The Effect of Oral α-Galactosidase on Intestinal Gas Production and Gas-Related Symptoms


Bloating, abdominal distention, and flatulence represent very frequent complaints in functional disorders but their pathophysiology and treatment are largely unknown. Patients frequently associate these symptoms with excessive intestinal gas and the reduction of gas production may represent an effective strategy. The aim was to evaluate the effect of α-galactosidase administration, in a randomized double-blind placebo-controlled protocol, on intestinal gas production and gas-related symptoms after a challenge test meal in healthy volunteers. Eight healthy volunteers ingested 300 or 1200 GalU of α-galactosidase or placebo during a test meal containing 420 g of cooked beans. Breath hydrogen excretion and occurrence of bloating, abdominal pain, discomfort, flatulence, and diarrhea were measured for 8 hr. The administration of 1200 GalU of α-galactosidase induced a significant reduction of both breath hydrogen excretion and severity of flatulence. A reduction in severity was apparent for all considered symptoms, but both 300 and 1200 GalU induced a significant reduction in the total symptom score. α-Galactosidase reduced gas production following a meal rich in fermentable carbohydrates and may be helpful in patients with gas-related symptoms.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Thomson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA (1999) Functional bowel disorders and functional abdominal pain. Gut 45(Suppl II):II43–II47

    Article  Google Scholar 

  2. 2.

    Johnsen R, Jacobsen BK, Forde OH (1986) Association between symptoms of irritable colon and psychological and social conditions and lifestyle. BMJ 292:1633–1635

    PubMed  CAS  Google Scholar 

  3. 3.

    Kay L, Jorgensen T, Jensen KH (1994) The epidemiology of irritable bowel syndrome in a random population. Prevalence, incidence, natural history and risk factors. J Intern Med 236:23–30

    PubMed  CAS  Article  Google Scholar 

  4. 4.

    Strocchi A, Levitt D (1993) Intestinal gas. In: Sleisenger MH, Fordtran JS (eds) Gastrointestinal disease. Philadelphia, Saunders, pp 1035–1042

    Google Scholar 

  5. 5.

    Levitt MD, Furne J, Olsson S (1996) The relation of passage of gas and abdominal bloating to colonic gas production. Ann Intern Med 124:422–424

    PubMed  CAS  Google Scholar 

  6. 6.

    Di Stefano M, Strocchi A, Malservisi S, Veneto G, Ferrieri A, Corazza GR (2000) Non-absorbable antibiotics for managing intestinal gas production and gas related symptoms. Aliment Pharmacol Ther 14:1001–1008

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Friis H, Bodè S, Rumessen JJ (1991) Effect of simethicone on lactulose-induced H2 production and gastrointestinal symptoms. Digestion 49:227–230

    PubMed  CAS  Article  Google Scholar 

  8. 8.

    Danhof IE, Stavola JJ (1974) Accelerated transit of intestinal gas with simethicone. Obstet Gynecol 44:148–154

    PubMed  CAS  Google Scholar 

  9. 9.

    Hall RG Jr, Thompson H, Strother A (1981) Effects of orally administered activated charcoal on intestinal gas. Am J Gastroenterol 75:192–196

    PubMed  Google Scholar 

  10. 10.

    Jai NK, Patel VP, Pitchumoni CS (1986) Activated charcoal, simethicone, and intestinal gas: a double-blind study. Ann Intern Med 105:61–62

    Google Scholar 

  11. 11.

    Potter T, Ellis C, Levitt MD (1985) Activated charcoal: in vivo and in vitro studies of effects on gas formation. Gastroenterology 88:620–624

    PubMed  CAS  Google Scholar 

  12. 12.

    White JG, Hightower NC, Riggs M, Dyck WP (1991) Does activated charcoal relieve gas symptoms? A placebo controlled study. Gastroenterology 100:A261

    Google Scholar 

  13. 13.

    Sutalf LO, Levitt MD (1979) Follow-up of a flatulent patient. Dig Dis Sci 24:652–654

    Article  Google Scholar 

  14. 14.

    Gaon D, Garmendia C, Murrielo NO, et al. (2002) Effect of Lactobacillus strains (L. casei and L. acidophilus strains cereal) on bacterial overgrowth related chronic diarrhea. Medicina (B Aires) 62:159–163

    Google Scholar 

  15. 15.

    Nobaek S, Johansson ML, Molin G, Ahrne S, Jeppsson B (2000) Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol 95:1231–1238

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    O’Mahony L, McCarthy J, Kelly P, Hurley G, Luo F, Chen K, O’Sullivan GC, Kiely B, Collins JK, Shanahan F, Quigley EM (2005) Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology 128:541–551

    PubMed  Article  Google Scholar 

  17. 17.

    Kim HJ, Camilleri M, McKinzie S, Lempke MB, Burton DD, Thomforde GM, Zinsmeister AR (2003) A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 17:895–904

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Di Stefano M, Malservisi S, Veneto G, Ferrieri A, Corazza GR (2000) Rifaximin versus chlortetracycline in the short-term treatment of small intestinal bacterial overgrowth. Aliment Pharmacol Ther 14:551–556

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Corazza GR, Strocchi A, Sorge M, Bentai G, Gasbarrini G (1993) Prevalence and consistency of low breath H2 excretion following lactulose ingestion. Possible implications for the clinical use of the H2 breath test. Dig Dis Sci 38:2010–2016

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Huskinsson EC (1974) Measurement of pain. Lancet 2:1127–1131

    Article  Google Scholar 

  21. 21.

    Kotler OP, Holt PR, Rosensweig NS (1982) Modification of the breath hydrogen test increased sensitivity for the detection of carbohydrate malabsorption. J Lab Clin Med 100:798–805

    PubMed  CAS  Google Scholar 

  22. 22.

    Thompson DG, O’Brien JD, Hardie JM (1986) Influence of the oropharyngeal microflora on the measurements of exhaled breath hydrogen. Gastroenterology 191:853–860

    Google Scholar 

  23. 23.

    Rosenthal A, Solomons NW (1983) Time-course of cigarette smoke contamination of clinical hydrogen breath-analysis tests. Clin Chem 29:1980–1981

    PubMed  CAS  Google Scholar 

  24. 24.

    Payne DL, Welsh JD, Claypool PL (1983) Breath hydrogen (H2) response to carbohydrate malabsorption after exercise. J Lab Clin Med 102:147–150

    PubMed  CAS  Google Scholar 

  25. 25.

    Kotler OP, Holt PR, Rosensweig NS (1982) Modification of the breath hydrogen test increased sensitivity for the detection of carbohydrate malabsorption. J Lab Clin Med 100:798–805

    PubMed  CAS  Google Scholar 

  26. 26.

    Serra J, Azpiroz F, Malagelada JR (2001) Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome. Gut 48:14–19

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Serra J, Azpiroz F, Malagelada JR (2001) Mechanisms of intestinal gas retention in humans: impaired propulsion versus obstructed evacuation. Am J Physiol Gastrointest Liver Physiol 281:G138–G143

    PubMed  CAS  Google Scholar 

  28. 28.

    Waye JD, Pitman E, Weiss A, Krueger K (1975) The bubble problem in endoscopy. Gastrointest Endosc 14:34–35

    Google Scholar 

  29. 29.

    Caldarella MP, Serra J, Azpiroz F, Malagelada JR (2002) Prokinetic effects in patients with intestinal gas retention. Gastroenterology 22:1748–1755

    Article  Google Scholar 

  30. 30.

    Muller–Lissner SA, Fumagalli I, Bardhan KD, Pace F, Pecher E, Nault B, Ruegg P (2001) Tegaserod, a 5HT(4) receptor partial agonist, relieves symptoms in irritable bowel syndrome patients with abdominal pain, bloating and constipation. Aliment Pharmacol Ther 15:1655–1666

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Di Stefano M, Missanelli A, Miceli E, Mazzocchi S, Corazza GR (2004) Tegaserod improves abdominal bloating without modifying intestinal gas production capacity. Dig Liv Dis 36:174

    Article  Google Scholar 

  32. 32.

    Muller-Lissner S, Holtmann G, Rueegg P, Weidinger G, Loffler H (2005) Tegaserod is effective in the initial and retreatment of irritable bowel syndrome with constipation. Aliment Pharmacol Ther 21:11–20

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Gillis JC, Brogden RN (1995) Rifaximin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic potential in conditions mediated by gastrointestinal bacteria. Drugs 49:467–484

    PubMed  CAS  Google Scholar 

  34. 34.

    Attar A, Flourie B, Rambaud JC, Franchisseur C, Ruszniewski P, Bouhnik Y (1999) Antibiotic efficacy in small intestine bacterial overgrowth related chronic diarrhea: a crossover, randomized trial. Gastroenterology 17:794–797

    Article  Google Scholar 

  35. 35.

    Sen S, Mullan MM, Parker TJ, Woolner JT, Tarry SA, Hunter JO (2002) Effect of Lactobacillus plantarum 299v on colonic fermentation and symptoms of irritable bowel syndrome. Dig Dis Sci 47:2615–2620

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Castiglione F, Rispo A, Di Girolamo E, et al. (2003) Antibiotic treatment of small bowel bacterial overgrowth in patients with Crohn's disease. Aliment Pharmacol Ther 18:1107–1112

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Di Stefano M, Miceli E, Missanelli A, Mazzocchi S, Corazza GR (2005) Absorbable versus non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome. Aliment Pharmacol Ther 21:985–992

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Lettieri JT, Dain B (1998) Effect of beano on the tolerability and pharmacodynamics of acarbose. Clin Ther 20:497–504

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Solomons NW, Guerrero AM, Zepeda E, Grazioso C (1991) The efficacy of an oral α-galactosidase to promote oligosaccaride hydrolysis and to reduce intolerance symptom after ingestion of beans: a dose response trial. Am J Clin Nutr 53:P28

    Google Scholar 

  40. 40.

    Ganiats TG, Norcross WA, Halverson AL, Burford PA, Palinkas LA (1994) Does beano prevent gas? A double blind crossover study of oral α-galactosidase to treat dietary oligosaccharide intolerance. J Fam Pract 39:441–445

    PubMed  CAS  Google Scholar 

  41. 41.

    Kellow JE, Phillips SF (1987) Altered small bowel motility in irritable bowel syndrome is correlated with symptoms. Gastroenterology 92:1885–1893

    PubMed  CAS  Google Scholar 

  42. 42.

    Whitehead WE, Holtkotter B, Enck P, Hoelzl R, Holmes KD, Anthony J, Shabsin HS, Schuster MM (1990) Tolerance for rectosigmoid distention in irritable bowel syndrome. Gastroenterology 98:1187–1192

    PubMed  CAS  Google Scholar 

  43. 43.

    Mayer EA, Gebhart GF (1994) Basic and clinical aspects of visceral hyperalgesia. Gastroenterology 107:271–293

    PubMed  CAS  Google Scholar 

  44. 44.

    Swarbrick ET, Hegarty JE, Bat L, Williams CB, Dawson AM (1980) Site of pain from the irritable bowel. Lancet 2:443–446

    PubMed  Article  CAS  Google Scholar 

  45. 45.

    Moriarty KJ, Dawson AM (1982) Functional abdominal pain: further evidence that whole gut is affected. BMJ 284:1670–1672

    PubMed  CAS  Article  Google Scholar 

  46. 46.

    Mearin F, Cucala M, Azpiroz F, Malagelada JR (1991) The origin of symptoms on the brain–gut axis in functional dyspepsia. Gastroenterology 101:999–1006

    PubMed  CAS  Google Scholar 

  47. 47.

    Silverman DH, Munakata JA, Ennes H, Mandelkern MA, Hoh CK, Mayer EA (1997) Regional cerebral activity in normal and pathological perception of visceral pain. Gastroenterology 112:64–72

    PubMed  Article  CAS  Google Scholar 

  48. 48.

    Aggarwal A, Cutts TF, Abell TL, Cardoso S, Familoni B, Bremer J, Karas J (1994) Predominant symptoms in irritable bowel syndrome correlate with specific autonomic nervous system abnormalities. Gastroenterology 106:945–950

    PubMed  CAS  Google Scholar 

  49. 49.

    Spiller RC, Brown ML, Phillips SF (1986) Decreased fluid tolerance, accelerated transit, and abnormal motility of the human colon induced by oleic acid. Gastroenterology 91:100–107

    PubMed  CAS  Google Scholar 

  50. 50.

    Kamath PS, Hoepfner MT, Phillips SF (1987) Short-chain fatty acids stimulate motility of the canine ileum. Am J Physiol 253(4; Pt 1):G427–G433

    PubMed  CAS  Google Scholar 

  51. 51.

    Corsetti M, Gevers AM, Caenepeel P, Tack J (2004) The role of tension receptors in colonic mechanosensitivity in humans. Gut 53:1787–1793

    PubMed  Article  CAS  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Gino Roberto Corazza.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Di Stefano, M., Miceli, E., Gotti, S. et al. The Effect of Oral α-Galactosidase on Intestinal Gas Production and Gas-Related Symptoms. Dig Dis Sci 52, 78–83 (2007).

Download citation


  • Bloating
  • Functional bowel disorders
  • α-Galactosidase
  • Intestinal gas production
  • Colonic fermentation