Effective Management of Flatulence
Carter, Nakia Joyce
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Probiotics and rifaximin (Xifaxan) have been shown to reduce total number of flatus episodes and associated discomfort. (Strength of Recommendation [SOR]: B, based on small randomized controlled trials [RCTs]). Oral alpha-galactosidase (Beano) has been shown to reduce volume of flatus associated with fermentable carbohydrates and high-fiber diets. (SOR: B, based on small RCTs). Oral bismuth subsalicylate (Pepto-Bismol) and odor-reducing external devices containing activated charcoal have shown benefit in reducing flatus-associated odor. (SOR: C, based on disease-oriented evidence). Evidence for oral activated charcoal and simethicone has been inconsistent and does not support their use. (SOR: B, based on multiple small RCTs).
Clinical Inquiries, 2009 (MU)
American Family Physician, 79(12) 2009: 1098+.