Gluten-Free Medications for Diarrhea, Constipation, and Heartburn

Tums, anti-diarrhea tablets, and colace soft gels

Verywell / Anastasia Tretiak

If you have celiac disease or non-celiac gluten sensitivity, you may be accustomed to gastrointestinal issues such as diarrhea, constipation, or heartburn. Gluten issues frequently go hand-in-hand with these problems.

So where can you turn for occasional symptom relief? As it turns out, there are multiple gluten-free anti-diarrhea medications, gluten-free laxatives, and gluten-free antacids available over-the-counter that may help.

But you can't just stop at the pharmacy and pick up any brand. Many of the best-known, name-brand medications for constipation, diarrhea, and heartburn are not gluten-free. Still, there are good gluten-free alternatives—mainly store brands, but a few name-brand medications, too.

This article lists both gluten-free and regular medications for diarrhea, constipation, and heartburn.

Gluten-Free Anti-Diarrhea Medications

Diarrhea may be the most common celiac disease symptom, and it's also a common gluten sensitivity symptom. Plenty of people get diarrhea if they accidentally ingest gluten (called "getting glutened") and you may want to try an anti-diarrhea medication to see if it helps your symptoms.

It's also possible that your diarrhea may be caused by something other than gluten—perhaps by the stomach flu or food poisoning. In these cases, an over-the-counter medication may help.

There are two main active ingredients in over-the-counter anti-diarrhea medications: loperamide hydrochloride and bismuth subsalicylate. The former (found in Imodium) works by slowing down movement in your intestines, which in turn allows your body to absorb liquids from your stool. Bismuth subsalicylate (found in Pepto-Bismol and some pills) works by coating your intestinal lining and calming inflammation. It also prevents too much liquid from entering the stool.

The main over-the-counter anti-diarrheal medicines you'll find in any pharmacy contain one of these two ingredients. Here's a rundown of popular brands, both gluten-free and regular.

Gluten-Free

Gluten-free anti-diarrhea medications include:

  • Target Up and Up 5 Symptom Digestive Relief liquid (30 mL), 8-ounce size: This contains the same active ingredient as Pepto-Bismol and Kaopectate. Look for the "gluten-free" designation near the "Drug Facts" panel on the box.
  • Target Up and Up (house brand) loperamide hydrochloride (2mg) caplets: Safe boxes will have a "gluten-free" designation near the "Drug Facts" panel.
  • Walgreens Brand Diarrhea Relief caplets (262mg): The active ingredient in these is bismuth subsalicylate. Look for the "gluten-free" designation on the box.
  • Walgreens Brand loperamide hydrochloride (1mg) liquid suspension in mint flavor: This is a generic version of Imodium. Look for boxes that say "gluten-free."

Not Gluten-Free

These brand-name, over-the-counter anti-diarrhea medications are not gluten-free:

Imodium

Made by Johnson & Johnson, the Imodium line of products includes Imodium A-D soft gels, Imodium A-D caplets, Imodium A-D liquid, Imodium for children, and Imodium Multi-Symptom Relief (which also treats gas, cramps, and bloating).

The products don't include gluten ingredients, but Johnson & Johnson says they're not guaranteed to be gluten-free. Therefore, choose Target Up and Up loperamide hydrochloride caplets or Walgreens Brand loperamide hydrochloride in gluten-free-labeled packages.

Pepto-Bismol

The familiar pink liquid, marketed by Procter & Gamble to treat diarrhea, heartburn, indigestion, nausea, gas, belching, and fullness, contains bismuth subsalicylate. Pepto-Bismol also offers chewable tablets, capsules, and children's formulations.

The products don't contain gluten but may be subject to gluten cross-contamination at the facility where they're made. Instead of brand-name Pepto-Bismol, consider products that contain bismuth subsalicylate, such as Walgreens Brand Diarrhea Relief caplets or Target Up and Up 5 Symptom Digestive Relief liquid.

Kaopectate

Like Pepto-Bismol, Kaopectate's active ingredient is bismuth subsalicylate. It comes in cherry, vanilla, peppermint, and max (also peppermint) liquid varieties, along with coated caplets.

According to manufacturer Chattem Inc., Kaopectate products have not been tested to determine their gluten content. Therefore, you should substitute one of the gluten-free-labeled products that contain bismuth subsalicylate.

The bottom line on gluten-free anti-diarrhea medications: The most familiar brand-name drugs—Imodium, Pepto-Bismol, and Kaopectate—are not considered gluten-free, but generic store-brand alternatives are and can be found at Target and Walgreens.

Gluten-Free Laxatives

To ward off constipation, try and increase the amount of fiber you consume. You can do this by making sure to get plenty of gluten-free fiber sources in your diet or to take a gluten-free fiber supplement. These can help bulk up your stool and make it easier to pass.

Some people also find that probiotics help keep them regular. (Be sure to choose only gluten-free probiotics). However, once you're actually constipated—whether it's constipation due to celiac disease or some other cause—you have several alternatives of over-the-counter remedies.

Stool softeners, considered the most gentle laxatives, work by helping your body mix fluids into your stool, softening it, and making it easier to pass. The drugs used as stool softeners include docusate.

Meanwhile, osmotic laxatives actually help to move more fluid into your intestines and your stool, which (as with stool softeners) makes the stool easier to pass. Polyethylene glycol and magnesium hydroxide solution are two examples of osmotic laxatives.

Finally, stimulant laxatives prompt your large intestine to contract and move stool. Because these laxatives are considered harsh and can be addictive, you shouldn't use them for more than a few days at any given time. Senna and bisacodyl are two examples of stimulant laxatives.

Gluten-Free

Certain laxatives are considered gluten-free, including:

  • Colace: This line of laxatives and stool softeners includes three options: Colace capsules, Colace Clear soft gels, and Peri Colace tablets. Colace and Colace Clear each contain 100 mg of the stool softener docusate sodium while Peri Colace tablets contain both docusate sodium and the stimulant senna.
  • Senokot: This brand makes senna-based laxatives. There are three types of Senokot available: Senocot (the active ingredient is sennosides, 8.6mg), Senocot-S (it contains both sennosides, 8 mg and docusate sodium, 50mg), and SenocotXTRA (it contains sennosides in double strength, or 17.2mg).
  • MiraLAX: MiraLAX is available only as a powder in a variety of different-sized bottles. The active ingredient is polyethylene glycol (17mg), an osmotic laxative. To use MiraLAX, mix it into water or another beverage. According to manufacturer Bayer, MiraLAX is considered gluten-free.

Not Gluten-Free

These brand-name laxatives are not considered gluten-free:

Dulcolax

This brand name, manufactured by Sanofi, offers seven different products, including pills and laxatives that treat constipation and gas. Those labeled as laxatives contain bisacodyl while those labeled as stool softeners contain docusate sodium.

Instead of Dulcolax, choose another medication that contains bisacodyl or docusate sodium.

Ex-Lax

This laxative, which contains sennosides as the active ingredient, comes in chocolate-flavored pieces and pills. None of the three Ex-Lax versions is considered gluten-free. Therefore, you should reach for a gluten-free senna-based laxative, such as Senokot.

Phillips Milk of Magnesia and other Phillips products

Phillips, a Bayer company, makes Milk of Magnesia (active ingredient: magnesium hydroxide) along with Phillips Laxative caplets (active ingredient: magnesium oxide) and Phillips Stool Softener liquid gels (active ingredient: docusate sodium).

Instead of Phillips products, try a gluten-free stool softener like Colace or a gluten-free osmotic laxative like MiraLAX.

The bottom line on gluten-free laxatives: Assuming you shop around carefully, you can find a gluten-free laxative that contains a stool softener, an osmotic drug, or a senna-based drug. However, once again you'll need to steer clear of some name-brand products.

Gluten-Free Antacids

Colace soft gels

Verywell / Anastasia Tretiak

It's not uncommon for people with celiac disease or non-celiac gluten sensitivity to have heartburn—that burning sensation in the upper chest. In fact, some research shows that people with celiac disease may be more likely to have acid reflux or gastroesophageal reflux disease (GERD) once they've gone gluten-free.

If you have heartburn or have been diagnosed with GERD, there's a multitude of over-the-counter medications you can take. These drugs are known as antacids. They work by reducing the amount of acid in your stomach, thereby calming the burning sensation.

A group of drugs called H2 blockers reduces the amount of acids your stomach actually makes. The active ingredients ranitidine and famotidine are examples of H2 blockers. Meanwhile, proton-pump inhibitors also reduce acid but through a different mechanism in the stomach. Examples of proton-pump inhibitors include the active ingredients omeprazole and lansoprazole. Finally, calcium carbonate-based and magnesium hydroxide-based antacids neutralize the acid that's already in your stomach, helping to decrease acid-related discomfort.

Generally speaking, when it comes to antacids, it can be difficult to find a brand name, over-the-counter treatment that's labeled gluten-free. However, there are plenty of store-brand alternatives.

Gluten-Free

Gluten-free antacids on the market include:

  • Equate (Walmart) brand antacid tablets: These contain calcium carbonate, which makes them similar to Tums. They come in a variety of different flavors and strengths. Make sure to choose one that has a "gluten-free" designation on the label.
  • Equate (Walmart) brand famotidine (20mg) tablets: This is a generic version of Pepcid AC. Look for the term "gluten-free" below the "Drug Facts" panel on the packaging.
  • Equate (Walmart) brand ranitidine (150mg) tablets: This is a generic version of Zantac. Look for "gluten-free" below the "Drug Facts" panel. Only some Equate packages are marked in this way, so stick with these.
  • Target Up and Up brand antacid tablets: These calcium carbonate-based antacids are similar to Tums and come in a variety of flavors and strengths. Again, look for the words "gluten-free."
  • Target Up and Up brand antacid soft chews: These cherry-flavored calcium carbonate antacids are certified gluten-free by the Gluten-Free Certification Organization (GFCO), which requires testing to below 10 parts per million of gluten. Look for the GFCO symbol on the back of the package.
  • Target Up and Up brand 24-hour lansoprazole (15mg) pills: This is a generic version of Prevacid. Check for the "gluten-free" designation near the "Drug Facts" panel.
  • Target Up and Up brand ranitidine (150mg) pills: This is a generic version of Zantac. Look for the "gluten-free" designation.
  • Tums: This is the only brand-name antacid that makes a gluten-free claim. Tums tablets, which come in a wide variety of flavors and strengths, contain the active ingredient calcium carbonate and are considered gluten-free, according to the manufacturer.
  • Walgreens Brand extra-strength antacid tablets in wildberry flavor: These tablets, with 750 mg of calcium carbonate, are a generic version of Tums. They carry the "gluten-free" label.
  • Walgreens Brand lansoprazole (15mg) pills: This is a generic version of Prevacid. Look for the appropriate designation near the "Drug Facts" panel.

Not Gluten-Free

These brand-name antacids are not considered gluten-free:

  • Alka-Seltzer: This "pop, pop, fizz, fizz" brand name offers several different heartburn and gas relief effervescent remedies. However, a spokesperson for manufacturer Bayer says the products are made in a facility shared with gluten-containing products and are not considered gluten-free.
  • Nexium: Known as the "purple pill," Nexium contains 22.3mg of esomeprazole, a proton-pump inhibitor. Manufacturer Pfizer, Inc. does not guarantee that the product is gluten-free.
  • Pepcid: Pepcid AC contains the H2 blocker famotidine while Pepcid Complete contains famotidine plus the acid reducers calcium carbonate and magnesium hydroxide. However, manufacturer McNeil Consumer Pharmaceuticals, Inc., does not guarantee that the products are gluten-free.
  • Prevacid: This product, made by Takeda Pharmaceuticals U.S.A., Inc., contains the proton-pump inhibitor lansoprazole. Takeda does not guarantee that the product is gluten-free.
  • Prilosec: Made by Procter & Gamble, Prilosec contains the proton-pump inhibitor omeprazole. Its manufacturer does not say whether the product is gluten-free.
  • Zantac: Zantac, manufactured by Boehringer Ingelheim, contains ranitidine, an H2 blocker. Like the other brand-name drugs in this category, Zantac is not guaranteed to be gluten-free.

There is a gluten-free, over-the-counter generic substitute for almost every name-brand antacid available. So, if necessary, you can try several to find the one that works best for you.

A Word From Verywell

Whether you need an antacid, anti-diarrheal medication, or a laxative, there are gluten-free alternatives available. Often, you will be better off with a generic version of a brand-name drug since they're more reliably labeled "gluten-free." Still, you may need to shop around; not every drug store or national big-box store will carry every medication in a gluten-free version. When purchasing over-the-counter drugs, make certain that you check packages for the "gluten-free" designation. If a product is truly gluten-free, it will say so.

Frequently Asked Questions

  • How do I know if my medication has gluten?

    According to the FDA, the majority of oral drugs contain no gluten or “virtually” no gluten. However, you need to check labels and inserts carefully to be sure. For non-prescription drugs, check the ingredients on the “Drug Facts” label in the “inactive ingredients” section. For prescription drugs, check ingredients listed in the “Description” section of the label. Among the ingredients to check for are wheat, starches, dextrates, dextrin, dextrimaltose, and caramel coloring. 

  • Do proton-pump inhibitors cause celiac disease?

    Proton-pump inhibitors (PPI) reduce stomach acid and help with gastroesophageal reflux disease, ulcers, and other digestive issues. Some researchers have observed a relationship between people who take PPIs and a risk of developing celiac disease. However, more research is needed to understand this connection.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Al-toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7(5):583-613. doi:10.1177/2050640619844125.

  2. American Academy of Family Physicians. Anti-diarrheal medicines: OTC relief for diarrhea.

  3. Zhao Y, Yu YB. Intestinal microbiota and chronic constipationSpringerplus. 2016;5(1):1130. doi:10.1186/s40064-016-2821-1.

  4. American Academy of Family Physicians. Laxatives: OTC products for constipation.

  5. Nachman F, Vázquez H, González A, et al. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. Clin Gastroenterol Hepatol. 2011;9(3):214-9. doi:10.1016/j.cgh.2010.06.017.

  6. American Academy of Family Physicians. Antacids and acid reducers: OTC relief for heartburn and acid reflux.

  7. Food and Drug Administration. Medications and Gluten.

  8. Lebwohl B, Spechler SJ, Wang TC, Green PHR, Ludvigsson JF. Use of proton pump inhibitors and subsequent risk of celiac disease. Digestive and Liver Disease. 2014;46(1):36-40. doi:10.1016%2Fj.dld.2013.08.128

By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.