What is the treatment for abdominal cramping due to gas (flatulence)?

From the Guidelines

To treat abdominal cramping due to gas, the most effective approach is to start with dietary changes, such as avoiding gas-producing foods and eating smaller, more frequent meals, as recommended by the British Society of Gastroenterology guidelines on the management of irritable bowel syndrome 1.

Key Recommendations

• Avoid gas-producing foods like beans, cabbage, and carbonated drinks
• Eat smaller, more frequent meals to reduce symptoms
• Chew food thoroughly to aid digestion
• Consider taking soluble fibre, such as ispaghula, at a low dose (3–4 g/day) and gradually increasing as needed, as it can help alleviate global symptoms and abdominal pain in IBS 1

Additional Relief Measures

• For immediate relief, try gentle abdominal massage in clockwise circles
• Apply a heating pad to your stomach for 15 minutes to help relax intestinal muscles
• Take a short walk to help move gas through your system
• Drinking peppermint or ginger tea can provide additional relief, although a recent study found no improvement in bloating symptoms with peppermint oil at the 6-week end point 1

Medical Treatments

• Loperamide may be an effective treatment for diarrhoea in IBS, but its use for abdominal cramping due to gas is not well established 1
• Antispasmodics, such as dicycloverine and mebeverine, may be effective in treating global symptoms and abdominal pain in IBS, but their use for gas cramping is not well studied 1
• Central neuromodulators, such as antidepressants, may be beneficial in reducing visceral sensations and improving symptoms, but their use for gas cramping is not well established 1

Important Considerations

• If symptoms persist beyond two weeks, are severe, or are accompanied by other concerning symptoms like weight loss or blood in stool, consult a healthcare provider as this could indicate an underlying condition
• Probiotics are not recommended for treating bloating or distention due to insufficient evidence and potential adverse effects 1

From the FDA Drug Label

Use for the relief of pressure and bloating commonly referred to as gas The treatment for abdominal cramping due to gas (flatulence) is simethicone (PO), which is used for the relief of pressure and bloating commonly referred to as gas 2.

From the Research

Treatment Options for Abdominal Cramping due to Gas

• The treatment for abdominal cramping due to gas (flatulence) can involve various approaches, including dietary changes, medications, and other interventions 3, 4, 5, 6, 7.
• Dietary changes, such as avoiding foods containing partially digested or absorbed polysaccharides, can help alleviate symptoms of bloating and gaseous distension 3.
• Replacement enzymes, such as alfa-galactosidase or lactase, can also be effective in improving symptoms 3.
• Medications like activated charcoal, prokinetic agents (e.g., tegaserod and metoclopramide), and antispasmodics (e.g., hyoscine-N-butyl bromide and mebeverine) can provide relief from abdominal cramping and other symptoms associated with intestinal gas 3, 4, 5, 6, 7.
• A combination of loperamide and simethicone has been shown to be effective in treating acute diarrhea with gas-related abdominal discomfort 4.
• A simethicone, activated charcoal, and magnesium oxide combination (Carbosymag®) has been found to be effective in reducing overall dyspeptic symptom intensity, including post-prandial fullness, epigastric pain, epigastric burning, and abdominal bloating 6.
• Antispasmodics, such as those mentioned above, are considered the primary treatment for gastric and intestinal cramping pain, with acetaminophen/NSAIDs added for more severe cases 7.

Specific Treatments

• Loperamide-simethicone combination: effective in treating acute diarrhea with gas-related abdominal discomfort 4.
• Simethicone, activated charcoal, and magnesium oxide combination (Carbosymag®): effective in reducing overall dyspeptic symptom intensity 6.
• Antispasmodics (e.g., hyoscine-N-butyl bromide and mebeverine): primary treatment for gastric and intestinal cramping pain 7.
• Acetaminophen/NSAIDs: added for more severe cases of gastric and intestinal cramping pain 7.