Dr. Ahmed Are you experiencing sulfur burps with Ozempic or Mounjaro? Most people have some tummy-related side effects while using Ozempic.
Sulfur burps are not uncommon in patients who are using Ozempic, Mounjaro, Saxenda, or any of the GLP-1 analogs.
Mild symptoms of sulfur burps can be noticed when you start using Ozempic or Mounjaro or when you increase your dose. These symptoms are usually temporary and can be managed with a change in your diet.
However, some individuals have severe sulfur burps which can be very disturbing. Such individuals usually have to ask for help from their doctors or reduce their doses.
How do people describe Sulfur Burps?
Sulfur burps, as the name suggests, are excessive burping or belching that smells or tastes like sulfur. Sulfur is an acid produced by bacteria in the gut. It has a peculiar smell just like rotten eggs.
People describe sulfur burps as:
- Foul-smelling burps
- Rotten egg-like burps
- Metallic burps
- Sulfuric burps
- Disgusting and horrific
- Nauseating burps
- Retching burps
- Bad tasting burps
- Smelly burps
- Sour burps
- Eggy burps
In addition to Sulfur burps, patients may have associated nausea, vomiting, diarrhea, constipation, abdominal pain, anxiety, or bloating.
Why do people develop Sulfur Burps when using Ozempic or Mounjaro?
Sulfur burps with Ozempic, Mounjaro, Saxenda, or any other GLP-1 analog may develop because of the following reasons:
Ozempic reduces stomach movements:
One of the mechanisms by which Ozempic, Mounjaro, Saxenda, or Trulicity work by lowering glucose spikes is to slow stomach movements. This is better described as “delayed gastric emptying“.
Because the stomach remains full most of the time while a person is on Ozempic, it sends signals to the nausea center of the brain and the person feels nauseated.
In addition, when the stomach is distended, food, acid, and gases may go up the esophagus (the food pipe) and people develop sulfur burps, acid brash, nausea, and retching.
Eating foods rich in sulfur:
Sulfur-rich foods are liked by obese and diabetic people because most of them are low in calories, rich in nutrients including vitamins and minerals, high in proteins, and high in fiber.
Examples of sulfur-rich foods include:
Sulfur-rich foods | Examples of sulfur-rich foods |
| Low in Calories | Broccoli, Lentils, Almonds |
| Nutrient-dense | Kale, Brussels Sprouts, Cabbage, eggs, cheese |
| High protein | Lentils, chickpeas, Quinoa, fish, chicken breast, chia seeds, flax seeds, greek yogurt, Salmon, Tuna |
| Fiber-rich | Kale, Brussels Sprouts, Broccoli, Avocado, Coconut, Lentils, Chickpeas, Oats, Brown rice, Almonds, Chia seeds, Flax seeds |
Sulfur-rich foods are broken down in the intestine by bacteria producing hydrogen sulfide gas that smells like a rotten egg.
People on Ozempic or Mounjaro who are eating lots of the above sulfur-rich foods should switch to other low-calorie, high-fiber, and high-protein foods.
Bacterial overgrowth:
Bacterial overgrowth is common in diabetics, people who consume lots of simple sugars, and those who have constipation or an anatomical GI disorder.
People using Ozempic and Mounjaro are also at high risk of developing bacterial overgrowth because these drugs slow the gut and stomach movements. The more the food stays in your stomach, the greater the chances of bacterial growth.
Excessive acid production and GERD:
People who take medications like Ozempic, Mounjaro, and other GLP-1 analogs may experience stomach distension because these medications delay the emptying of the stomach.
When the stomach is filled with food or becomes distended, it triggers the production of more acid to aid in the digestion process.
Furthermore, stomach distension can cause the upper stomach sphincter to open, allowing acid and food to flow back up into the esophagus. This can lead to symptoms such as heartburn, nausea, burping, and retching.
Food intolerance:
Individuals taking Ozempic and Mounjaro often make changes to their food choices in order to achieve weight loss and better manage their blood glucose levels.
However, it is important to note that certain food items may not be well tolerated by these individuals, leading to feelings of discomfort instead of improvement.
Food intolerance can result in various symptoms, including nausea, vomiting, heartburn, retching, sulfur burps (which have a distinct smell similar to rotten eggs), constipation or diarrhea, and abdominal pain.
Food poisoning or gut infection:
There is no direct connection between the use of Ozempic and Mounjaro and the occurrence of food poisoning or gastroenteritis.
However, individuals who had been tolerating these medications without any issues but suddenly experience symptoms such as diarrhea, nausea, vomiting, and sulfur burps may potentially be experiencing food poisoning.
It is essential to consult your doctor if you are experiencing symptoms such as fever, abdominal pain, diarrhea, bloating, and excessive gas.
Individuals with IBS or other GI disorders:
People who suffer from conditions such as irritable bowel syndrome (IBS) or inflammatory bowel diseases (IBDs) like Ulcerative Colitis and Crohn’s disease often experience symptoms such as abdominal pain, bloating, gas, sulfur burps, diarrhea, or constipation.
Individuals with IBS have a heightened sensitivity to new foods or medications that directly impact the intestines. If you have been diagnosed with IBS or IBD, it is important to make careful choices when it comes to your diet.
It is advisable to introduce any changes gradually, trying one food or medication at a time, until you find the best fit that helps alleviate your stomach symptoms while also potentially assisting in lowering blood glucose levels and aiding weight loss.
It is also likely that Mounjaro and Ozempic may relieve your symptoms of IBS as reported by most individuals on different social media platforms.
How can we get rid of Ozempic or Mounjaro-associated Sulfur Burps?
Sulfur Burps and Bloating:
To get rid of sulfur burps and bloating caused by Ozempic or Mounjaro, you should try small meals, keep yourself hydrated, titrate the dose gradually and only if you can tolerate the high dose, and identify triggers such as foods, stress, and anxiety.
The table below can help you manage sulfur burps and bloating:
Managing Sulfur Burps and Bloating | |
| Foods that may help | Low FODMAP diet, lean proteins (chicken, fish), Oats, brown rice, probiotic-rich foods like yogurt, peppermint tea or oil, ginger or ginger tea |
| OTC Medicines | Simethicone, digestive enzymes, antacids, pepto-bismol, and fiber supplements |
| Prescription Medicines | Omeprazole or other PPIs, Maxolon, Rifaximin, Diphenhydramine, Zofran, and Itopride |
Sulfur Burps and Diarrhea:
If you have sulfur burps and diarrhea while using Ozmepic or Mounjaro, consider the following reasons and manage them accordingly:
GI infection:
- infections can cause both diarrhea and sulfur burps. You may need to take antibiotics like metronidazole or a gut antiseptic like Rifaximin. Always consult your doctor if your symptoms are severe, not improving, or you have associated fever or blood in your stools.
Food intolerance:
- If you have switched to a new food after watching TikTok weight loss influencers and have developed sulfur burps and diarrhea, you may need to change back to your normal diet.
IBS:
- Your IBS symptoms may worsen when you start using Ozempic or Mounjaro (although most people reported improvement in their symptoms of IBS, some developed worsening symptoms).
- You may be unlucky if Ozempic worsens your IBS symptoms. You should lower your dose or may space two doses by more than a week unless you tolerate it.
If you don’t want to discontinue or lower the dose of Ozempic, you can manage your symptoms with the help of the following table:
Managing Sulfur Burps and Diarrhea | |
| Foods that help Sulfur burps and diarrhea | Banana, rice, toast, applesauce, ginger, peppermint, chamomile tea |
| OTC medicines | Probiotics, pepto-bismol, antacids, ORS, Loperamide |
| Prescription medicines | Loperamide, Lomotil, Antibiotics |
Sulfur Burps and Constipation:
Constipation is one of the most common side effects of Ozempic and Mounjaro. It is also very common in the aged and diabetic patients.
Constipation can result in gas formation by the bacteria because the gut bacteria get more time to ferment the food.
In addition, people who have constipation usually have associated nausea, abdominal pain, and burping because the gases move up the gravity if there are fewer GI movements.
To get relief from constipation and sulfur burps, you can try these medical and non-medical interventions:
Managing Sulfur Burps and Constipation | |
| Foods that help Sulfur burps and Constipation | Increase dietary fiber (Vegetables and fruits), whole bread, brown rice, bran cereal, whole grains, prunes, flax seeds, chia seeds, ginger, peppermint, teas (senna tea, cascara tea, peppermint tea, dandelion tea, black coffee) |
| OTC medicines |
|
| Prescription medicines | Duphalac, Enulose, Generlac, Linzess, Amitiza, Trulance |
Sulfur Burps and Nausea or Vomiting:
Nausea and vomiting are commonly associated with sulfur burps. Most people develop retching and sulfur burps followed by nausea and vomiting.
Nausea is one of the most common side effects of Ozempic and Mounjaro. Because the stomach is full all the time and the functional valve at the lower gastroesophageal junction is not tight enough to stop the acid, food, and stomach content from going up, people on Ozempic often feel nauseous.
To get relief from Sulfur burps and nausea/ vomiting, you can try these home remedies and medical therapies:
Managing Sulfur Burps and Nausea/ Vomiting | |
| Foods that help Sulfur burps and Nausea/ Vomiting | General: Take small meals, Avoid fatty meals, Avoid carbonated drinks, and avoid taking lots of iron and calcium supplementsHome remedies: Lemon and ginger tea |
| OTC medicines to treat nausea and sulfur burps | Gelusil, Pepto-bismol, Alka-seltzer, Benadryl, Dimenhydrinate |
| Prescription medicines to treat nausea and sulfur burps |
|
Sulfur Burps and Heartburn:
People who develop sulfur burps almost always have heartburn as well. This is because the acid that enters the esophagus is mainly responsible for sulfur burps and heartburn.
People on Ozempic may complain of pain in the chest, heaviness, sharp pain going up the throat, or a burning sensation when taking food.
Managing Sulfur Burps and Heartburn | |
| Foods that help Sulfur burps and Heartburn | General: take small meals, Avoid fatty and spicy meals, carbonated drinks, and snacking, and take lots of iron and calcium supplementsHome remedies: Ginger, Oatmeal, Apples, bananas (non-citrus fruits) green vegetables, peppermint and chamomile tea, licorice root |
| OTC medicines to treat nausea and heartburn |
|
| Prescription medicines to treat nausea and heartburn |
|
Sulfur Burps and Abdominal Pain:
Sulfur burps and abdominal pain may occur when gases get trapped in the intestines, especially in patients with constipation.
Sulfur burps and abdominal pain are also common in patients with IBS-C, IBS-D, and IBS-M. Pain is usually described as crampy pain or pain that comes and goes in waves.
To get relief from sulfur burps and abdominal pain, you can try these non-medical and medical remedies:
Managing Sulfur Burps and Abdominal Pain | |
| Foods that help Sulfur burps and Abdominal Pain | Ginger, Peppermint, chamomile tea, fennel seeds |
| OTC medicines |
|
| Prescription medicines |
|
In Summary:
Mounjaro or Ozempic-associated sulfur burps are pungent or bad-smelling, rotten egg-like burps. These are very disturbing for the patient especially in crowded areas and in the social circle of the patient.
Sulfur burps are usually associated with nausea, vomiting, abdominal pain, constipation, diarrhea, or retching.
These symptoms can be managed by using the smallest effective dose, titrating the dose slowly, and eating healthy and small meals.
Sometimes, one may also need to take certain medications to relieve their symptoms including OTC and prescription medications.
