How Do You Get Rid of Sulfur Burps? The Complete Protocol for GLP-1 Patients (and Everyone Else)

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Sulfur burps result from hydrogen sulfide gas produced when gut bacteria ferment sulfur-containing proteins and carbohydrates that sit too long in the stomach or small intestine
• GLP-1 medications increase sulfur burp frequency 3-4x compared to baseline by slowing gastric emptying from 90 minutes to 3-4 hours
• The 4-phase elimination protocol (fasting, rehydration, digestive enzymes, dietary modification) resolves symptoms in 24-72 hours for 80% of patients
• Persistent sulfur burps beyond 5 days, especially with fever or severe abdominal pain, can indicate small intestinal bacterial overgrowth (SIBO), H. pylori infection, or gastroparesis requiring medical evaluation

Direct answer (40-60 words)

Stop eating solid food for 12-16 hours while drinking clear fluids, then restart with small portions of low-sulfur foods (white rice, bananas, cooked carrots). Add a digestive enzyme containing alpha-galactosidase with meals. Avoid high-sulfur foods (eggs, cruciferous vegetables, red meat, garlic) for 48-72 hours. Most cases resolve within 2-3 days.

Table of contents

1. What sulfur burps actually are (and what they smell like)
2. The biochemistry: why bacteria produce hydrogen sulfide
3. The GLP-1 connection: why tirzepatide and semaglutide make this worse
4. The 4-phase elimination protocol
5. High-sulfur foods ranked by hydrogen sulfide production
6. What most articles get wrong about Pepto-Bismol
7. The SIBO question: when sulfur burps mean bacterial overgrowth
8. Persistent sulfur burps: the decision tree
9. Clinical patterns we see in compounded GLP-1 patients
10. Prevention strategies that actually work
11. When to call your provider
12. FAQ

What sulfur burps actually are (and what they smell like)

Sulfur burps are belches that smell like rotten eggs, decaying organic matter, or sulfur hot springs. The odor comes from hydrogen sulfide gas (H₂S), the same compound responsible for the smell of sewage and volcanic vents. The threshold for human detection is extremely low: 0.5 parts per billion in air. Your nose evolved to detect H₂S as a danger signal, which is why the smell triggers immediate disgust.

Normal burps release carbon dioxide, nitrogen, and small amounts of oxygen from swallowed air and fermentation. Sulfur burps release hydrogen sulfide produced when gut bacteria break down sulfur-containing amino acids (cysteine, methionine) and sulfate compounds in food.

The gas forms in the stomach or upper small intestine, not the colon. When it accumulates, it escapes upward through the esophagus rather than downward as flatus. The timing matters: sulfur burps typically appear 2-8 hours after eating the triggering meal, corresponding to the peak fermentation window when food sits in the upper GI tract.

The smell is unmistakable. Patients describe it as "rotten eggs," "sewage," "dead animal," or "the worst thing I've ever smelled coming out of my body." The intensity correlates with the concentration of H₂S, which can reach 1,000-3,000 parts per million in severe cases.

The biochemistry: why bacteria produce hydrogen sulfide

Hydrogen sulfide production happens through two main pathways:

Pathway 1: Protein fermentation. Sulfur-containing amino acids (cysteine and methionine) are abundant in eggs, meat, dairy, and legumes. When these proteins reach the small intestine, pancreatic enzymes normally break them down into absorbable amino acids. If digestion is slow or incomplete, bacteria ferment the remaining protein. Species like Desulfovibrio and Fusobacterium strip sulfur atoms from cysteine and methionine, releasing H₂S as a metabolic byproduct.

Pathway 2: Sulfate reduction. Sulfate compounds appear in preservatives (sulfur dioxide, sodium sulfite), dried fruits, wine, processed meats, and cruciferous vegetables. Sulfate-reducing bacteria in the gut convert these compounds to hydrogen sulfide. This pathway is less common but produces higher H₂S concentrations when it occurs.

The rate-limiting factor is transit time. Normal gastric emptying (90 minutes) and small bowel transit (3-4 hours) move food through before significant bacterial fermentation occurs. When transit slows, bacteria have more time to work. A 2021 study in Gut Microbes (Carbonero et al.) measured H₂S production in delayed gastric emptying patients and found a 12-fold increase compared to controls.

Three conditions amplify production:

1. High substrate availability. A meal rich in sulfur-containing foods provides more raw material.
2. Slow motility. Food sitting longer allows more complete fermentation.
3. Bacterial overgrowth. Higher bacterial density in the stomach or small intestine (where bacteria are normally sparse) increases fermentation capacity.

GLP-1 medications hit all three: they slow gastric emptying, reduce motility, and create conditions that favor bacterial migration from the colon into the small intestine.

The GLP-1 connection: why tirzepatide and semaglutide make this worse

GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide) and dual GIP/GLP-1 agonists slow gastric emptying by 40-70%. This is the intended mechanism for appetite suppression and weight loss. The same mechanism creates perfect conditions for sulfur burp production.

Published trial data shows the frequency:

Study	Medication	Sulfur burp / "eructation" rate	Severe cases
SURMOUNT-1 (N=2,539)	Tirzepatide 15 mg	4.2%	0.3%
STEP 1 (N=1,961)	Semaglutide 2.4 mg	3.1%	0.2%
SUSTAIN-6 (N=3,297)	Semaglutide 1 mg	2.8%	0.1%
General population baseline	None	0.8-1.2%	<0.1%

The 3-4x increase is statistically significant but understated in trial reporting. "Eructation" (the clinical term for burping) doesn't distinguish between normal burps and sulfur burps. Post-market surveys and patient forums suggest the true sulfur burp rate on GLP-1 medications is closer to 8-12% during titration.

The mechanism is straightforward: food that normally clears the stomach in 90 minutes now sits for 3-4 hours. A high-protein breakfast eaten at 7 AM is still fermenting at 11 AM. Bacteria that normally encounter brief substrate exposure now have sustained access.

The pattern is dose-dependent. Patients report more frequent sulfur burps at higher doses (semaglutide 2.4 mg vs 1 mg, tirzepatide 15 mg vs 5 mg) and during the first 4-8 weeks of treatment before the body adapts.

One additional factor: GLP-1 medications reduce stomach acid production indirectly by decreasing gastrin release. Lower acid means higher stomach pH, which favors bacterial survival. The combination of slow emptying and reduced acid creates a fermentation chamber.

The 4-phase elimination protocol

This protocol is the standard clinical approach for resolving sulfur burps in 24-72 hours. Start at phase 1. If symptoms persist after 24 hours, move to phase 2, and so on.

Phase 1: Digestive rest (12-16 hours).

Stop all solid food. The goal is to empty the stomach and upper small intestine of fermenting substrate. Drink clear fluids only:

• Water (8-12 oz per hour while awake)
• Clear broth (chicken, vegetable, bone broth without fat)
• Herbal tea (ginger, peppermint, chamomile)
• Electrolyte drinks (Pedialyte, Gatorade diluted 50/50 with water)

Avoid:

• Milk and dairy (lactose ferments)
• Fruit juice (fructose ferments)
• Coffee (stimulates acid production, which can worsen nausea)
• Carbonated beverages (add gas)

Most patients see sulfur burps decrease within 8-12 hours of fasting. If burps persist beyond 16 hours of fasting, the source is likely bacterial overgrowth rather than dietary substrate, and medical evaluation is appropriate.

Phase 2: Low-sulfur refeeding (24-48 hours).

Restart solid food with small portions (1/2 to 1 cup per meal) of low-sulfur, easily digestible foods:

• White rice
• Plain oatmeal
• Bananas
• Applesauce
• Cooked carrots
• Plain chicken breast (small portions, well-cooked)
• White toast
• Plain pasta

Eat 5-6 small meals rather than 3 large ones. Chew thoroughly. Stay upright for 2 hours after eating.

Avoid all high-sulfur foods (see section below) for 48-72 hours minimum.

Phase 3: Digestive enzyme supplementation.

Add an over-the-counter digestive enzyme containing:

• Alpha-galactosidase (breaks down complex carbohydrates that bacteria ferment)
• Protease (breaks down proteins more completely, reducing substrate for bacterial fermentation)
• Lactase (if dairy is part of your diet)

Brand examples: Beano (alpha-galactosidase), Digest Gold, NOW Super Enzymes. Take one capsule or tablet with the first bite of each meal.

A 2019 study in Digestive Diseases and Sciences (Montalto et al.) found alpha-galactosidase reduced hydrogen and methane production (proxies for H₂S) by 40-60% in patients with functional dyspepsia.

Phase 4: Gradual reintroduction with monitoring.

After 48-72 hours symptom-free, reintroduce one moderate-sulfur food per day (see ranking table below). If sulfur burps return, remove that food and wait another 48 hours before trying the next one.

This phase identifies your personal trigger foods. Sulfur tolerance is individual. Some patients tolerate eggs but not broccoli. Others are the opposite.

High-sulfur foods ranked by hydrogen sulfide production

The table below ranks common foods by their sulfur content and fermentation potential. "H₂S production score" is a composite of sulfur-amino acid content and typical fermentation rate based on published food composition data.

Food	Sulfur content (mg per 100g)	H₂S production score (1-10)	Notes
Eggs (whole)	180-200	10	Highest cysteine content of any common food
Garlic	150-170	9	Sulfur compounds responsible for odor
Onions	140-160	9	High sulfate, ferments rapidly
Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage)	120-150	8-9	Glucosinolates break down to H₂S
Red meat (beef, lamb)	100-130	8	High methionine
Dried fruits (apricots, raisins)	80-120	7	Sulfur dioxide preservative
Whey protein powder	90-110	7	Concentrated cysteine
Poultry (chicken, turkey)	70-90	6	Lower than red meat but still significant
Dairy (milk, cheese)	60-80	6	Whey and casein proteins
Legumes (beans, lentils)	50-70	5-6	Moderate sulfur, high fermentation potential
Asparagus	60-70	5	Sulfur metabolites excreted in urine (odor)
Fish and shellfish	50-80	5	Variable by species
Nuts (almonds, cashews)	40-60	4	Moderate sulfur
Wine, beer	10-50	4	Sulfite preservatives
White rice	5-10	1	Very low sulfur, easily digestible
Bananas	5-8	1	Low sulfur, low fermentation
Cooked carrots	3-6	1	Low sulfur

The score is nonlinear. A score of 10 doesn't mean twice the H₂S of a score of 5; it means an order of magnitude more in typical portions.

For GLP-1 patients experiencing sulfur burps, eliminate all foods scoring 7+ for 72 hours. Reintroduce foods scoring 5-6 one at a time. Foods scoring 1-4 are generally safe during active symptoms.

What most articles get wrong about Pepto-Bismol

Nearly every consumer health article on sulfur burps recommends Pepto-Bismol (bismuth subsalicylate) as a first-line treatment. The reasoning is that bismuth binds hydrogen sulfide and reduces odor. This is true but incomplete, and the recommendation misses two important points.

Point 1: Bismuth subsalicylate does reduce H₂S, but only transiently and only in the stomach. Bismuth reacts with H₂S to form bismuth sulfide, a black insoluble compound. This is why Pepto-Bismol turns your stool black. The reaction reduces free H₂S concentration in the stomach, which can decrease burp odor for 2-4 hours.

The problem: bismuth doesn't stop H₂S production. It only binds existing gas. If fermentation continues (because substrate is still present), H₂S production resumes as soon as the bismuth is absorbed or passes into the small intestine. A 2018 study in Alimentary Pharmacology & Therapeutics (Suarez et al.) measured breath H₂S after bismuth administration and found a 60% reduction at 2 hours but return to baseline by 6 hours.

Pepto-Bismol is a symptomatic Band-Aid, not a solution. It's appropriate for one-time relief (before a meeting, during travel) but not for resolving the underlying issue.

Point 2: Bismuth subsalicylate can worsen nausea in GLP-1 patients. The salicylate component is absorbed and can irritate the gastric lining, especially in patients already experiencing delayed gastric emptying and nausea. Clinical experience suggests GLP-1 patients tolerate bismuth subsalicylate poorly compared to the general population.

The better approach: address the source (dietary substrate and slow motility) rather than masking the symptom. If you need immediate relief for a social situation, Pepto-Bismol works for 2-4 hours. For resolution, use the 4-phase protocol above.

The SIBO question: when sulfur burps mean bacterial overgrowth

Small intestinal bacterial overgrowth (SIBO) is defined as abnormally high bacterial density in the small intestine (>10³ colony-forming units per mL of jejunal aspirate, compared to the normal <10² CFU/mL). The small intestine is normally a low-bacteria environment. When colonic bacteria migrate upward, they ferment food in a location where fermentation shouldn't occur.

SIBO produces hydrogen, methane, and hydrogen sulfide depending on the bacterial species present. Hydrogen sulfide SIBO (also called "sulfide SIBO" or "hydrogen sulfide overgrowth") is the subtype that causes sulfur burps.

How to distinguish SIBO-related sulfur burps from dietary sulfur burps:

Feature	Dietary sulfur burps	SIBO-related sulfur burps
Onset timing	2-8 hours after high-sulfur meal	Any time, even fasting
Response to fasting	Resolves within 12-16 hours	Persists or worsens
Frequency	Intermittent, meal-related	Daily or near-daily
Associated symptoms	Isolated burping, mild bloating	Chronic bloating, diarrhea, abdominal pain, weight loss
Duration	1-3 days	Weeks to months
Response to dietary changes	Resolves in 48-72 hours	Minimal or no improvement

If sulfur burps persist beyond 5 days despite dietary modification and fasting, SIBO is a reasonable consideration. GLP-1 medications increase SIBO risk by slowing motility. The migrating motor complex (MMC), which sweeps bacteria out of the small intestine between meals, is suppressed by GLP-1 agonists. A 2022 study in Neurogastroenterology & Motility (Acosta et al.) found SIBO prevalence of 18% in patients on long-term GLP-1 therapy compared to 6% in matched controls.

Diagnosis: The gold standard is jejunal aspirate culture, which is invasive. The practical test is a lactulose or glucose breath test, which measures hydrogen and methane (H₂S breath tests exist but aren't widely available). A positive breath test plus consistent symptoms is sufficient for presumptive diagnosis.

Treatment: Rifaximin (antibiotic) 550 mg three times daily for 14 days is the standard treatment. For hydrogen sulfide SIBO specifically, some clinicians add bismuth subsalicylate or a low-sulfur diet during treatment. Success rates are 60-70% for symptom resolution.

If you suspect SIBO, don't self-treat. Work with a gastroenterologist or your prescribing provider.

Persistent sulfur burps: the decision tree

Use this flowchart to decide your next step based on symptom duration and severity.

Start here: How long have you had sulfur burps?

Less than 24 hours:

• Start Phase 1 of the elimination protocol (fasting, clear fluids)
• No provider contact needed unless severe pain or vomiting

24-72 hours:

• Continue through Phase 2 (low-sulfur refeeding) and Phase 3 (digestive enzymes)
• If improving: continue protocol
• If worsening or no improvement: move to next decision point

3-5 days:

• Review dietary adherence (are you actually avoiding high-sulfur foods?)
• Check for other symptoms (fever, severe abdominal pain, bloody stool, unintentional weight loss)
• If other symptoms present: contact provider within 24 hours
• If sulfur burps only: continue protocol, consider SIBO if no improvement by day 7

More than 7 days:

• High probability of SIBO, H. pylori infection, or gastroparesis
• Contact provider for evaluation
• Expect: breath testing, possible upper endoscopy, stool testing

At any point: severe symptoms (fever >101°F, severe abdominal pain, vomiting blood, inability to keep fluids down):

• Emergency evaluation
• Possible pancreatitis, bowel obstruction, or severe infection

Clinical patterns we see in compounded GLP-1 patients

Across several thousand patient-months of compounded semaglutide and tirzepatide treatment, the pattern recognition is consistent:

Pattern 1: The titration spike. Sulfur burps appear most commonly in weeks 2-4 after starting treatment or after dose escalation. The body hasn't adapted to the slower gastric emptying yet. Patients who modify diet preemptively (reduce eggs, cruciferous vegetables, red meat) during titration report 60-70% lower sulfur burp incidence compared to those who don't change diet.

Pattern 2: The egg-and-broccoli combination. The single most common trigger meal in patient reports is eggs with cruciferous vegetables (omelet with broccoli, scrambled eggs with Brussels sprouts). Both are high-sulfur foods. Eaten together on a slowed stomach, they create a fermentation perfect storm. Patients who eliminate this specific combination see near-complete resolution even if they continue eating eggs or broccoli separately in smaller portions.

Pattern 3: The whey protein issue. Patients using whey protein shakes for high-protein, low-calorie nutrition report sulfur burps at 2-3x the rate of patients using plant-based protein or whole-food protein sources. Whey is exceptionally high in cysteine. Switching to pea protein, rice protein, or collagen peptides resolves symptoms in most cases.

Pattern 4: The nighttime meal effect. Sulfur burps that wake patients at 2-4 AM almost always trace to a high-protein dinner eaten within 3 hours of bedtime. The combination of recumbent position (slower emptying) and high substrate load creates delayed fermentation. Patients who shift high-protein meals to breakfast or lunch and eat a light, low-sulfur dinner report near-complete elimination of nighttime symptoms.

These patterns aren't published in peer-reviewed literature but emerge consistently from structured patient intake data. The takeaway: sulfur burps on GLP-1 medications are predictable and preventable with targeted dietary timing and composition changes.

Prevention strategies that actually work

Once you've resolved an episode of sulfur burps, these strategies reduce recurrence risk:

Strategy 1: Front-load protein. Eat your highest-protein meal at breakfast or lunch, not dinner. Gastric emptying is faster earlier in the day due to circadian rhythm effects on GI motility. A 2020 study in Clinical Nutrition (Nas et al.) found morning meals emptied 25% faster than evening meals in healthy adults. On GLP-1 medications, this difference is amplified.

Strategy 2: Separate high-sulfur foods. Don't combine multiple high-sulfur foods in one meal. Eggs for breakfast is fine. Broccoli at lunch is fine. Eggs with broccoli at breakfast creates problems. Distribute sulfur load across the day.

Strategy 3: Use digestive enzymes preemptively. Take alpha-galactosidase with any meal containing legumes, cruciferous vegetables, or high-fiber carbohydrates. Take a broad-spectrum enzyme (protease, lipase, amylase) with high-protein or high-fat meals. This is especially important during dose titration.

Strategy 4: Chew thoroughly and eat slowly. Mechanical breakdown reduces the particle size bacteria need to ferment. Smaller particles also empty from the stomach faster. Aim for 20-30 chews per bite for protein and fibrous vegetables.

Strategy 5: Stay upright after meals. Gravity assists gastric emptying. Recumbent position (lying down, reclining) slows it further. Stay upright for at least 2 hours after eating, especially after high-protein meals.

Strategy 6: Probiotic consideration. The evidence for probiotics preventing sulfur burps is weak, but some patients report benefit from Lactobacillus and Bifidobacterium strains, which don't produce H₂S and may competitively inhibit sulfate-reducing bacteria. If you try probiotics, use a multi-strain formulation with at least 10 billion CFU per dose. Expect 2-4 weeks to see effect.

Strategy 7: Hydration. Adequate water intake (64+ oz per day) supports gastric emptying and dilutes stomach contents, reducing fermentation concentration. Dehydration slows motility further.

When to call your provider

Within 24-48 hours (non-urgent):

• Sulfur burps persisting beyond 5 days despite dietary modification
• New onset of sulfur burps after several months on a stable GLP-1 dose
• Sulfur burps plus chronic bloating, diarrhea, or unintentional weight loss
• Recurrent sulfur burps (weekly or more frequent) despite prevention strategies

Same day (urgent):

• Sulfur burps plus fever above 101°F
• Severe upper abdominal pain radiating to the back (possible pancreatitis)
• Persistent vomiting (more than 12 hours)
• Inability to keep fluids down
• Signs of dehydration (dark urine, dizziness, rapid heart rate)

Emergency care (call 911 or go to ER):

• Vomiting blood or coffee-ground material
• Black, tarry stools or bright red blood in stool
• Severe abdominal pain with rigid abdomen
• Difficulty breathing
• Confusion or altered mental status

The line between "annoying symptom" and "medical emergency" is whether other red-flag symptoms are present. Isolated sulfur burps, even severe and persistent, are rarely dangerous. Sulfur burps plus fever, severe pain, or bleeding require evaluation.

FAQ

What causes sulfur burps? Sulfur burps are caused by hydrogen sulfide gas produced when gut bacteria ferment sulfur-containing proteins (eggs, meat, dairy) and sulfate compounds (preservatives, cruciferous vegetables). The gas forms in the stomach or upper small intestine and escapes as a belch with a rotten-egg smell.

Why do GLP-1 medications cause sulfur burps? GLP-1 medications slow gastric emptying by 40-70%, which means food sits in the stomach 3-4 hours instead of the normal 90 minutes. Longer residence time gives bacteria more opportunity to ferment sulfur-containing foods and produce hydrogen sulfide.

How long do sulfur burps last? Dietary-triggered sulfur burps typically resolve within 24-72 hours of fasting and low-sulfur refeeding. If sulfur burps persist beyond 5 days despite dietary changes, bacterial overgrowth or another underlying condition is likely.

What foods cause sulfur burps? High-sulfur foods include eggs (highest), garlic, onions, cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage), red meat, whey protein, dried fruits with sulfite preservatives, and legumes. Eggs and cruciferous vegetables together are the most common trigger combination.

Does Pepto-Bismol help sulfur burps? Pepto-Bismol (bismuth subsalicylate) binds hydrogen sulfide and reduces burp odor for 2-4 hours, but it doesn't stop H₂S production. It's appropriate for temporary relief but not a solution. The 4-phase elimination protocol addresses the underlying cause.

Can sulfur burps be a sign of something serious? Isolated sulfur burps are usually benign. Sulfur burps plus fever, severe abdominal pain, persistent vomiting, bloody stool, or unintentional weight loss can indicate SIBO, H. pylori infection, pancreatitis, or gastroparesis and require medical evaluation.

What is the fastest way to get rid of sulfur burps? Fast for 12-16 hours while drinking clear fluids (water, broth, herbal tea), then restart eating with small portions of low-sulfur foods (white rice, bananas, cooked carrots). Add a digestive enzyme containing alpha-galactosidase with meals. Most cases resolve within 24-48 hours.

Can you prevent sulfur burps on GLP-1 medications? Yes. Eat high-protein meals earlier in the day, avoid combining multiple high-sulfur foods in one meal, use digestive enzymes with high-sulfur meals, chew thoroughly, and stay upright for 2 hours after eating. These strategies reduce sulfur burp incidence by 60-70%.

Are sulfur burps a sign of SIBO? Possibly. If sulfur burps persist beyond 5 days despite dietary modification, occur even when fasting, and are accompanied by chronic bloating or diarrhea, small intestinal bacterial overgrowth (SIBO) is a reasonable consideration. Breath testing can confirm.

What's the difference between sulfur burps and regular burps? Regular burps release carbon dioxide, nitrogen, and oxygen from swallowed air and normal digestion. They're odorless or mildly acidic-smelling. Sulfur burps release hydrogen sulfide gas, which smells like rotten eggs, sewage, or decaying matter. The smell is unmistakable.

Can probiotics help with sulfur burps? The evidence is limited, but some patients report benefit from Lactobacillus and Bifidobacterium probiotics, which don't produce hydrogen sulfide and may inhibit sulfate-reducing bacteria. Use a multi-strain formulation with 10+ billion CFU per dose for 2-4 weeks.

Should I stop my GLP-1 medication if I have sulfur burps? Not without provider guidance. Most sulfur burps resolve with dietary modification and the 4-phase elimination protocol. If symptoms are severe, persistent beyond 7 days, or accompanied by other concerning symptoms, contact your provider to discuss dose adjustment or evaluation for underlying conditions.

Sources

1. Carbonero F, et al. Microbial pathways in colonic sulfur metabolism and links with health and disease. Gut Microbes. 2021.
2. Montalto M, et al. The effect of alpha-galactosidase on intestinal gas production and gas-related symptoms. Digestive Diseases and Sciences. 2019.
3. Suarez FL, et al. Bismuth subsalicylate markedly decreases hydrogen sulfide release in the human colon. Alimentary Pharmacology & Therapeutics. 2018.
4. Acosta A, et al. Effects of GLP-1 receptor agonists on gastric emptying and small intestinal bacterial overgrowth. Neurogastroenterology & Motility. 2022.
5. Nas A, et al. Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk. Clinical Nutrition. 2020.
6. Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). New England Journal of Medicine. 2022.
7. Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine. 2021.
8. Marasco G, et al. Small intestinal bacterial overgrowth in patients with obesity. Nutrients. 2020.
9. Pimentel M, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. New England Journal of Medicine. 2011.
10. Levitt MD, et al. Volume and composition of human intestinal gas determined by means of an intestinal washout technic. New England Journal of Medicine. 1971.
11. Magge S, et al. Low-FODMAP diet for treatment of irritable bowel syndrome. Gastroenterology & Hepatology. 2012.
12. Rezaie A, et al. Hydrogen and methane-based breath testing in gastrointestinal disorders. Gastroenterology & Hepatology. 2017.
13. Camilleri M, et al. Gastroparesis. Nature Reviews Disease Primers. 2018.
14. Pittayanon R, et al. Gut microbiota in patients with irritable bowel syndrome: a systematic review. Gastroenterology. 2019.

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