If there is one subject few people discuss, passing gas just might be it. Don’t let your embarrassment keep you from staying healthy.

Intestinal gas is completely normal, and it goes unnoticed until it is passed through your mouth as a burp or your rectum as flatulence. The problem is when passing gas becomes excessive or overly foul-smelling. How can you tell if gas is just an inconvenience or a sign that something more serious is happening?

Does your gas occur after eating?

Many common and healthy foods produce gas. These include beans, sodas and other carbonated drinks, sugar substitutes such as sorbitol and other artificial sweeteners, milk and dairy products, cabbage, bran and pasta. Having gas after eating these foods is perfectly normal. But, if you have places to go after eating that might not be conducive to passing gas, skip these menu items.

On the other hand, if your gas is particularly bad after eating foods such as these, you may suffer from irritable bowel syndrome (IBS).

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“Chronic daily bloating, especially if also accompanied by diarrhea or constipation, can be a sign of IBS or celiac disease,” according to Caroline Hwang, MD, assistant professor of clinical medicine in the division of gastroenterology at the Keck School of Medicine of USC. “IBS is a common disorder affecting up to one in four Americans, caused by altered gut motility, gut nerve transmission or microbiota imbalance.”

Do you bloat and pass gas after eating foods with wheat, barley or rye?

It could signal a more serious condition called celiac disease, an immune reaction that, over time, damages the lining of your small intestine and keeps nutrients from being absorbed into the body.

“Celiac disease is a condition in which the immune system mistakes gluten (found in wheat and barley) as a foreign protein that needs to be attacked,” said Dr. Hwang, who also is a gastroenterologist at Keck Medicine of USC. “Celiac disease is different from gluten intolerance or sensitivity in which there is no immune reaction or intestinal damage, but individuals still may have symptoms of bloating, diarrhea or fatigue.”

According to the Celiac Disease Foundation, 2.5 million Americans go undiagnosed and may be at risk for long-term health complications, such as the development of other autoimmune disorders, including type I diabetes; multiple sclerosis (MS); dermatitis herpetiformis (itchy skin rash); anemia; osteoporosis; infertility and miscarriage; neurological conditions, such as epilepsy and migraines; short stature and intestinal cancers.

Is your gas worse after eating foods with dairy products?

People who suffer from lactose intolerance will experience diarrhea, gas, abdominal cramping, bloating and nausea from 30 minutes to two hours after eating food containing lactose. The cure is to eliminate dairy from your diet and find alternative foods to eat, but the challenge is maintaining healthy doses of calcium in your diet. Supplements may be recommended by your doctor, as well as a diet rich in natural calcium, such as spinach, broccoli, oranges and salmon.

Have you had stomach surgery?

If you have had bariatric surgery, it could be that your gas is a symptom of a malfunction in the way your stomach is emptying waste into the small intestine. This condition is called Dumping Syndrome. It occurs when waste is rapidly flushed from the stomach into the duodenum – either too early or too late – after eating. Nausea, excessive gas, severe cramping, sweating, dizziness, diarrhea, bloating and an irregular heartbeat are all symptoms of Dumping Syndrome.

For any of these concerns, it is important that you visit your doctor to discuss your symptoms and possible treatments. Waiting might only make your condition worse.

By Heidi Tyline King

Concerned about bowel health? Schedule an appointment with a gastroenterologist at Keck Medicine of USC. If you are in the Los Angeles area, make an appointment by calling (800) USC-CARE (800-872-2273) or by visiting https://digestive.keckmedicine.org/request-an-appointment/