Medications and other therapies
Some medications and other treatments have been found to help ease the symptoms of bloating and distension. Your doctor may talk to you about some of these options, depending on your symptoms and other health related considerations.
Antispasmodics: These can relax the muscles of the bowel and provide relief. Examples include dicyclomine (Bentyl) and hyoscyamine (Levsin) in the United States and otilonium bromide or pinaverium bromide available in Latin America and some countries in Europe and Asia and a combination of pinaverium bromide with simethicone (Alevian Duo) in some Latin America countries.
Probiotics: These dietary supplements contain live bacteria that help balance out the existing bacteria of the intestines. Some that include a relatively low level of probiotic bacteria are available over the counter or in yogurt varieties. Other options include Bifidobacterium infantis 35624 for individuals with irritable bowel syndrome (IBS) in general, and Bifidobacterium animalis DN-0173 10 for patients with IBS with constipation (IBS-C).
Rifaximin: This antibiotic is only slightly absorbed and can be used for short periods of time. Usually it is used (off-label) to lessen bloating in people with IBS whose symptoms do not include constipation, or in those with small intestinal bacterial overgrowth.
Prokinetics: These are medications that improve the time it takes for food to travel through the digestive tract. Some prokinetics have been shown to improve bloating. A person’s age, health and other considerations must be taken into account for these therapies and availabilities vary from country to country.
Antidepressants: These drugs affect receptors in the gut and in the brain. Given in lower dosages than what is used to treat depression, they have been shown to help alleviate bloating and distension. For example, citalopram (Celexa), an SSRI (selective serotonin reuptake inhibitor), has been shown to help improve bloating in individuals with IBS. Amitryptiline (Elavil), a tricyclic antidepressant, is commonly used to treat pain and discomfort, as well as diarrhea, and may be helpful for bloating.
Other options: Medications that increase fluid content in stools, lubiprostone (Amitiza) or linaclotide (Linzess) for example, may also be used.
Psychological therapies: Treatments including hypnotherapy and cognitive-behavioral therapy can be useful and help with symptoms and mood.
Low FODMAP diet: Working with a doctor or registered dietitian to determine a diet low in FODMAPs is an option for alleviating bloating and distension symptoms. FODMAPs are shortchain carbohydrates that are poorly absorbed in the small intestine and rapidly fermented by bacteria in the gut.
Foods that are rich in FODMAPs include:
- Fruits such as mangoes, apples, pears, avocados, blackberries, and plums
- Dairy products like cow, sheep, and goat milk, as well as yogurt, ice cream, and soft cheeses including cottage cheese, cream cheese and mascarpone
- Vegetables and legumes such as asparagus, bell peppers, broccoli, Brussels sprouts, cabbage, cauliflower, eggplant, onion, garlic, baked beans, kidney beans, and lentils
- Sweeteners like sorbitol and maltitol (frequently used in gum and other candies)
Bloating and distension are both very common, for the general population and for those with FGIDs and motility disorders. Either of the two may be very bothersome to individuals that are experiencing the symptoms, as well as challenging to those trying to treat them. There is not a conclusive cause for bloating or distension, nor is there a universally effective treatment. With the help of a physician, individuals can find different treatment options that may help alleviate their symptoms.
For specific guidance regarding personal health questions, we advise consultation with a qualified healthcare professional familiar with your particular circumstances. Be sure to thoroughly discuss treatment options and the use of any medications for treatment with your physician. When prescribed a medication, disclose the use of all other drugs or supplements (whether prescription or over-the-counter) with your physician.
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