Patients whose gas and bloating is accompanied by recurrent, severe or prolonged abdominal pain should notify their physician because this may indicate the presence of another underlying condition – especially if the patient also experiences bleeding, nausea, vomiting, fever or weight loss. The physician will perform a physical examination and compile a thorough medical history. Screening tests, such as an endoscopy, sigmoidoscopy or colonoscopy, may also be conducted to help determine the cause of gas and bloating.

Most gas symptoms that are unrelated to a medical condition are brief in duration. Because of this, gas is often treated by minimizing further symptoms. Problematic gas can often be relieved by identifying and eliminating the factors that cause the gas.

A food diary can be helpful in identifying these factors. A food diary is a journal in which patients carefully track the amounts, the times and the kinds of food consumed and any subsequent gas symptoms. These diaries should be as detailed as possible. Patients are generally recommended to specify the time and conditions under which they eat (e.g., rushed breakfast at 6 A.M., casual lunch at noon). Times, types and severity of gas symptoms also need to be recorded.

Because a large amount of gas is caused by swallowing air (aerophagia), taking steps to avoid swallowing excess air may help reduce gas. Methods to avoid swallowing air include:

• Do not suck on hard candy or chew gum
• Do not gulp beverages
• Do not drink through a straw, out of small-mouthed bottles or from water fountains
• Do not drink during meals
• Do not eat when particularly anxious, upset or in a hurry
• Do not attempt to induce belching
• Eat and drink slowly, with mouth closed
• Make sure dentures fit properly
• Cut down on or quit smoking

Gas and gas symptoms can also be relieved by dietary changes.  Foods that are particularly troublesome for many people include those that contain raffinose. These include many vegetables, especially beans. However, recent research indicates that fermenting beans prior to cooking them eliminates most of their soluble fiber content, thereby reducing their gaseous effects. Milk products and fruits also contain sugars that may be difficult to digest in some people (e.g., lactose, fructose, sorbitol). Patients should discuss any dietary changes with their physician.

It is often recommended that patients cut out or reduce their intake of gas-producing foods. These are different for everyone. For example, a patient may experience gas after eating pears, but not apples. Patients are encouraged to determine precisely which foods are bothersome for them. Cutting back on fat may also help relieve symptoms of gas. This is because a diet high in fat slows the passage of food in the digestive tract, allowing fermentation to take place for a longer time.

Fiber is an important dietary nutrient, but it frequently causes gas symptoms. It is often useful to temporarily cut back on high-fiber foods and then slowly reintroduce them into the diet. This provides the bowels with sufficient time to adjust to the fiber intake. It is also important to drink plenty of liquids with increased fiber intake. In some cases, fiber may actually help ease gas.

Patients are generally encouraged to eat smaller, more frequent meals. This allows the stomach to empty faster and makes digestion easier.

It is often recommended that patients with problematic gas symptoms avoid carbonated beverages. These beverages release carbon dioxide gas. If patients refuse to eliminate these, it may help to pour them in a glass to let some of the “fizz” out.

Some medications and products that may help reduce gas include:

• Digestive enzymes. Help people lacking enzymes to process nutrients that are difficult to digest. Lactase is commonly used to help people with lactose intolerant digest dairy products. Products containing alpha-galactosidase are available to help digest raffinose.
  
  
• Some antacids. Antacids that contain the foaming agent simethicone pool gas bubbles together. Although this has no effect on intestinal gas, it may help with stomach gas. However, antacids that contain bicarbonate or carbonate may worsen gas.
  
  
• Activated charcoal and chlorophyll. Ingredients in many over-the-counter products. The effectiveness of activated charcoal is controversial, but it may help ease symptoms in some people. Both activated charcoal and chlorophyll may help reduce the offensive odor of some gas. However, chlorophyll may turn stools green. Bismuth subsalicylate (a type of antacid) may help to significantly reduce gas odor due to hydrogen sulfide. However, it cannot be taken for more than a few days.

Research also indicates that some medications used to treat diarrhea and constipation may be effective in relieving gas and bloating in some individuals.

It is generally considered best to experiment with only one gas-reducing product at a time. Patients are urged to follow dosing directions carefully and to ask a physician or pharmacist about proper use of prescription and over-the-counter medications.