How do I alleviate flatulence (gas)?

From the Guidelines

To get rid of gas, the most effective approach is to follow a low FODMAP diet, as it has been shown to reduce symptoms of irritable bowel syndrome (IBS) and gas, with a significant reduction in the risk of remaining symptomatic, compared to other dietary interventions 1.

Key Recommendations

• Start with traditional dietary advice, which includes adopting healthy eating patterns, such as regular meals, maintaining adequate nutrition, limiting alcohol and caffeine intake, adjusting fibre intake, and reducing consumption of fatty and spicy foods 1.
• Consider a low FODMAP diet as a second-line approach, which involves limiting foods that are high in fermentable oligo-, di-, and mono-saccharides, and polyols, such as certain fruits, vegetables, dairy products, and wheat 1.
• Avoid carbonated beverages, chewing gum, and gas-producing foods like beans, cabbage, and onions.
• Eat slowly and avoid drinking through straws to minimize swallowing air.
• Regular physical activity can help stimulate digestion and move gas through your system.

Important Considerations

• If gas problems persist or are accompanied by other symptoms like severe pain, weight loss, or changes in bowel habits, consult a healthcare provider as it could indicate an underlying condition.
• Probiotics and medical foods are not recommended for bloating or distention, as there is insufficient evidence to support their use 1.
• Central neuromodulators, such as antidepressants, may be effective in reducing visceral sensations and improving symptoms of bloating and distention 1.
• Gut-related medications that treat constipation, such as secretagogues and 5-hydroxytryptamine 4 receptor agonists, may also help bloating symptoms 1.

From the FDA Drug Label

Use for the relief of pressure and bloating commonly referred to as gas Purpose Antigas Directions adults: swallow with water 1 or 2 softgels as needed after meals and at bedtime do not exceed 2 softgels in 24 hours except under the advice and supervision of a physician

To get rid of gas, you can use simethicone (PO), an antigas medication. The recommended dosage is to swallow 1 or 2 softgels as needed after meals and at bedtime, with a maximum of 2 softgels in 24 hours unless advised otherwise by a physician 2, 2, 2.

From the Research

Symptoms of Gas and Bloating

• Abdominal pain, distention, diarrhea, and bloating are common symptoms associated with small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) 3
• SIBO can be diagnosed using a small bowel aspirate culture or a positive hydrogen lactulose or glucose breath test 3

Treatment Options for SIBO and IBS

• Rifaximin, a locally acting antibiotic, has been shown to be effective in eradicating SIBO syndrome and improving IBS symptoms 4
• Dietary manipulation, such as a low FODMAP diet, may alleviate SIBO gastrointestinal symptoms, but its effectiveness is still hypothetical and requires further research 5
• Supplementation with soluble fiber and targeted probiotic therapy may also help regulate bowel movements and increase the effectiveness of antibiotic treatment 5

Relationship between SIBO and IBS

• SIBO is highly prevalent in IBS patients, with approximately 45.8% of IBS patients testing positive for SIBO 4
• The presence of SIBO can contribute to the development of IBS symptoms, and treating SIBO can improve IBS symptoms 6
• Antibiotics and microecological agents can be used to correct SIBO and improve IBS symptoms, as well as reduce inflammatory factors 6