Brief Answer: There are various options ma'am; listed for you Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I can understand how this condition can be embarrassing and at times even frustrating. But, there are many treatment options available ma'am. First of all, a diagnosis is what is most important. With all the investigations conducted, was a diagnosis not established so far? If a diagnosis was established, could you share it with me? If not, do not worry. Let us concentrate on all the possible stems you can take to help reduce the flatulence: -Drink plenty of fluid as this neutralized acid produced in the stomach -Avoid food that increase flatulence (eg. fatty/oily/fried food; chewing gum; lettuce; lentils; cauliflower; carbonated drinks; baked beans, candy; sprouts; acidic fruits like lemons, apples, oranges, pears, peaches; broccoli, etc. -Avoid alcohol -Avoid smoking -Consuming small meals and eating slowly -Eat small meals so you can eat more frequently, preventing the stomach from being empty, which would in turn increase the acid production and result in abdominal bloating as well -Medications: You already seem to be on a proton-pump inhibitor and an anti-foaming agent. I would suggest the addition of a histamine H2 antagonist and a syrup containing the component sucralfate, which has also shown to have great results in preventing flatulence -Avoid strenuous exercise -Avoid stress: This is very important, as it is found to be one of the most common causes of flatulence in the current population -Avoid dieting and other crash courses to lose weight -Avoid milk and dairy products or wheat if you experience flatulence immediately after consuming any of these products, as this could indicate lactose or gluten-intolerance -Conditions like peptic ulcer disease, types of gastritis, irritable bowel syndrome, celiac diseases, lactose or gluten intolerance, etc; should be ruled out As for surgeries, there are various type of surgical options available which cut of supply to those parts of the stomach that produce acid, this has an end result of reduced acid production in the stomach. This has been especially effective in patients who have severe acid reflux or peptic ulcer related conditions. Do write back to me if you wish to learn more about this type of surgery, I would gladly help you. I hope you find my response helpful and informative ma'am. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

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