Flatulence is the most normal thing in the world and is nothing to be ashamed of; however, the reality is that dealing with excessive and smelly gas is no fun at all and often includes unavoidable embarrassment. Finding a treatment that gets to the root cause of abnormal intestinal gas would be ideal. Research suggests that there are probiotics for eliminating gas.

Gas and Probiotics

Normal respiratory and metabolic processes produce most intestinal gasses, which are odorless. The smell comes from sulfur containing gasses like hydrogen sulfide, methanethiol and dimethylsulfide1. These gasses are caused by bacterial fermentation, and it takes very little of the sulfur containing gasses (1 part in 10,000) to cause a problem1. All of us have gas-producing intestinal bacteria. However, those with abnormally smelly gas suffer from two main problems: poor carbohydrate digestion and an altered intestinal microflora2.

Studies have shown that probiotics can address both of these issues. For example, the inability to digest lactose is for many a huge source of intestinal gas, and is one that can be improved by probiotics3. Likewise, there is evidence that probiotic bacteria can help keep gas-forming bacteria under control. One of the most interesting studies has been conducted with gas-causing bacteria isolated from colicky babies. The addition of Lactobacillus delbrueckii subsp. delbrueckii DSM 20074 and L. plantarum MB 456 effectively blocked gas production of the offending bacteria in assays4.

Your Best Bets Based on Clinical Evidence

Not many researchers specifically run trials looking for flatulence treatments. However, trials involving other gastrointestinal complaints, such as irritable bowel syndrome (IBS), often measure flatulence and other gas symptoms as parameters. Using these studies, I was able to get an overview of what seems to be working and, also, what isn’t working. To be clear, what doesn’t work is prebiotics. These almost always lead to increased intestinal gas5-11.

My suggestions come from a limited selection of studies (mainly randomized, placebo-controlled, double-blind studies). From a total of 35 studies collected looking at prebiotics and probiotics and gas symptoms, only six of them proved interesting enough to mention. The best bests are listed below.

1. Lactobacillus plantarum 299v

This strain is an extremely effective strain for IBS treatment (see previous post), and it appears to also improve gas symptoms12, 13. Two studies examined this strain and included flatulence as a parameter. One study was in IBS patients and the other in healthy volunteers, which is fairly unique. Supplementation even lowered the numbers of sulfur gas producing bacteria12. In IBS patients, it specifically halved the number of days that the patients experienced abundant gas13. The product used in the studies was a probiotic drink fortified with L. plantarum 299v called ProViva14. ProViva is, however, only available in Sweden. Another option with the same probiotic strain is produced by Jarrow Formulas and is specifically made for those with IBS.

2. Prescript-Assist

Prescript-Assist is a probiotic formula containing 29 different bacterial species15. Unlike most probiotics, these bacterial species aren’t lactic acid bacteria. Instead, they represent soil-based bacteria. This means that they are conditioned for survival in the open environment and are often hardier than their lactic acid bacteria kin. It is likely that early humans ingested these bacteria abundantly while eating due to the lack of clean cooking areas. Therefore, they may have a yet undiscovered role in our digestion. A study with IBS patients indicated that treatment with Prescript-Assist strongly reduced indigestion and flatulence after two weeks of treatment16. An extension of the same study showed that the effects could be maintained for an additional year with continual supplementation17. Prescript-Assist can be ordered via Amazon.

3. Probinul

The third in this ranking is an Italian product called Probinul produced by Cadigroup. This product contains a mixture of 9 probiotic strains plus a special prebiotic18. Unlike Prescript-Assist, this one is purely based on lactic acid bacteria species. It was tested on 64 IBS patients and was found to significantly reduce flatulence over a four week treatment period19. It is possible to buy this one from the Cadigroup website, but it is in Italian.

4. VSL#3

The last in this list is VSL#3. This product is well known for its use in ulcerative colitis, pouchitis and IBS. It contains a mixture of eight bacteria strains, mostly lactic acid bacteria species20. In a study using 48 IBS patients, it effectively reduced flatulence after four weeks of treatment21. However, this product is considered a medical food and should be only used under the guidance of a medical practitioner. It is still available via Amazon though.

While it is obvious that more research needs to be done in the area of probiotics and gas, there are indications that they could help. However, probiotics will be ineffective in cases of gas caused by poor diet and an underlying medical condition. Seeking a doctor’s advice in the situation of chronic symptoms is always advisable.

Please note: The product links listed here are my Amazon affiliate links.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

References

1. Suarez FL, Levitt MD. An understanding of excessive intestinal gas. Curr Gastroenterol Rep 2000; 2(5): 413-419.

2. Serra J. Intestinal gas: has diet anything to do in the absence of a demonstrable malabsorption state? Curr Opin Clin Nutr Metab Care 2012; 15(5): 489-493.

3. Rabot S, Rafter J, Rijkers GT, Watzl B, Antoine JM. Guidance for substantiating the evidence for beneficial effects of probiotics: impact of probiotics on digestive system metabolism. J Nutr 2010; 140(3): 677S-689S.

4. Savino F, Cordisco L, Tarasco V, Locatelli E, Di Gioia D, Oggero R et al. Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants. BMC Microbiol 2011; 11: 157.

5. Cloetens LB, W. F.; Delaedt, Y.; Ollevier, F.; Courtin, C. M.; Delcour, J. A.; Rutgeerts, P.; Verbeke, K. Tolerance of arabinoxylan-oligosaccharides and their prebiotic activity in healthy subjects: a randomised, placebo-controlled cross-over study. Br J Nutr 2010; 103(5): 703-713.

6. Costabile AK, S.; Klinder, A.; Gietl, E.; Bauerlein, M.; Frohberg, C.; Landschutze, V.; Gibson, G. R. A double-blind, placebo-controlled, cross-over study to establish the bifidogenic effect of a very-long-chain inulin extracted from globe artichoke (Cynara scolymus) in healthy human subjects. Br J Nutr 2010; 104(7): 1007-1017.

7. Francois IEL, O.; Veraverbeke, W. S.; Marzorati, M.; Possemiers, S.; Evenepoel, P.; Hamer, H.; Houben, E.; Windey, K.; Welling, G. W.; Delcour, J. A.; Courtin, C. M.; Verbeke, K.; Broekaert, W. F. Effects of a wheat bran extract containing arabinoxylan oligosaccharides on gastrointestinal health parameters in healthy adult human volunteers: a double-blind, randomised, placebo-controlled, cross-over trial. Br J Nutr 2012; 108(12): 2229-2242.

8. Kleessen BS, S.; Boehm, A.; Fuhrmann, H.; Richter, A.; Henle, T.; Krueger, M. Jerusalem artichoke and chicory inulin in bakery products affect faecal microbiota of healthy volunteers. Br J Nutr 2007; 98(3): 540-549.

9. Mitsou EKT, K.; Anapliotis, P.; Zisi, D.; Spiliotis, V.; Kyriacou, A. Impact of a jelly containing short-chain fructo-oligosaccharides and Sideritis euboea extract on human faecal microbiota. Int J Food Microbiol 2009; 135(2): 112-117.

10. Ramnani PG, E.; Bingham, M.; van Bruggen, P.; Tuohy, K. M.; Gibson, G. R. Prebiotic effect of fruit and vegetable shots containing Jerusalem artichoke inulin: a human intervention study. Br J Nutr 2010; 104(2): 233-240.

11. Slavin JF, J. Chicory inulin does not increase stool weight or speed up intestinal transit time in healthy male subjects. Food Funct 2011; 2(1): 72-77.

12. Johansson MLN, S.; Berggren, A.; Nyman, M.; Bjorck, I.; Ahrne, S.; Jeppsson, B.; Molin, G. Survival of Lactobacillus plantarum DSM 9843 (299v), and effect on the short-chain fatty acid content of faeces after ingestion of a rose-hip drink with fermented oats. Int J Food Microbiol 1998; 42(1-2): 29-38.

13. Nobaek SJ, M. L.; Molin, G.; Ahrne, S.; Jeppsson, B. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol 2000; 95(5): 1231-1238.

14. ProViva. ProViva – http://www.proviva.se Accessed:January 3, 2013.

15. Prescript-Assist Broad Spectrum Probiotic. Prescript-Assist – http://www.prescript-assist.com/products/ Accessed:January 2, 2014.

16. Bittner ACC, R. M.; Stranahan, M. C. Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study. Clin Ther 2005; 27(6): 755-761.

17. Bittner ACC, R. M.; Stranahan, M. C.; Yokelson, T. N. Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial. Clin Ther 2007; 29(6): 1153-1160.

18. Products Probinul. Cadigroup – http://cadigroup.eu/probinul-il-simbiotico-innovativo/?lang=en Accessed:January 3, 2014.

19. Cappello CT, F.; Pascariello, A.; Ciacci, C.; Iovino, P. A randomised clinical trial (RCT) of a symbiotic mixture in patients with irritable bowel syndrome (IBS): effects on symptoms, colonic transit and quality of life. Int J Colorectal Dis 2013; 28(3): 349-358.

20. Discover the Difference – VSL#3. VSL#3 The Living Shield – http://www.vsl3.com/discover.asp Accessed:January 3, 2014.

21. Kim HJVR, M. I.; Camilleri, M.; Stephens, D.; Burton, D. D.; Baxter, K.; Thomforde, G.; Zinsmeister, A. R. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil 2005; 17(5): 687-696.