What are the medications for flatulence and bloating?

From the Guidelines

For gas and bloating, I recommend linaclotide, a guanylate cyclase-C agonist, as it has been shown to be effective in reducing abdominal bloating and improving symptoms of irritable bowel syndrome with constipation (IBS-C) 1.

Medication Options

• Linaclotide is a peptide that acts as a guanylate cyclase-C agonist, and it has been found to be superior to placebo in improving abdominal pain and increasing bowel movements in patients with IBS-C 1.
• The recommended dose of linaclotide is 290 μg once a day, and it has been shown to be effective in reducing abdominal bloating in patients with IBS-C 1.
• Other medication options for gas and bloating include lubiprostone, plecanatide, and tenapanor, which are also secretagogues that can help soften stools and accelerate transit 1.

Important Considerations

• It is essential to note that these medications are typically used as second-line treatments for IBS-C and should be considered in secondary care if laxatives are not effective 1.
• Patients should be counselled about the potential side effects of these medications, including diarrhea, nausea, and abdominal pain 1.
• Dietary changes, such as avoiding gas-producing foods and eating slowly, can also help alleviate symptoms of gas and bloating 1.

Key Takeaways

• Linaclotide is a effective medication for reducing abdominal bloating and improving symptoms of IBS-C.
• Other secretagogues, such as lubiprostone, plecanatide, and tenapanor, can also be effective in treating gas and bloating.
• Patients should be counselled about potential side effects and dietary changes can also help alleviate symptoms.

From the FDA Drug Label

The IBS-D population from the three studies had mean age of 47 (range: 18 to 88) years of which approximately 11% of patients were ≥65 years old, 72% were female, and 88% were White Symptoms that Cumulatively Support the Diagnosis of Irritable Bowel Syndrome: – Abnormal stool frequency (for research purposes “abnormal” may be defined as greater than 3 bowel movements per day and less than 3 bowel movements per week); Abnormal stool form (lumpy/hard or loose/watery stool); Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation); Passage of mucus; Bloating or feeling of abdominal distension. The efficacy of XIFAXAN for the treatment of IBS-D was established in 3 randomized, multi‑center, double-blind, placebo-controlled trials in adult patients. Adequate relief of IBS symptoms was experienced by more patients receiving XIFAXAN than those receiving placebo during the month following 2 weeks of treatment

Rifaximin (XIFAXAN) is used to treat Irritable Bowel Syndrome with Diarrhea (IBS-D), which includes symptoms such as:

• Abnormal stool frequency
• Abnormal stool form
• Abnormal stool passage
• Passage of mucus
• Bloating or feeling of abdominal distension It has been shown to provide adequate relief of IBS symptoms in patients with IBS-D 2.

From the Research

Medications for Gas and Bloating

• Rifaximin is a medication that has been studied for its effectiveness in treating irritable bowel syndrome (IBS) symptoms, including gas and bloating 3, 4, 5, 6, 7.
• Studies have shown that rifaximin can improve symptoms of bloating, flatulence, and abdominal pain in patients with IBS 3, 6.
• Rifaximin has also been shown to be effective in treating small intestinal bacterial overgrowth (SIBO), a condition that can cause gas and bloating 7.
• The medication works by altering the gut microbiota and reducing the amount of bacteria in the small intestine 4, 7.
• Rifaximin can be used alone or in combination with probiotics to treat IBS symptoms, and the combination therapy has been shown to be more effective than rifaximin monotherapy 5.
• The medication has a low risk of adverse events and is generally well-tolerated 4, 7.

Efficacy of Rifaximin

• A study published in 2012 found that rifaximin improved symptoms of bloating, flatulence, and abdominal pain in patients with IBS, with significant improvements seen at week 4 and maintained at week 14 3.
• A 2025 study found that rifaximin combined with probiotics was superior to rifaximin monotherapy in improving IBS symptoms, including bloating and abdominal pain 5.
• Another 2025 study found that rifaximin-alpha increased lactase activity and improved symptoms of abdominal pain, bloating, and flatulence in patients with IBS without constipation and SIBO 6.
• A 2017 systematic review and meta-analysis found that rifaximin was effective and safe for the treatment of SIBO, with an overall eradication rate of 70.8% 7.