Medication for Trapped Wind (Bloating and Gas)
For trapped wind, start with simethicone 125 mg after meals (up to 4 times daily) as first-line treatment, which directly addresses gas-related symptoms by breaking down gas bubbles in the intestinal tract. 1
First-Line Pharmacological Treatment
Simethicone (125 mg after meals, up to 4 times daily) is the most direct treatment for trapped wind, as it is an antifoaming agent that reduces bloating and gas-related abdominal discomfort by breaking down gas bubbles. 1, 2
The combination of loperamide-simethicone provides faster and more complete relief than simethicone alone when diarrhea accompanies the trapped wind, with significantly shorter time to relief of gas-related abdominal discomfort (gas pain, cramps, gas pressure, and bloating). 1
If IBS is the Underlying Condition
For IBS with Predominant Bloating and Wind
Peppermint oil can be used as an antispasmodic specifically for gas and bloating symptoms in IBS patients. 3, 4
Probiotics should be tried for at least 4 weeks (or up to 12 weeks) while monitoring effect, as they can improve global IBS symptoms including bloating. 3, 4
Antispasmodics with anticholinergic properties are effective for gas-related abdominal pain, though they cause dry mouth, visual disturbance, and dizziness as common side effects. 3, 4
Dietary Modifications to Reduce Wind
Limit intake of high-fiber foods (wholemeal bread, bran, brown rice) as these can worsen bloating and gas. 3
Reduce "resistant starch" found in processed or recooked foods, which ferments in the colon producing gas. 3
Avoid sorbitol (artificial sweetener in sugar-free products) as it causes gas and bloating. 3
Restrict fizzy drinks and alcohol which introduce and produce gas in the GI tract. 3
Eat oats and linseeds (up to 1 tablespoon per day) specifically for wind and bloating symptoms. 3
Limit fresh fruit to 3 portions daily (approximately 80g each) to reduce fermentable sugars. 3
If Symptoms Persist: Second-Line Approach
Low-FODMAP diet should be implemented under supervision of a healthcare professional with expertise in dietary management, as this reduces fermentable carbohydrates that produce gas. 3
Tricyclic antidepressants (amitriptyline 10 mg once daily, titrated to 30-50 mg) are effective for global IBS symptoms including bloating when first-line treatments fail, though the mechanism is neuromodulation rather than direct gas reduction. 3, 4
Critical Pitfalls to Avoid
Do not use aloe vera for IBS-related trapped wind, as guidelines specifically discourage its use. 3
Do not recommend IgG antibody-based food elimination diets, as they lack evidence and may lead to unnecessary dietary restrictions. 4
Avoid anticholinergic antispasmodics in IBS with constipation, as they will worsen the constipation and potentially increase bloating. 4
Do not use metoclopramide in complete bowel obstruction, though this is relevant only if obstruction is suspected rather than simple trapped wind. 3