While interviewing a pt who was suffering from gas pains, I was asked about the efficacy of beano.  After having no clue as to what beano was or how it worked, and only being able to recall the "be-no-gas" advertisement, I decided to learn more about beano.

When undigested carbohydrates enter the colon, bacterial fermentation of these carbohydrates produces intestinal gas, which can lead to abdominal pain and flatulence.  Beano is an over-the-counter oral solution of alpha-galactosidase, which is used to prevent flatus and other gastrointestinal symptoms resulting from a high-fiber (=high carb) diet.  In theory, beano is supposed to enhance the breakdown of carbohydrates before they reach the lower intestine.  More broken down carbs = less carbs for intestinal bacterial to ferment = less gas.  But does it work?

Believe it or not, there was actually a small study where 19 subjects were fed chili and monitored for 6 hours.  Two groups were made; one received beano and another received placebo.  One week later, the group treatments were switched and the groups were re-fed.  The study reported that the number of flatulence events per hour was significantly less in a group treated with alpha-galactosidase than a placebo group over the 6-hour follow-up period.  Who knew?

Another study evaluated beano and its effect on acarbose treatment (an alpha-glucosidase inhibitor used in the treatment of type 2 diabetes mellitus).  This study found that patients who took Beano with acarbose had  significantly less flatulence than did those who took acarbose alone (0.79 vs 1.09).  Breath hydrogen concentration was lower after administration of acarbose plus Beano than with acarbose alone (31.2 ppm vs 50.5 ppm). However, Beano had variable effects on the ability of acarbose to reduce the postprandial serum glucose concentration.  It was observed that postprandial serum glucose levels were higher in patients who received acarbose plus Beano than in those who received acarbose alone.  However, both treatments (with or without Beano) resulted in postprandial serum glucose levels that were significantly lower than those seen with placebo. The study concluded that while Beano appeared to decrease the activity of acarbose, postprandial serum glucose concentrations were still decreased significantly while the flatulence associated with acarbose treatment was alleviated.