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The urge to pass intestinal gas can strike at the worst possible moment — during an important meeting, on a crowded elevator or on a first date. And although passing intestinal gas (flatus) usually isn't serious, it can be seriously embarrassing.

Everyone passes gas, generally at least 12 or more times a day. But some people have excessive gas that bothers them most of the time. In some cases, gas you can't expel can cause intense, intermittent abdominal pain.

The good news is that although you can't stop gas from forming, a few simple measures can go a long way toward reducing the amount of gas you produce and relieving your discomfort and embarrassment.

For most people, the signs and symptoms of excess gas and gas pain are all too obvious. They include:

• The voluntary or involuntary passing of gas, either as belching or as flatus.
• Sharp, jabbing pains or cramps in your abdomen. These pains may occur anywhere in your abdomen and can change locations quickly. You may also have a "knotted" feeling in your stomach. The pain may sometimes be so intense that it feels like something is seriously wrong. When the pain occurs on the upper left side, gas pain may be mistaken for heart disease. When the pain occurs on the right side, it may be mistaken for gallstones or appendicitis.
• Abdominal bloating (distension).

You swallow air every time you eat or drink. You may even unknowingly swallow air when you're nervous, eat too fast, chew gum or drink through a straw. Some of that air finds its way into your lower digestive tract. But most lower intestinal gas is produced when bacteria in your colon ferment carbohydrates that aren't digested in your small intestine.

Unfortunately, healthy foods — such as fruits, vegetables, whole grains and legumes (beans and peas) — are often the worst offenders. That's because these foods are high in fiber. Fiber has many health benefits, including keeping your digestive tract in good working order and regulating blood sugar and cholesterol levels. But fiber can also lead to the formation of gas. Fiber supplements containing psyllium, such as Metamucil, may cause such problems, especially if added to your diet too quickly. Carbonated beverages, such as soda and beer, also are important causes of gas.

Other causes of excess gas include:

• Another health condition. Excess gas may be one of several signs and symptoms of a more serious chronic condition. Examples include diverticulitis or an inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.
• Antibiotics. In some cases of excess gas, antibiotic use may be a factor because antibiotics disrupt the normal bacterial flora in your bowel.
• Laxatives. Excessive use of laxatives or constipating drugs also may contribute to the problems with excess gas.
• Constipation. Constipation may make it difficult to pass gas, leading to bloating and discomfort.
• Food intolerances. If your gas and bloating occur mainly after eating dairy products, it may be because your body isn't able to break down the sugar (lactose) in dairy foods. Many people aren't able to process lactose efficiently after age 6, and even infants are sometimes lactose intolerant. Other food intolerances, especially to gluten — a protein found in wheat and some other grains — also can result in excess gas, diarrhea and even weight loss.
• Artificial additives. It's also possible that your system can't tolerate the artificial sweeteners sorbitol and mannitol found in some sugar-free foods, gums and candies. Many healthy people develop gas and diarrhea when they consume these sweeteners.

Anything that causes intestinal gas or is associated with constipation or diarrhea can lead to gas pains. These pains generally occur when gas builds up in your intestines and you're not able to expel it. Gas pains are usually intense but brief. Once the gas is gone, your pain often disappears too. The gas you pass is a combination of oxygen, nitrogen, hydrogen, carbon dioxide and methane.

You're more likely to have problems with gas if you are lactose or gluten intolerant, eat a diet rich in fruits, vegetables, whole grains and legumes, or have a chronic intestinal condition, such as irritable bowel syndrome, diverticulitis or inflammatory bowel disease.

It's considered normal to pass gas anywhere from 10 to 20 times a day. But call your doctor if you have severe, prolonged or recurrent pain in your abdomen, especially if you also have nausea, vomiting, bleeding, weight loss or fever. In addition, talk to your doctor if your gas or gas pains are so persistent or severe that they interfere with your ability to live a normal life. In most cases, treatment can help reduce or alleviate the problem.

Your doctor will likely diagnose your problem based on your medical history and a physical exam. During the exam, your doctor may check to see if your abdomen is distended and listen for a hollow sound when your abdomen is tapped. A hollow sound usually indicates the presence of excess gas. Depending on your other symptoms, your doctor may recommend further tests in order to rule out conditions that are more serious, such as partial bowel obstruction.

If your gas pains are caused by another health problem, treating the underlying condition may offer relief. Otherwise, bothersome gas is generally treated with dietary measures, lifestyle modifications or over-the-counter medications. Although the solution isn't the same for everyone, with a little trial and error, most people are able to find some relief.

Diet
The following dietary changes may help reduce the amount of gas your body produces or help gas move more quickly through your system:

• Try to identify and avoid the foods that affect you the most. Some of the worst offenders for many people include beans, onions, broccoli, brussels sprouts, cauliflower, artichokes, asparagus, pears, apples, peaches, prunes, sugar-free candies and chewing gum, whole-wheat bread, bran cereals or muffins, beer, sodas and other carbonated beverages, milk, cream, ice cream and ice milk.
• Try cutting back on fried and fatty foods. Often, bloating results from eating fatty foods. Fat delays stomach emptying and can increase the sensation of fullness.
• Temporarily cut back on high-fiber foods. Add them back gradually over weeks. If you take a fiber supplement, try cutting back on the amount you take and build up your intake gradually. If your symptoms persist, you might try a different fiber supplement. Be sure to take fiber supplements with at least 8 ounces of water and drink plenty of extra liquids throughout each day.
• Reduce your use of dairy products. Try using low-lactose dairy foods, such as yogurt, instead of milk. Or try using products that help digest lactose, such as Lactaid or Dairy Ease. Consuming small amounts of milk products at one time or consuming them with other foods also may make them easier to digest. In some cases, however, you may need to eliminate dairy foods completely.
• Try a cup of peppermint tea. Peppermint oil contains menthol, which appears to have an antispasmodic effect on the smooth muscles of your digestive tract. You may find that a warm cup of peppermint tea can provide relief from gas and gas pain. On the other hand, peppermint may contribute to heartburn and acid reflux.

Lifestyle
The following modifications to your lifestyle also may help:

• Try smaller meals. Eat several small meals throughout the day instead of two or three larger ones.
• Eat slowly, chew your food thoroughly and don't gulp. If you have a hard time slowing down, put down your fork between each bite.
• Avoid chewing gum, hard candies and drinking through a straw. These activities can cause you to swallow more air.
• Don't eat when you're anxious, upset or on the run. Try to make meals relaxed occasions and eat slowly. Eating when you're stressed can interfere with digestion.
• Check your dentures. Poorly fitting dentures can cause you to swallow excess air when you eat and drink.
• Don't smoke. Cigarette smoking can increase the amount of air you swallow.

Over-the-counter remedies
Some products may help, but they aren't always effective. Consider trying:

• Beano. Add Beano to beans and vegetables to help reduce the amount of gas they produce. For Beano to be effective, you need to take it with your first bite of food. It works best when there's only a little gas in your intestines.
• Lactase supplements. Supplements of the enzyme lactase (Lactaid), which helps you digest lactose, may help if you are lactose intolerant. You might also try dairy products that are lactose-free or have reduced lactose. They're available at most grocery stores.
• Simethicone. See if you benefit from using one of the many over-the-counter products that contain simethicone (Gas-X, Gelusil, Mylanta, Mylicon). Simethicone helps break up the bubbles in gas and may help with excessive belching.
• Activated charcoal. Charcoal tablets (CharcoCaps, Charcoal Plus, others) also may help. You take them before and after a meal. They're available in natural food stores and many drugstores.