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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

## Medical Therapy

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### Pharmacotherapy

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Digestive enzyme supplements may significantly reduce the amount of flatulence caused by some components of foods not being digested by the body and thereby promoting the action of microbes in the small and large intestines. It has been suggested that alpha-galactosidase enzymes, which can digest certain complex sugars, are effective in reducing the volume and frequency of flatus.[1] The enzymes alpha-galactosidase (brands Beano, Bean-zyme), lactase (brand Lactaid), amylase, lipase,protease, cellulase, glucoamylase, invertase, malt diastase, pectinase, and bromelain are available, either individually or in combination blends, in commercial products.

The antibiotic rifaximin, often used to treat diarrhea caused by the microorganism E. coli, may reduce both the production of intestinal gas and the frequency of flatus events.[2]

While not affecting the production of the gases themselves, surfactants (agents which lower surface tension) can reduce the disagreeable sensations associated with flatulence, by aiding the dissolution of the gases into liquid and solid fecal matter. Preparations containing simethicone reportedly operate by promoting the coalescence of smaller bubbles into larger ones more easily passed from the body, either by burping or flatulence. Such preparations do not decrease the total amount of gas generated in or passed from the colon, but make the bubbles larger and thereby allowing them to be passed more easily.

Often it may be helpful to ingest small quantities of acidic liquids with meals, such as lemon juice or vinegar, to stimulate the production of gastrichydrochloric acid. In turn, acid ingestion may increase normal gastric enzyme and acid production, facilitating normal digestion and perhaps limiting intestinal gas production. Ingestion of bromelain\- or papain-containing supplements (such as pineapple or papaya, respectively, may be helpful.

Odor from flatulence, caused by the intestinal bacteria called microflora in the bowel, can be treated by taking bismuth subgallate (brand Devrom). Bismuth subgallate is commonly used by individuals who have had ostomy surgery, bariatric surgery, fecal incontinence and irritable bowel syndrome.[3][4]

### Post Release

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In 1998, Chester "Buck" Weimer of Pueblo, Colorado, USA received a patent for the first undergarment that contained a replaceablecharcoal filter. The undergarments are air-tight and provide a pocketed escape hole in which a charcoal filter can be inserted.[5]

A similar product was released in 2002, but rather than an entire undergarment, consumers are able to purchase an insert similar to a pantiliner that contains activated charcoal.[6] The inventors, Myra Conant|Myra and Brian Conant of Milihani, Hawaii, USA still claim on their website to have discovered the undergarment product in 2002 (8 years after Chester Weimer filed for a patent for his product), but states that their tests "concluded" that they should release an insert instead.[7]

## References

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1. ↑ Ganiats TG (1994). "Does Beano prevent gas? A double-blind crossover study of oral alpha-galactosidase to treat dietary oligosaccharide intolerance". J Fam Pract. 39: 441–445. Unknown parameter `|coauthors=` ignored (help)
2. ↑ Di Stefano M (2000). "Non-absorbable antibiotics for managing intestinal gas production and gas-related symptoms". Aliment Pharmacol Ther. 14: 1001–1008. Unknown parameter `|coauthors=` ignored (help)
3. ↑ Turnbull G (2005). "The Ostomy Files:The Issue of Oral Medications and a Fecal Ostomy". Ostomy/Wound Management. 51: 14–16.
4. ↑ "Colostomy Guide". 2006-01-04. Retrieved 2007-09-10.
5. ↑ Weimer, Chester (1997-01-14). "Protective underwear with malodorous flatus filter". Retrieved 2007-07-27.
6. ↑ Conant, Brian J. (2001-11-06). "Flatulence deodorizer". Retrieved 2007-09-10. Unknown parameter `|coauthors=` ignored (help)
7. ↑ "Flat-D Innovations Inc.: About the American Inventor". Retrieved 2007-09-10.

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