Aside from the social embarrassment of belching and passing gas, excessive gas in your stomach can be rather painful.

If you experience this common digestive health concern, your first step in treating it is to find the cause.

Excessive Gas Types and Symptoms

Many terms are used to describe excessive gas: burping, belching, flatulence, bloating. “Most of them are synonyms and describe whether the gas exits from the top or bottom of the gastrointestinal tract,” says Stephen Bickston, MD, professor of internal medicine and director of the inflammatory bowel disease program at Virginia Commonwealth University Health Center in Richmond, Va.

For example, burping and belching usually refer to gas that escapes from the mouth while flatulence, or farting, is intestinal gas that escapes from the rectum. Bloating is used to describe the sensation of excess stomach gas that has not yet been released.

Some gas after eating — and releasing it through belching or flatulence — is normal. According to the National Digestive Diseases Information Clearinghouse, most people produce as many as one to four pints of gas a day, which they pass, on average, about 14 times a day.

However, if you’re experiencing painful gas and the embarrassment of chronic and foul smelling flatulence, you can start to play detective and try to eliminate the cause.

Excessive Gas: Foods to Avoid

Foods such as dairy products, beans, and certain vegetables cause some people to have excessive gas. Foods like these contain fiber, sugars, and starches that don’t get digested and absorbed, eventually causing intestinal gas when they are finally broken down in the large intestine.

One way to manage flatulence and belching is to eat fewer of the well-known gassy foods. Everyone reacts differently, but common gassy foods are fruits, such as apples and pears, certain vegetables including broccoli, Brussels sprouts, and onions, whole grains like bran, and dairy products, from milk to cheese to ice cream.

Foods containing sorbitol, a naturally occurring sugar found in fruits, are on some people’s gassy-foods list. Others are bothered by carbonated soft drinks and fruit drinks. If you discover that these foods are causing you excess gas, eliminate them from your diet or eat them in small portions. When it comes to foods to avoid, the key is to be like the Greeks, Dr. Bickston says. “Everything in moderation.”

Keep in mind that almost any food or combination of foods can cause gas in a particular individual. “Certain foods don’t get along together in certain people,” says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. “For example, some people find they are gassy if they eat fruits with proteins, or if they eat starches and proteins together. It’s personal and requires a little experimentation to find out what the culprits are.” Dr. Novey suggests keeping a food diary and noting when you feel gassy. “If you find you’re gassy after eating a certain food, eliminate it from your diet and see if it helps.”

Cooking may help with the breakdown of some of the offending ingredients, Bickston says. “But the style of cooking can also decrease healthy chemicals found in vegetables. Boiling seems to breakdown chlorophyll and other desirable ingredients.” Look for recipes that call for steaming as that seems to be a better cooking method for gassy foods.

Excessive Gas: Not Just (Hot) Air

Here are other steps you can take to help cut down on painful gas:

• Drink before meals. If you drink liquids with your meals, you lose stomach acids and then can’t break down the foods as well, Novey says. Try drinking about 30 minutes before a meal to help your stomach better digest food, he suggests.
• Eat and drink slowly. When you eat or drink fast, you can swallow a lot of air, which can cause gas, Bickston says. The simple solution? Slow down when you eat — you will swallow less air and be less gassy. If you have dentures, check with your dentist to be sure they fit properly so you’re not gasping air while eating.
• Take over-the-counter digestive aids. Digestive enzymes are available as over-the-counter supplements. “I recommend going to the health-food store and getting a digestive enzyme,” Novey says. “You can take one or two. You will know very rapidly — within a few weeks — if it makes a difference.” Some people also find that activated charcoal helps to reduce and treat excess gas, which is unlikely to cause any harm. However, antacids won’t do much for excessive gas, says Bickston.
• Be a Beano counter. Another over-the-counter digestive aid, Beano, contains an enzyme that can allow the body to digest the sugar in beans and many vegetables. The sugar-digesting enzyme is sold in liquid and tablet form. Add five drops of the liquid form or swallow one Beano tablet per half-cup serving of food before eating. Heating degrades the enzyme in Beano, so adding it to foods while cooking reduces its effectiveness. Beano will not help if excessive gas is caused by fiber or lactose.
• Don’t fill up on air. Habits like smoking, chewing gum, and drinking through a straw may cause your stomach to fill with air, leading to gas.
• Avoid artificial sweeteners. Sorbitol and related sugar alcohols used in many sugar-free versions of foods can also aggravate gas as they are digested by gut bacteria which ferment and release gas and have a laxative effect. “Sorbitol is the first ingredient in every brand of sugar-free gum I’ve found at local grocery stores,” Bickston says. “One to two sticks is akin to eating a prune.” However, the sugar substitutes that are found at a typical coffee stand or in popular soft drinks are not the kind that cause gas. The various packet sweeteners — yellow (sucralose), pink (saccharine), and blue (aspartame) — are not associated with gas or laxative effects.

Related Conditions That Could Be to Blame

If the problem of excessive body gas is persistent or severe, consult your doctor — it could be a sign of a more serious digestive condition. Don’t simply ignore the problem or blame it on indigestion, referred to as dyspepsia by doctors.

Some of the conditions that should be considered if dietary changes don’t help and excessive gas persists:

• Lactose intolerance. People who are lactose intolerant are unable to digest lactose, the sugar that is found in milk and milk products. “I test with a milk challenge,” Bickston says. “The patient drinks a pint or two of milk — it can be any percent fat. What follows tells the patients whether they should limit their milk intake.”
• Irritable bowel syndrome (IBS). “Patients who meet the diagnostic checklist for irritable bowel syndrome suffer more pain at the lower levels of abdominal cavity,” Bickston says.
• Colon cancer. “Excess gas is rarely the presenting symptom for patients with colon cancer,” Bickston says. “But it does trigger my reflex to remind patients to get screened for colorectal cancer.
• Upper gastrointestinal disorders. Occasional belching is normal, but frequent belching may be a sign of an upper gastrointestinal disorder. These include peptic ulcers, gastroesophageal reflux disease (GERD), or gastroparesis, also called delayed gastric emptying.

Also, warns Bickston, if you have had abdominal surgery, a hernia, or significant weight loss or weight gain, never dismiss your gas-like symptoms as normal. Get them checked out.

As annoying as it might be, some gas is a natural by-product of the body’s digestive system. But if your gas is excessive, painful, or chronic, talk to your doctor about possible causes and remedies.