Over-the-Counter and Home Remedies for Bloating
Start with dietary modifications and diaphragmatic breathing as first-line home remedies, while simethicone is the only FDA-approved OTC medication for bloating relief, though evidence for its efficacy is limited. 1, 2
Immediate Home Remedies You Can Start Today
Dietary Modifications (First-Line Approach)
Establish regular meal patterns with consistent timing and avoid skipping meals or prolonged fasting between eating. 1 This prevents the pre-meal bloating that occurs when the gut remains empty for extended periods.
- Eat slowly and chew food thoroughly to reduce air swallowing and improve digestion 1
- Drink at least 8 cups of water daily, primarily water or non-caffeinated beverages 1
- Limit tea and coffee to 3 cups per day and reduce alcohol and carbonated beverages 1
- Restrict fresh fruit to 3 portions per day (approximately 80g per portion) 1
- Avoid artificial sweeteners like sorbitol found in sugar-free products 1
Diaphragmatic Breathing Technique
Diaphragmatic breathing is a safe, inexpensive home remedy that reduces vagal tone and sympathetic activity. 3 This technique specifically addresses abdominophrenic dyssynergia, where paradoxical muscle contractions cause visible abdominal distention. Expert consensus from brain-gut behavioral therapists reports improvement in patient symptoms with this method. 3
Over-the-Counter Medications
Simethicone (Gas-X, Mylicon)
Simethicone is FDA-approved for relief of pressure and bloating commonly referred to as gas. 2 However, it functions as a gas-reducing agent without strong evidence for efficacy in functional bloating.
What NOT to Use
Do NOT use probiotics for bloating. 3, 1, 4 The 2023 American Gastroenterological Association guidelines explicitly recommend against probiotics because:
- No studies have examined their efficacy specifically for bloating 3
- They may paradoxically cause brain fogginess, bloating, and lactic acidosis 3, 1
- The newest British, European, and American guidelines for IBS and functional dyspepsia have not endorsed their use 3
Peppermint oil lacks evidence for bloating improvement. 3, 1 A recent placebo-controlled randomized trial found no improvement in bloating symptoms at the 6-week endpoint, despite its common use. 3
Low-FODMAP Diet (Structured Home Remedy)
If simple dietary modifications fail after 3-4 weeks, implement a low-FODMAP diet in three distinct phases: restriction (4-6 weeks), reintroduction, and personalization. 1, 4 This approach addresses fructose intolerance, which affects approximately 60% of patients with digestive disorders, with dietary restriction improving symptoms in up to 80% of cases. 1
Critical Implementation Details
- Do NOT exceed 4-6 weeks in the restriction phase to prevent negative impacts on gut microbiome, including decreased Bifidobacterium species and malnutrition 3, 1
- Consider daily multivitamin supplementation during the restriction phase 1
- Limit fructans rather than gluten, as fructans may be more problematic in causing bloating 3, 1
- Work with a gastroenterology dietitian when implementing this diet to avoid malnutrition 3, 1, 4
Important Pitfall to Avoid
Screen for eating disorders before implementing restrictive diets. 3, 1 If an elimination diet shows no benefit after the trial period, discontinue it immediately to prevent malnutrition. 3, 1
When to Seek Medical Evaluation
Seek immediate medical attention if you experience alarm features: 5, 4
- Unintentional weight loss
- Gastrointestinal bleeding or blood in stool
- Persistent vomiting
- Iron-deficiency anemia
- Family history of gastrointestinal malignancy
Women ≥50 years old should maintain high suspicion for ovarian cancer, as bloating and abdominal fullness are often presenting symptoms in this population. 5
Prescription Options (When Home Remedies Fail)
If OTC and home remedies fail after 4-6 weeks, prescription options include:
- Central neuromodulators (tricyclic antidepressants like amitriptyline or SNRIs like duloxetine) reduce visceral sensation and work best for bloating occurring during or after meals 3, 1, 4
- Rifaximin for confirmed small intestinal bacterial overgrowth 1, 4
- Secretagogues (linaclotide, lubiprostone) for bloating associated with constipation 3, 1, 4