What are medications for flatulence (anti-gas)?

From the Guidelines

Anti-gas medications like simethicone (Gas-X, Mylicon) are effective for relieving bloating and gas discomfort, and should be taken as needed, with a recommended dose of 125-250 mg after meals and at bedtime. According to the most recent and highest quality study 1, simethicone is a safe and effective option for relieving bloating and gas discomfort. Alternatives include activated charcoal capsules (250-500 mg before meals) or alpha-galactosidase enzyme supplements (Beano) taken with gas-producing foods. For persistent gas, consider combination products like Mylanta Gas or Gas-X Extra Strength. These medications work by breaking up gas bubbles in your digestive tract, making them easier to expel.

Key Considerations

• Simethicone is not absorbed into the bloodstream, making it safe for most people.
• If gas problems persist despite medication use for more than two weeks, consult a healthcare provider as it could indicate an underlying digestive disorder.
• Prevention strategies include avoiding gas-producing foods like beans, cabbage, and carbonated beverages, eating slowly, and avoiding chewing gum.
• Central neuromodulators, such as antidepressants, may also be effective in reducing bloating symptoms by reducing the perception of incoming visceral signals and improving psychological comorbidities 1.
• Gut-related medications that treat constipation, such as secretagogues (e.g., lubiprostone, linaclotide, and plecanatide), may also help bloating symptoms 1.

Additional Options

• Brain–gut behavioral therapies, such as hypnotherapy and cognitive behavioral therapy, may be combined with central neuromodulators and other GI treatments to improve overall quality of life parameters, anxiety, stress, and burden associated with digestive disorders 1.
• Anorectal biofeedback therapy may also be effective in reducing bloating symptoms by improving pelvic floor function and reducing abdominal distention 1.

From the FDA Drug Label

This product contains an enzyme that helps digest the complex carbohydrates found in manyfoods, so they don’t cause gas, bloating and discomfort‡. This product helps digest many foods including: Beans, Cabbage, Cucumber, Broccoli, Carrots,Leeks, Beets, Cauliflower, Lettuce, Brussels Sprouts, Corn and Onions.

The alpha-galactosidase enzyme in the medication works by helping to digest complex carbohydrates in foods, which can cause gas, bloating, and discomfort. The medication is intended to prevent these symptoms when taken before or after eating foods that are known to cause gas, such as beans, cabbage, and broccoli 2 2.

From the Research

Anti-Gas Medication Efficacy

• The efficacy of anti-gas medications, such as simethicone, activated charcoal, and magnesium oxide combinations, has been evaluated in several studies 3, 4, 5.
• A study published in 2011 found that a simethicone, activated charcoal, and magnesium oxide combination (Carbosymag®) significantly reduced overall dyspeptic symptom intensity and individual symptoms such as post-prandial fullness, epigastric pain, epigastric burning, and abdominal bloating compared to a placebo 3.
• Another study published in 2012 compared the efficacy of alpha-galactosidase and active charcoal in improving sonographic visualization of abdominal organs in patients with excessive intestinal gas, and found that both treatments improved visualization, but alpha-galactosidase was more effective in improving visualization of certain organs 4.
• A 2009 study evaluated the efficacy of a commercial combination of simethicone and activated charcoal (Carbosylane) in dyspeptic syndrome, and found that it significantly reduced symptom intensity and improved symptoms such as abdominal fullness, bloating, and slow digestion compared to a placebo 5.

Mechanisms of Action

• Simethicone is thought to work by reducing surface tension in the gastrointestinal tract, allowing gas bubbles to coalesce and be more easily passed 3.
• Activated charcoal is believed to work by adsorbing gas and other substances in the gastrointestinal tract, reducing symptoms such as bloating and discomfort 4, 5.
• Alpha-galactosidase is an enzyme that breaks down complex carbohydrates, reducing gas production in the gastrointestinal tract 4.

Clinical Implications

• The use of anti-gas medications such as simethicone, activated charcoal, and magnesium oxide combinations may be effective in reducing symptoms of dyspepsia and improving sonographic visualization of abdominal organs 3, 4, 5.
• These medications may be particularly useful in patients with excessive intestinal gas or dyspeptic syndrome, and may provide symptomatic relief and improve quality of life 3, 5.