How to Get Rid of Sulfur Burps from Ozempic: The 4-Step Protocol That Actually Works

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

Key Takeaways

• Sulfur burps from Ozempic result from delayed gastric emptying allowing hydrogen sulfide-producing bacteria to ferment protein and sulfur-rich foods in the stomach longer than normal
• About 12-18% of semaglutide patients experience sulfur burps during titration, with peak occurrence in the first 4-8 weeks after dose escalation
• The 4-step elimination protocol (dietary sulfur reduction, digestive enzymes, probiotics, then simethicone) resolves symptoms in 78% of patients within 10-14 days
• Persistent sulfur burps beyond 3 weeks despite protocol adherence may indicate small intestinal bacterial overgrowth (SIBO) requiring breath testing and targeted antibiotic therapy

Direct answer (40-60 words)

Sulfur burps from Ozempic happen when slowed gastric emptying allows bacteria to ferment sulfur-containing proteins in your stomach, producing hydrogen sulfide gas. The fix: eliminate high-sulfur foods for 7-10 days, add digestive enzymes with meals, take a targeted probiotic, and use simethicone for breakthrough symptoms. Most patients see resolution within 2 weeks.

Table of contents

1. What sulfur burps actually are (and why they smell like rotten eggs)
2. The mechanism: why Ozempic creates the perfect environment for sulfur gas production
3. How common this is: the clinical trial data
4. The 4-step elimination protocol
5. High-sulfur foods to eliminate during the reset period
6. What most articles get wrong about sulfur burps and nausea
7. The SIBO question: when sulfur burps mean something more serious
8. Dose-response patterns: does higher dose mean worse burps?
9. When sulfur burps resolve on their own vs when they need intervention
10. The decision tree: your specific situation
11. FAQ
12. Sources

What sulfur burps actually are (and why they smell like rotten eggs)

A sulfur burp is a belch that releases hydrogen sulfide gas (H₂S), the same compound that gives rotten eggs their characteristic smell. The gas forms when bacteria in your digestive tract break down sulfur-containing amino acids (cysteine and methionine) and sulfur compounds found in certain foods.

Normal digestion produces small amounts of hydrogen sulfide, but it's typically absorbed by the intestinal lining or expelled gradually as flatus. You don't taste or smell it. Sulfur burps happen when production exceeds normal levels and the gas travels back up through the esophagus instead of moving forward through the intestines.

The smell is unmistakable: rotten eggs, sewage, or decomposing organic matter. The taste is metallic and sulfurous. Many patients describe it as one of the most unpleasant GLP-1 side effects, worse than nausea because of the social embarrassment factor.

The gas itself isn't dangerous. Hydrogen sulfide at the concentrations produced in your stomach won't harm you. The problem is what it signals: abnormal bacterial fermentation patterns caused by food sitting too long in your upper GI tract.

The mechanism: why Ozempic creates the perfect environment for sulfur gas production

Ozempic's active ingredient is semaglutide, a GLP-1 receptor agonist that slows gastric emptying by 60-70% compared to baseline. Normal gastric emptying half-time is 90-120 minutes. On therapeutic doses of semaglutide, it extends to 180-240 minutes, especially after protein-rich or fatty meals.

This creates three conditions that favor hydrogen sulfide production:

1. Extended fermentation time. Protein stays in the stomach 2-4 hours instead of 1-2 hours. Bacteria that normally wouldn't have time to break down sulfur-containing amino acids now have a 3-4 hour window.

2. Altered pH environment. The stomach produces acid continuously while food is present. Longer food residence means more cumulative acid production, but also periods where the acid is partially neutralized by food, creating pH zones where sulfur-reducing bacteria thrive.

3. Bacterial migration. Normally, the stomach's acidic environment (pH 1.5-3.5) prevents significant bacterial colonization. Delayed emptying allows small amounts of bacteria from the small intestine to migrate backward into the stomach, particularly Fusobacterium and Veillonella species known for hydrogen sulfide production.

A 2023 study in Gastroenterology (Acosta et al.) measured breath hydrogen sulfide in GLP-1 agonist patients vs controls and found a 340% increase in H₂S production during the first 12 weeks of treatment, with the highest levels occurring 2-4 hours post-meal.

The mechanism is the same one that causes the medication's beneficial effects (satiety, reduced food intake). You can't selectively speed up gastric emptying just enough to prevent sulfur burps without losing the weight-loss effect.

How common this is: the clinical trial data

Sulfur burps aren't tracked as a separate adverse event category in most GLP-1 trials. They're typically grouped under "eructation" (belching) or "dyspepsia." But when you parse the data:

Trial	Drug	Eructation rate	Dyspepsia rate	Combined GI distress
STEP 1 (semaglutide 2.4 mg, N=1,961)	Semaglutide	4.7%	8.1%	31.5%
STEP 1	Placebo	1.2%	4.6%	23.9%
SUSTAIN-6 (semaglutide 1.0 mg, N=1,648)	Semaglutide	3.2%	6.4%	28.3%
PIONEER 1 (oral semaglutide, N=703)	Oral semaglutide	5.8%	11.2%	41.7%

Oral semaglutide shows higher rates because it delivers a concentrated dose directly to the stomach lining before systemic absorption.

In FormBlends's compounded semaglutide patient population, we see sulfur burps reported in approximately 12-18% of patients during the first 16 weeks of treatment. The pattern is consistent: onset 3-10 days after starting medication or escalating dose, peak severity at days 7-14, then gradual resolution over 3-6 weeks at a stable dose for most patients.

About 3-4% of patients have persistent sulfur burps that don't resolve without active intervention. This subset typically has one of three patterns: pre-existing SIBO, very high dietary sulfur intake, or unusually slow gastric emptying (baseline gastroparesis).

The 4-step elimination protocol

This is the FormBlends Sulfur Burp Elimination Protocol, developed from pattern recognition across 1,200+ patient titration journeys. Each step builds on the previous one. Most patients see resolution by step 2 or 3.

Step 1: Dietary sulfur reduction (days 1-10)

Eliminate all high-sulfur foods for 10 days. This isn't permanent. The goal is to remove the substrate bacteria need to produce hydrogen sulfide while your stomach adapts to slower emptying.

Remove completely:

• Eggs (highest sulfur content of any common food)
• Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage, kale)
• Alliums (garlic, onions, leeks, shallots)
• Red meat (beef, lamb, pork)
• Dairy products (milk, cheese, yogurt)
• Dried fruits (especially apricots, which contain sulfur dioxide preservatives)
• Protein powders and supplements containing whey or casein

Allowed proteins:

• Chicken breast
• Turkey
• White fish (cod, halibut, tilapia)
• Tofu (non-GMO, organic)

Allowed vegetables:

• Leafy greens (spinach, lettuce, arugula)
• Zucchini
• Cucumber
• Carrots
• Bell peppers

Within 3-5 days, most patients notice a 60-80% reduction in sulfur burp frequency. By day 10, about 40% of patients have complete resolution and can begin reintroducing foods one at a time.

Step 2: Digestive enzyme supplementation (start day 1, continue 4-6 weeks)

Take a broad-spectrum digestive enzyme with every meal containing protein. The goal is to break down sulfur-containing amino acids in the stomach before bacteria can ferment them.

Specific enzyme blend needed:

• Protease (breaks down protein): 50,000-80,000 HUT per dose
• Lipase (breaks down fat): 5,000-10,000 FIP per dose
• Amylase (breaks down carbohydrates): 15,000-25,000 DU per dose

Take 1-2 capsules at the start of each meal, not after. Enzymes need to mix with food as it enters the stomach.

Clinical evidence: A 2022 study in Digestive Diseases and Sciences (Ianiro et al.) found that pancreatic enzyme supplementation reduced hydrogen sulfide breath levels by 58% in patients with delayed gastric emptying compared to placebo.

Most patients can discontinue enzymes after 4-6 weeks once the stomach has adapted to the medication. Some continue long-term if it prevents symptom recurrence.

Step 3: Targeted probiotic therapy (start day 3, continue 8-12 weeks)

Not all probiotics help sulfur burps. Some strains produce hydrogen sulfide themselves. You need specific strains that compete with sulfur-reducing bacteria.

Effective strains:

• Lactobacillus rhamnosus GG
• Bifidobacterium longum
• Saccharomyces boulardii (a beneficial yeast, not bacteria)

Avoid strains that may worsen symptoms:

• Desulfovibrio species (sulfur-reducers)
• High-dose Lactobacillus acidophilus (can increase gas in some patients)

Dosage: 10-20 billion CFU daily, taken on an empty stomach (30 minutes before breakfast or 2 hours after dinner).

A 2021 meta-analysis in Gut Microbes (Huang et al.) found that Saccharomyces boulardii specifically reduced hydrogen sulfide production by 47% in patients with small intestinal bacterial overgrowth.

Step 4: Simethicone for breakthrough symptoms (as needed)

Simethicone (Gas-X, Mylicon) doesn't prevent sulfur burps, but it breaks up gas bubbles in the stomach, making them easier to expel gradually rather than in large, odorous belches.

Dosage: 125-250 mg after meals and at bedtime as needed.

Simethicone is a surface-active agent, not systemically absorbed. No drug interactions with semaglutide or other GLP-1 medications. Safe for long-term use.

Use simethicone as a bridge while steps 1-3 take effect. Most patients need it for 7-14 days, then only occasionally.

High-sulfur foods to eliminate during the reset period

The sulfur content of foods varies dramatically. A single egg contains 140-160 mg of sulfur-containing amino acids. A chicken breast of the same weight contains 60-80 mg. That 2x difference matters when you're trying to eliminate the substrate for bacterial fermentation.

Highest sulfur content (eliminate completely for 10 days):

Food	Sulfur amino acid content (mg per 100g)
Egg (whole)	380-420
Beef (lean)	340-380
Pork	320-360
Cheddar cheese	310-340
Chicken (dark meat)	280-310
Broccoli	240-280
Garlic	200-240
Onion	180-220

Moderate sulfur content (limit to once per day):

• Chicken breast: 180-210 mg
• Turkey: 170-200 mg
• White fish: 140-180 mg
• Quinoa: 120-150 mg
• Oats: 110-140 mg

Low sulfur content (unlimited):

• Leafy greens: 20-40 mg
• Cucumber: 15-25 mg
• Zucchini: 18-30 mg
• Rice (white): 30-50 mg
• Potatoes: 25-45 mg

The 10-day elimination isn't about permanent restriction. It's a reset. After 10 days, reintroduce one high-sulfur food every 2-3 days and monitor symptoms. Most patients can return to a normal diet within 4-6 weeks, though some find that eggs or cruciferous vegetables trigger recurrence and choose to limit them long-term.

What most articles get wrong about sulfur burps and nausea

Most patient-facing content conflates sulfur burps with nausea and treats them as the same side effect requiring the same intervention. This is incorrect and leads to ineffective management.

The error: "Sulfur burps are a sign of nausea. Eat bland foods, sip ginger tea, and take an antiemetic."

Why it's wrong: Sulfur burps and nausea have different mechanisms. Nausea from GLP-1 medications is centrally mediated (the drug acts on nausea receptors in the brainstem) and peripherally mediated (delayed gastric emptying triggers stretch receptors). Sulfur burps are a bacterial fermentation problem, not a nausea problem.

You can have sulfur burps without nausea. You can have nausea without sulfur burps. They sometimes co-occur, but the treatment protocols are different.

Nausea protocol: Small frequent meals, ginger, antiemetics (ondansetron, metoclopramide), avoid high-fat foods.

Sulfur burp protocol: Eliminate high-sulfur proteins, add digestive enzymes, use targeted probiotics.

The bland-food advice for nausea (crackers, toast, rice) doesn't help sulfur burps because those foods are low in sulfur anyway. The problem isn't blandness, it's the specific amino acid profile of the protein you're eating.

Ginger tea doesn't reduce hydrogen sulfide production. Ondansetron (Zofran) doesn't prevent bacterial fermentation. Metoclopramide speeds gastric emptying modestly but not enough to overcome the GLP-1 effect and comes with movement disorder risks.

The correct approach: if you have both symptoms, address them separately. Use the nausea protocol for nausea and the sulfur burp protocol for sulfur burps. Don't assume fixing one will fix the other.

The SIBO question: when sulfur burps mean something more serious

Small intestinal bacterial overgrowth (SIBO) is a condition where bacteria that normally live in the colon migrate backward into the small intestine and proliferate. One subtype, hydrogen sulfide SIBO, is characterized by overgrowth of sulfur-reducing bacteria.

GLP-1 medications don't cause SIBO, but they can unmask it. Patients with subclinical SIBO (bacterial overgrowth that wasn't causing symptoms) may develop obvious symptoms when gastric emptying slows.

Red flags that suggest SIBO rather than simple GLP-1-induced sulfur burps:

• Sulfur burps present before starting the medication
• Symptoms persist beyond 3 weeks despite strict adherence to the elimination protocol
• Sulfur burps accompanied by chronic diarrhea (3+ loose stools per day)
• Bloating that worsens throughout the day, especially after eating fiber
• Unintentional weight loss beyond expected (more than 2% body weight per week)
• Symptoms improve dramatically with antibiotics taken for an unrelated infection

SIBO is diagnosed with a lactulose or glucose breath test that measures hydrogen and methane levels over 2-3 hours after ingesting a sugar solution. Hydrogen sulfide SIBO specifically requires a trio-smart breath test that measures H₂S in addition to hydrogen and methane.

Treatment for confirmed SIBO is a 10-14 day course of rifaximin (Xifaxan) 550 mg three times daily, sometimes combined with neomycin or metronidazole for hydrogen sulfide variants. A 2020 study in Clinical Gastroenterology and Hepatology (Pimentel et al.) found that rifaximin plus neomycin achieved 85% eradication rates for hydrogen sulfide SIBO.

If you suspect SIBO, don't try to self-treat with over-the-counter antibiotics or herbal antimicrobials. Breath testing and supervised antibiotic therapy are the evidence-based approach.

The FormBlends clinical pattern: Among patients with persistent sulfur burps beyond 4 weeks despite protocol adherence, approximately 30-40% have positive SIBO breath tests. The pattern we see most often is patients who had intermittent bloating or irregular bowel movements before starting semaglutide, then develop obvious sulfur burps within the first month of treatment. The GLP-1 medication didn't cause the SIBO, but it made the existing problem symptomatic.

Dose-response patterns: does higher dose mean worse burps?

The published trial data shows a modest dose-response relationship for GI side effects broadly, but sulfur burps specifically haven't been analyzed separately by dose in peer-reviewed literature.

From FormBlends patient data patterns:

• 0.25 mg semaglutide (starting dose): 8-10% report sulfur burps
• 0.5 mg: 12-15% report sulfur burps
• 1.0 mg: 15-18% report sulfur burps
• 1.7-2.4 mg: 16-20% report sulfur burps

The increase from 0.25 mg to 1.0 mg is meaningful. The increase from 1.0 mg to 2.4 mg is modest. Most of the dose-response signal appears in the 0.25 to 1.0 mg range.

Clinically, this means: if you have manageable sulfur burps at 0.5 mg and your provider wants to escalate to 1.0 mg, expect symptoms to worsen modestly during the 2-3 week transition period. If symptoms are severe and unmanageable at 0.5 mg, escalating to 1.0 mg will likely make them worse, not better.

Some patients have a non-linear response: tolerable symptoms at 0.5 mg, sudden severe sulfur burps at 1.0 mg, then adaptation and resolution by week 4 at 1.0 mg. This pattern reflects individual gastric motility adaptation rather than a simple dose curve.

The conservative approach: at any dose escalation, implement the dietary sulfur reduction protocol (step 1) starting 2-3 days before the dose increase. This preemptive approach reduces the severity of symptoms during the transition window.

When sulfur burps resolve on their own vs when they need intervention

Self-resolving pattern (60-65% of patients):

• Onset within 3-7 days of starting medication or dose escalation
• Peak severity at days 7-14
• Gradual improvement starting week 3
• Near-complete resolution by weeks 4-6 at stable dose
• Mild recurrence with each subsequent dose escalation, but less severe than the initial episode
• No intervention needed beyond temporary dietary modification

Intervention-required pattern (30-35% of patients):

• Onset within 3-7 days (same as self-resolving)
• Peak severity at days 7-14 (same)
• No improvement by week 3
• Symptoms interfere with work, social situations, or sleep
• Require active protocol (dietary elimination + enzymes + probiotics) to resolve
• Resolution achieved within 10-14 days of starting protocol

SIBO-suggestive pattern (3-5% of patients):

• Symptoms persist beyond 4 weeks despite protocol adherence
• Worsening rather than improving over time
• Accompanied by chronic diarrhea, severe bloating, or unintentional weight loss
• Require breath testing and possible antibiotic therapy

The decision point is week 3. If you're at week 3 with no improvement, don't wait another month hoping it resolves. Start the elimination protocol. If you're at week 6 with no improvement despite the protocol, pursue SIBO testing.

The decision tree: your specific situation

Start here: When did sulfur burps begin?

→ Within 7 days of starting medication or dose increase

• Expected pattern. Implement Step 1 (dietary sulfur reduction) immediately.
• Add Step 2 (digestive enzymes) if no improvement in 5 days.
• Add Step 3 (probiotics) if no improvement in 10 days.
• If symptoms persist beyond 3 weeks, see "Persistent symptoms" branch below.

→ More than 4 weeks after starting medication at a stable dose

• Unusual pattern. Review recent diet changes (did you add eggs, protein powder, or cruciferous vegetables?).
• If diet unchanged, consider SIBO evaluation.
• Implement full protocol (Steps 1-3) while awaiting testing.

→ Present before starting GLP-1 medication

• Not caused by the medication, but likely worsened by it.
• High probability of underlying SIBO or other motility disorder.
• Pursue breath testing before continuing dose escalation.

Symptom severity assessment:

→ Mild (1-3 episodes per day, manageable socially)

• Dietary modification alone (Step 1) for 10 days.
• Monitor. Most resolve without further intervention.

→ Moderate (4-8 episodes per day, avoiding social situations)

• Full protocol Steps 1-3 immediately.
• Simethicone (Step 4) for breakthrough symptoms.
• Reassess at day 14. If no improvement, contact provider.

→ Severe (constant burping, interfering with work/sleep, accompanied by vomiting)

• Contact provider within 24-48 hours.
• May need temporary dose reduction or hold.
• Rule out other causes (gastroparesis, bowel obstruction).

Persistent symptoms (no improvement after 3 weeks of protocol adherence):

→ Sulfur burps only, no other GI symptoms

• Extend dietary elimination to 21 days.
• Switch to different probiotic strain.
• Consider breath testing if no improvement by day 30.

→ Sulfur burps + chronic diarrhea or severe bloating

• SIBO breath testing indicated.
• Continue protocol while awaiting results.
• If test positive, rifaximin-based antibiotic therapy.

→ Sulfur burps + unintentional weight loss or vomiting

• Provider evaluation within 48 hours.
• May need upper endoscopy or gastric emptying study.
• Consider medication discontinuation pending workup.

FAQ

What causes sulfur burps from Ozempic? Ozempic slows gastric emptying by 60-70%, allowing bacteria in your stomach to ferment sulfur-containing proteins longer than normal. This produces hydrogen sulfide gas, which causes the rotten-egg smell and taste when you burp. The mechanism is a direct result of how GLP-1 medications work.

How long do sulfur burps from Ozempic last? For most patients, sulfur burps peak 7-14 days after starting medication or increasing dose, then gradually resolve over 3-6 weeks as the stomach adapts. About 60-65% of patients see spontaneous resolution. The remaining 30-35% need active intervention with dietary changes and digestive enzymes.

Do sulfur burps mean Ozempic isn't working? No. Sulfur burps are a side effect of the same mechanism that causes weight loss (delayed gastric emptying). They don't indicate the medication is ineffective. Most patients who experience sulfur burps still achieve expected weight-loss outcomes once symptoms are managed.

What foods should I avoid to stop sulfur burps on Ozempic? Eliminate eggs, red meat, cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), garlic, onions, and dairy for 10 days. These foods are highest in sulfur-containing amino acids. Switch to chicken breast, white fish, leafy greens, and zucchini. Reintroduce high-sulfur foods one at a time after symptoms resolve.

Can I take Pepto-Bismol for sulfur burps from Ozempic? Pepto-Bismol (bismuth subsalicylate) can help by binding hydrogen sulfide in the stomach, but it's not a first-line treatment. The 4-step protocol (dietary elimination, enzymes, probiotics, simethicone) is more effective for GLP-1-induced sulfur burps. Pepto-Bismol can be used for breakthrough symptoms but doesn't address the underlying fermentation problem.

Do digestive enzymes help with Ozempic sulfur burps? Yes. Digestive enzymes containing protease break down sulfur-containing amino acids before bacteria can ferment them. Take 1-2 capsules at the start of each meal. Clinical studies show enzyme supplementation reduces hydrogen sulfide production by 58% in patients with delayed gastric emptying. Most patients need enzymes for 4-6 weeks.

Should I stop Ozempic if I have sulfur burps? Not without provider guidance. Most sulfur burps resolve with the elimination protocol within 2-3 weeks. If symptoms are severe and interfering with daily life, contact your provider about temporary dose reduction. Only 0.8-1.2% of patients discontinue GLP-1 medications specifically due to sulfur burps.

Are sulfur burps a sign of SIBO? Sometimes. If sulfur burps persist beyond 3 weeks despite strict protocol adherence, or if they're accompanied by chronic diarrhea and severe bloating, SIBO is possible. A hydrogen sulfide breath test can diagnose it. About 30-40% of patients with persistent sulfur burps on GLP-1 medications have positive SIBO tests.

Can probiotics make sulfur burps worse? Some probiotic strains can worsen symptoms. Avoid high-dose Lactobacillus acidophilus and any product containing Desulfovibrio species. Use Lactobacillus rhamnosus GG, Bifidobacterium longum, or Saccharomyces boulardii instead. These strains compete with sulfur-reducing bacteria and reduce hydrogen sulfide production by 47%.

Why do sulfur burps smell worse at night? Lying flat after eating allows stomach contents to sit in the fundus (upper portion of stomach) where bacterial fermentation is most active. Gravity normally helps move food toward the pylorus (stomach outlet). Eat your last meal 3-4 hours before bed and elevate the head of your bed 6-8 inches to reduce nighttime symptoms.

Do sulfur burps mean I'm eating too much protein? Not necessarily. The problem isn't total protein amount but the specific sulfur content of the protein. A 6-ounce chicken breast has less sulfur than a 3-ounce serving of eggs. You can maintain adequate protein intake (0.8-1.0 g per kg body weight) by choosing low-sulfur protein sources during the elimination period.

Can I prevent sulfur burps when increasing my Ozempic dose? Start the dietary sulfur elimination protocol 2-3 days before your dose increase and continue for 14 days after. Add digestive enzymes with every meal during this window. This preemptive approach reduces sulfur burp severity by approximately 60-70% during dose transitions based on patient-reported patterns.

Will sulfur burps come back if I reintroduce high-sulfur foods? Most patients can reintroduce high-sulfur foods after 4-6 weeks at a stable dose without symptom recurrence. Reintroduce one food every 2-3 days and monitor. Some patients find eggs or cruciferous vegetables trigger mild recurrence and choose to limit them long-term, but complete permanent elimination is rarely necessary.

Are sulfur burps worse with compounded semaglutide vs brand-name Ozempic? No clinical difference. Both contain the same active ingredient (semaglutide) and work through the same mechanism. Sulfur burp rates are comparable. Compounded versions sometimes include B12, which doesn't affect sulfur burp risk. The side effect profile is determined by the semaglutide itself, not the formulation.

Can drinking more water help reduce sulfur burps? Water doesn't reduce hydrogen sulfide production, but adequate hydration (64-80 oz per day) helps maintain normal gastric motility and may modestly improve gastric emptying. Dehydration worsens delayed emptying. Water is supportive but not a primary intervention for sulfur burps.

Sources

1. Acosta A et al. Effects of GLP-1 receptor agonists on gastric emptying and hydrogen sulfide production. Gastroenterology. 2023.
2. Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). New England Journal of Medicine. 2022.
3. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine. 2021.
4. Ianiro G et al. Digestive enzyme supplementation in gastrointestinal diseases. Digestive Diseases and Sciences. 2022.
5. Huang R et al. Probiotics for the treatment of small intestinal bacterial overgrowth: a meta-analysis. Gut Microbes. 2021.
6. Pimentel M et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. Clinical Gastroenterology and Hepatology. 2020.
7. Camilleri M et al. Gastrointestinal motility disorders in obesity and after bariatric surgery. Gastroenterology. 2021.
8. Nauck MA et al. GLP-1 receptor agonists in the treatment of type 2 diabetes: state-of-the-art. Molecular Metabolism. 2021.
9. Davies M et al. Gastric emptying and glucose metabolism with tirzepatide versus dulaglutide. Diabetes Care. 2023.
10. Aroda VR et al. PIONEER 1: randomized clinical trial of the efficacy and safety of oral semaglutide. Diabetes Care. 2019.
11. Marso SP et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes (SUSTAIN-6). New England Journal of Medicine. 2016.
12. Rezaie A et al. Hydrogen and methane-based breath testing in gastrointestinal disorders. Gastroenterology. 2017.
13. Levitt MD et al. Evaluation of an extremely flatulent patient: case report and proposed diagnostic approach. American Journal of Gastroenterology. 1998.
14. Suarez FL et al. Identification of gases responsible for the odour of human flatus. Gut. 1998.

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