Best Treatments for Gas
Simethicone is the first-line treatment for relief of gas and bloating, taken as 1-2 softgels after meals and at bedtime as needed. 1 However, evidence for its effectiveness is limited, with research showing it may relieve clinical symptoms but does not actually reduce the amount of gas in the gastrointestinal tract. 2, 3
First-Line Treatments
Simethicone
- Dosage: 1-2 softgels after meals and at bedtime
- Maximum: Do not exceed 2 softgels in 24 hours unless directed by a physician 1
- Mechanism: Works by breaking up gas bubbles in the digestive tract, making them easier to eliminate
- Available as: Chewable tablets, softgels, or liquid drops
Dietary Modifications
- Identify and avoid gas-producing foods:
- Beans, lentils, and other legumes
- Cruciferous vegetables (broccoli, cauliflower, cabbage)
- Onions, garlic
- Carbonated beverages
- High-fat foods
- Artificial sweeteners (especially sorbitol, mannitol)
- Eat smaller, more frequent meals rather than large meals
- Chew food thoroughly and eat slowly
Second-Line Treatments
Activated Charcoal
- Has shown effectiveness in adsorbing intestinal gas in healthy subjects, though not well-studied in patients with specific gas complaints 2
- Dosage: Typically 250-500 mg before meals and at bedtime
- Note: May interfere with medication absorption; take at least 2 hours apart from other medications
Prokinetic Agents
- May be beneficial if gas complaints are related to abnormal intestinal motility 2
- Examples include metoclopramide or domperidone (where available)
- Should be prescribed with caution due to potential side effects
Alpha-galactosidase Enzyme Supplements
- Helps break down complex carbohydrates that can cause gas
- Take before consuming gas-producing foods, especially beans and legumes
Combination Therapies
In cases where gas is associated with diarrhea or other digestive symptoms, combination therapies may be beneficial. Studies have shown that loperamide-simethicone combinations are more effective than either agent alone for treating acute diarrhea with gas-related abdominal discomfort. 4, 5
Ineffective Treatments
Research has shown limited evidence supporting the use of:
- Pancreatic enzymes for gas relief 2
- Anticholinergic agents 2
- Antibiotics (unless specific bacterial overgrowth is diagnosed) 2
Special Populations
Infants with Colic
- Simethicone has not shown greater effectiveness than placebo in treating infantile colic in randomized controlled trials 6
- For infants, focus on feeding techniques, burping, and gentle abdominal massage
Lifestyle Modifications
- Regular physical activity to promote intestinal motility
- Avoid chewing gum and using straws (which can increase air swallowing)
- Quit smoking (if applicable)
- Practice stress reduction techniques (stress can worsen gas symptoms)
When to Seek Further Evaluation
Gas symptoms warrant further investigation if:
- Accompanied by weight loss, blood in stool, or severe abdominal pain
- Persistent despite 2 weeks of treatment
- Associated with chronic diarrhea or constipation
- New onset in adults over 50 years of age
In these cases, consider evaluation for underlying conditions such as irritable bowel syndrome, inflammatory bowel disease, celiac disease, or small intestinal bacterial overgrowth.