,” Levitt recalls. “He said, ‘I think you ought to study gas.’ I said, ‘Why’s that?’ He said, ‘Because you’re pretty much of an incompetent, and this way if you discover anything, at least it’ll be new, and you’ll be able to publish something.’”

Levitt published thirty-four papers on flatus. He identified the three sulfur gases responsible for flatus odor. He showed that it is mainly trapped methane gas, not dietary fiber or fat, that makes the floater float. Most memorably, to this mind anyway, he invented the flatus-trapping Mylar “pantaloon.”

“Even now,” he says of his flatus work, “it overshadows everything else I do.” Levitt and I are sitting in a conference room upstairs from his lab at the Minneapolis VA Medical Center. Levitt has a goofy, lopsided smile and a pale complexion. I couldn’t recall, while writing this, whether his hair was gray, so I typed his identifiers into Google Images. A photograph of a can of baked beans came up.

For the record, here are some of Michael Levitt’s other contributions to medicine: He invented the breath hydrogen test, which originated not as a flatulence assessment technique but to diagnose malabsorption of carbohydrates in the small intestine. He debunked a diet fad for foods made with “nonabsorbable” carbohydrates. He showed that the wriggling movements of the villi are the key to intestinal stirring and to healthy absorption of nutrients. “I wrote the book on intestinal stirring.”

After what I judge to be a sufficient number of follow-up questions on intestinal stirring, I ask whether it might be possible to see the Mylar pantaloons.

Levitt designed the garment for a pair of studies that aimed both to identify the gases responsible for noxious flatus and to test devices claiming to adsorb—the formal term for binding to something’s surface—those gases. He doesn’t know where they are stored, but digs out a photograph of a woman standing in the lab, modeling them. Shown uninflated, they fit more snugly than I’d pictured them. The material is silver, crinkly, and reflective. They’re the sort of clothes baked potatoes wear.

I ask Levitt whether it was difficult to recruit volunteers for the flatus studies. It wasn’t, partly because the subjects were paid for their contributions. People who sell their flatus are more or less the same crowd who turn up to sell their blood.

“What was hard,” Levitt says, “was finding the judges.” Levitt needed a pair of odor judges to take “several sniffs” and rate the noxiousness—from “no odor” to “very offensive”—of each of the sixteen people’s flatal contributions.
*
The hypothesis was that noxiousness would correlate with the combined concentrations of the three sulfur gases. And it did.

Curious as to which olfactory notes the different sulfur gases contributed to the overall bouquet of flatus, Levitt purchased samples of the three gases from a chemical supply house. The judges agreed on the following descriptors: “rotten eggs” for hydrogen sulfide, the gas with the strongest correlation to stink; “decomposing vegetables” for methanethiol; and “sweet” for dimethyl sulfide. Though lesser players like methylmercaptan contribute as well, it is for the most part these three notes, in subtly shifting combinations and percentages, that create the infinite olfactory variety of human flatus. To quote Alan Kligerman, “A gas smell is as characteristic of a person as a fingerprint is.” But harder to dust for.

The great variety of flatus smells—from person to person and from meal to meal—presented a quandary for the second phase of the study, the evaluation of various odor-eliminating products. Which—whose—wind should represent the average American’s? No one’s, as it turned out. Using mean amounts from chromatograph readouts as his recipe and commercially synthesized gases as the raw ingredients, Levitt concocted a lab mixture deemed by the judges “to have a distinctly objectionable odour resembling that of flatus.” He reverse-engineered a fart. This “artificial flatus” was put to work testing a variety of activated-charcoal products: underwear, adhesive-backed underwear pads, and chair cushions. (Activated charcoal is known to be effective at binding sulfur gases. The circulating air supply in NASA spacesuits is filtered with activated charcoal, lest astronauts’ flatus be blown across their face three times a minute for the remainder of the spacewalk.)

In a separate study to simulate real-life gas-passing conditions, Levitt taped a tube beside the subject’s anus, beneath the charcoal pad or underpant and the subject’s pants. (Cushions were strapped in place.) The subject then pulled the Mylar pantaloons over whatever product was being tested, and an assistant duct-taped the cuffs and waistband to the skin. Levitt hit a switch, and just under a half cup (100 milliliters) of synthesized flatus shot through the tube for two seconds—Levitt’s best guess for the size and life span of a typical fart. “Immediately following gas instillation,” wrote Levitt in the final paper, “air inside the pantaloons was constantly mixed via vigorous palpation over a 30-second period.” Levitt claims to have no video footage. Last, a syringe was fitted into a port in the Mylar to withdraw the gas, and Levitt measured the sulfur gases the charcoal had failed to trap.

The challenge, it turned out, lies in bringing the gas fully into contact with the charcoal—easy with an airtight spacesuit, less so a business suit. Seat cushions were relatively useless, most products trapping a scant 20 percent of the sulfur gases. The underwear pads delivered a 55 to 77 percent reduction, their efficacy compromised by “rectal gas blow-by”: the tendency of the wind to glance off the pad and out the sides rather than penetrate it. The seventy-dollar briefs performed best, adsorbing virtually all sulfur gases, though it was unclear how many wearings they were good for. And given the cost, in terms of both cash and self-esteem, they would seem to have a limited market.

• • •

A
S AN ALTERNATIVE
to wearing activated charcoal or gluing it to your underpants, you could swallow some pills. But don’t bother, because Levitt has done a study on this too. Activated charcoal pills did not “appreciably influence the liberation of fecal gases.” Levitt surmised that the binding sites were saturated by the time the charcoal made it to the rectum.

Bismuth pills, on the other hand—and Levitt has tested these too—reduce 100 percent of sulfur gas odor. Bismuth is the
bism
in Pepto-Bismol. Daily doses of Pepto-Bismol can irritate the gut, but not bismuth subgallate, the active ingredient in Devrom “internal deodorant” pills.

I had never before heard of Devrom. This may be because mainstream magazines often refuse to run the company’s ads.
*
Devrom’s president, Jason Mihalopoulos, e-mailed me a full-page ad he had hoped to run in
Reader’s Digest
and
AARP
magazine. A smiling gray-haired couple stand arm in arm below the boldface headline “Smelly Flatulence? Not since we started using Devrom!” Mihalopoulos was told he could not use the phrases
smelly flatulence
and
stinky odor
or the word
stool
. One of the magazines suggested changing the copy to say that the product “eliminates intestinal gas,” but that’s not what Devrom does. That’s what Beano does. So unless you read the
Journal of Wound Ostomy & Continence Nursing
*
or the
International Journal of Obesity Surgery,
you won’t see the happy, internally deodorized Devrom couple.

The noxious-rectal-gas taboo in mainstream advertising has proved stronger and more lasting than that of condoms and even vibrators, which now turn up in brazenly suggestive ads on cable television (though still under the century-old euphemism “massager”). Mihalopoulos told me the editors of a CNBC feature on quirky businesses refused to air a segment about Parthenon, the family-run business that makes Devrom. “People don’t like to hear
flatulence
,” he said, quickly adding that he meant the word. Or anyway, people think people don’t.

Given the obvious strength of the taboo, I wondered who had posed for the Devrom ad. How much do you have to pay people to appear in a full-page ad in a national magazine, talking about their smelly flatulence?

“Oh, I’d be shocked if someone would be willing to pose in an ad we’d run,” Mihalopoulos said. “It’s a stock photo.” Meaning anyone, for a fee, can run the image for whatever purpose they choose. The couple probably have no idea. Think twice before you sign a model release form.

Most Devrom customers are people with extenuating digestive circumstances. They’ve had their stomachs stapled or bypassed to shed weight, or they’ve had all or most of a diseased gut removed and they’re excreting into an ostomy pouch. Mihalopoulos explained that, depending on how high up the opening is, the pouch may need to be emptied every few hours. Less time in the colon means less water is absorbed. The runnier the waste, the more surface area is exposed to the air and the more volatiles escape to reach the nose. “If you were to use the restroom at the airport, say . . .” Mihalopoulos paused to figure out where he was going with this. “You could tell right off that someone was emptying their pouch.”

It seemed, then, that we were not even talking about passing gas. “No, that too,” said Mihalopoulos. He explained that some people with an ostomy pouch will open a corner of it to let a little gas out. “It’s like Tupperware.”
*

Mihalopoulos didn’t have data he could share regarding the number of people who were taking Devrom to defang garden-variety flatus odor, rather than because of a medical situation. I’m guessing there aren’t very many of them, and I think I know why. I think I know what’s keeping internal deodorant from charging ahead as a mainstream product. I’m going to let Beano inventor Alan Kligerman tell you what it is. “When I talk to people,” he told me, “when I really get them down to the nitty-gritty, I don’t know anybody, really, in their heart of hearts, who has any objection to the smell of their own.” And, unlike bad breath or stinky feet, “smelly flatulence” is everyone’s problem.
*
And thus really, no one’s.

As with the first bottle of Scope, the first bottle of Devrom, Mihalopoulos confirmed, is often left anonymously by a coworker or purchased by a spouse. “They themselves don’t object to it,” he said, “it” referring to the smell, not the purchase. Levitt said he is constantly approached at cocktail parties by women complaining about their husbands’ gas. He has never once heard a husband complain about a wife, despite this scientifically proven (by Levitt) fact: “the flatus of women has a significantly greater concentration of hydrogen sulfide and was deemed to have a significantly worse odour by both judges.” (However, this is likely balanced out by the male’s “greater volume of gas per passage.”)

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