In this Article

• What causes belching?
• What causes bloating?
• What causes flatulence?
• What are the causes of intermittent abdominal bloating/distention?
• How is belching, bloating/distention, and flatulence evaluated?
• How is excessive intestinal gas treated?
• Intestinal Gas At A Glance
• Intestinal Gas (Belching, Bloating, Flatulence) Glossary
• Intestinal Gas (Belching, Bloating, Flatulence) Index

How is excessive intestinal gas treated?

The treatment of excessive intestinal gas depends on the cause. If there is maldigestion of specific sugars-lactose, sorbitol, or fructose--the offending sugars can be eliminated from the diet. In the case of lactose in milk, an alternative treatment is available. Enzymes that are similar to intestinal lactase can be added to the milk in order to break down the lactose prior to its ingestion so that it can be absorbed normally. Some people find that yogurt, in which the lactose has been broken down partially by bacteria, produces less gas than milk. There also are certain types of vegetables and fruits that contain types of starches that are poorly digested by people but well digested by bacteria. These include beans, lentils, cabbage, brussel sprouts, onions, carrots, bananas, apricots, and prunes. Reducing the intake of these vegetables and fruits, as well as foods made from whole grains, should reduce gas and flatulence. However, the list of gas-producing foods is rather long, and it may be difficult to eliminate them all without severely restricting the diet.

When maldigestion is due to pancreatic insufficiency, then supplemental pancreatic enzymes can be ingested with meals to replace the missing enzymes. If maldigestion and/or malabsorption is caused by disease of the intestinal lining, the specific disease must be identified, most commonly through a small bowel biopsy. Then, treatment can be targeted for that condition. For example, if celiac disease is found on the biopsy, a gluten-free diet can be started.

An interesting form of treatment for excessive gas is alpha-D-galactosidase, an enzyme that is produced by a mold. This enzyme, commercially available as Beano, is consumed as either a liquid or tablet with meals. This enzyme is able to break down some of the difficult-to-digest polysaccharides in vegetables so that they may be absorbed. This prevents them from reaching the colonic bacteria and causing unnecessary production of gas . Beano has been shown to be effective in decreasing the incidence of intestinal gas.

Two other types of treatment have been promoted for the treatment of gas; simethicone and activated charcoal. It is unclear if simethicone has an effect on gas in the stomach. However, it has no effect on the formation of gas in the colon. Moreover, in the stomach, simethicone would be expected only to affect swallowed air, which, as previously mentioned, is an uncommon cause of excessive intestinal gas. Nevertheless, some individuals are convinced that simethicone helps them. Activated charcoal has been shown to reduce the formation of gas in the colon, though the way in which it does so is unknown.

If there is a physical obstruction to the emptying of the stomach or passage of food, liquid, and gas through the small intestine, then surgical correction of the obstruction is required. If the obstruction is functional, medications that promote activity of the muscles of the stomach and small intestine are given. Examples of these medicines are erythromycin or metoclopramide (Reglan).

Bacterial overgrowth of the small bowel is usually treated with antibiotics. However, this treatment is frequently only temporarily effective or not effective at all. When antibiotics provide only a temporary benefit, it may be necessary to treat patients intermittently or even continuously with antibiotics. If antibiotics are not effective, probiotics (e.g., lactobacillus) can be tried although their use in bacterial overgrowth has not been studied. This condition may be difficult to treat.

Intestinal Gas At A Glance

• The usual cause of belching is excessive gas in the stomach that comes from swallowed air. However, discomfort in the abdomen for any reason may also cause belching. Therefore, belching does not always indicate the presence of excessive gas in the stomach.

• Bloating is the subjective feeling that the abdomen is enlarged but does not necessarily mean that the abdomen is, in fact, enlarged. Distention is the objective enlargement of the abdomen.

• Continuous distention of the abdomen is usually caused by fluid, tumors, enlarged organs, or fat within the abdomen.

• Intermittent distention of the abdomen may be caused by excessive formation of intestinal gas, as well as physical or functional obstruction of the intestines.

• Flatulence results from the production of gas by bacteria within the intestines when they digest sugars and polysaccharides.

• Excessive production of gas and increased flatulence may occur because of: (1) the greater ability of some bacteria to produce gas; (2) maldigestion or malabsorption of sugars and polysaccharides; and (3) bacterial overgrowth of the small intestine.

• Belching, bloating/distention, and flatulence are evaluated with a medical history, simple abdominal x-rays, small intestinal x-rays, gastric emptying studies, ultrasound examination, computerized tomography (CT), magnetic resonance imaging (MRI), tests for maldigestion and malabsorption, and hydrogen breath testing.

• The treatment of excessive intestinal gas depends on the underlying cause and may include dietary changes, medications that reduce the amount of gas, medications that stimulate the muscles of the intestine, or antibiotics.

Intestinal Gas - Effective Treatments

The MedicineNet physician editors ask:

What kinds of treatments have been effective for your intestinal gas?

Anonymously share your comment to help others.
See 2 Viewer Comments

Submit Your Comment

From the Doctors at MedicineNet.com

simethicone, Phazyme, Flatulex, Mylicon, Gas-X, Mylanta Gas - Emphasizes the medication simethicone (Phazyme, Flatulex, Mylicon, Gas-X, Mylanta Gas), a drug used to relieve abdominal pain. Source:MedicineNet Ovarian Cancer - Read about ovarian cancer (cancer of the ovaries) warning signs, symptoms, diagnosis, risk factors, research, information, statistics, tests and treatment (surgery). Source:Government Irritable Bowel Syndrome - Learn about Irritable Bowel Syndrome (IBS) causes, symptoms inlcuding diarrhea, constipation, abdominal pain, gas, and bloating. Information also includes diagnosis and treatment of IBS. Source:MedicineNet Read 49 more Intestinal Gas (Belching, Bloating, Flatulence) related articles ... Health Tip: Foods That Cause Gas Health Tip: Belching and Bloating Allergy Disorders Linked With Irritable Bowel Syndrome