Worried about intestinal gas? It’s a normal part of digestion, but sometimes digestive problems like gas can signal more worrisome conditions.

Like it or not, everyone passes gas. “On average, an adult produces two pints of gas every day,” says Sari Acra, MD, MPH, a professor and director of the division of paediatric gastroenterology, haepatology, and nutrition at Vanderbilt University in Nashville, Tennessee.

According to the National Institutes of Health, farting 13 to 21 times per day is normal.

Typically, gas in the digestive tract occurs as a result of swallowing air (aerophagia) and when bacteria in your large intestine breaks down certain foods.

A person can swallow large amounts of air by chewing gum, smoking, drinking carbonated beverages, eating or drinking too quickly, wearing loose-fitting dentures, or sucking on hard sweets.

If the air isn’t burped back up, it will move down into your gastrointestinal tract and get released through the anus.

Food can also cause gas, although the type of food can vary from person-to-person. Known gas culprits include:

  • Certain vegetables such as asparagus, brussels sprouts, cabbage, and broccoli
  • Beans and lentils
  • Milk products like cheese, ice cream, and yogurt
  • Drinks like apple juice, pear juice, and carbonated beverages containing high-fructose corn syrup

Regular gas is a sign that you’re consuming adequate amounts of fibre and that you have healthy gut microbes.

But gas accompanied by other red flags such as weight loss, anorexia, excessive diarrhoea, vomiting, fever, prolonged bloating, and severe stomach pain can be a sign of a digestive disorder or other gastrointestinal condition such as:

  • Irritable bowel syndrome (IBS)
  • Lactose intolerance
  • Pancreatitis
  • Ulcers
  • Coeliac disease
  • Gallstones
  • Diverticulitis

Trouble Passing Gas

The flipside of excessive gas is the inability to pass gas, which can also be a symptom of an underlying problem, like an abdominal obstruction. An intestinal blockage is a serious condition and occurs as a result of a partial or total blockage of the small or large intestine.

According to the Mount Sinai Medical Center, a tumour, scar tissue (adhesions), or narrowing of the intestines are all likely causes of abdominal obstruction.

If you’re experiencing gas pain and you either can’t pass gas or have excessive flatulence, speak to your healthcare provider. They may be able to offer at-home solutions to your digestive woes. Or your doctor may schedule tests to determine if your gas pain is caused by another, more serious problem.

If your gas comes with severe stomach pain, persistent bouts of diarrhoea or constipation and bloating that occurs at least three days a month, you might have irritable bowel syndrome (IBS). If you have IBS, then the nerves in your gastrointestinal tract will be more sensitive to the gas produced there. Dr. Acra says that the increased awareness of gas could make people feel like they’re passing gas more than usual.

IBS is a chronic, uncomfortable condition, but it won’t cause any damage to your GI tract. Symptoms can be managed with medication or diet.

Gas Pain Could Be Caused by Lactose Intolerance or a Food Allergy

If you notice that your gas seems worse after eating certain foods, such as dairy products (which contain lactose), the problem may be a particular food or a lactose intolerance. The body’s inability to tolerate a food or substance can trigger stomach or gas pain as your body struggles to digest it. When bacteria in your colon can’t properly digest these foods, they break down and are fermented into gas.

“Some people can’t digest the sugar contained in milk [lactose] because their intestines lack the enzyme necessary to break it down. Or they can’t absorb fructose, the sugar that is found in many foods, including corn syrup,” says Acra.

Gas Is a Very Common Symptom of Pancreatitis

Gas is normal. But flatulence that’s accompanied by swelling in the abdomen, fever, nausea, and vomiting is not. These symptoms can be warning signs of pancreatitis – inflammation of the pancreas, which assists in the digestive process. Gas is a very common symptom of pancreatitis. A Chinese case study published in April 2019 in the journal Medicine noted that intestinal gas frequently caused pain and bloating in patients with pancreatitis.

Peptic Ulcers Can Cause Gas and Stomach Pain

Peptic ulcers, which can be caused by bacteria, cause a dull or burning pain in the stomach. The pain comes and goes, lasting for minutes or hours and usually can be felt more on an empty stomach. Other symptoms may include vomiting, bloating, gas pain, and weight loss.

Ulcers can form in any part of your digestive tract, but most often occur in the lining of your stomach, the oesophagus, or the beginning of your small intestine (the duodenum). Though ulcers can be easily treated, they can cause serious and even life-threatening complications if unattended.

Excess Gas Could Be a Sign of Celiac Disease

Severe diarrhoea, abnormal stools (stools that are bulky, pale, or have a foul odour), and weight loss are potential warning signs of coeliac diseasea type of immune reaction to gluten, the protein in wheat.

“This immune reaction leads to changes in the intestinal lining that interferes with the absorption of foods, including carbohydrates, which then go undigested into the colon where bacteria ferment them to produce excess gas,” explains Acra.

Coeliac disease can cause damage to your intestines if left untreated. Once diagnosed, it’s necessary to eliminate gluten from your diet.

An Inability to Pass Gas Is a Sign of Appendicitis

Abdominal pain is the most common symptom of appendicitis, a serious infection caused by inflammation of your appendix. Other warning signs include being unable to pass gas, constipation, vomiting, and fever. Appendicitis usually occurs when a person is in their teens or early twenties. If left untreated, it can cause serious complications.

If you have appendicitis, surgery is usually required to remove your appendix before it bursts.

Gallbladder Problems Like Gallstones Can Cause Gas Pain

Excessive gas may be a warning sign of gallbladder problems if it’s accompanied by symptoms such as nausea, chronic diarrhoea, and stomach pain. When the gallbladder is functioning improperly, problems like gallstones or inflammation of the organ, known as cholecystitis, may occur.

In some cases, gallstones may not cause any symptoms at all, but gallbladder problems can be serious, so it’s important to seek immediate medical attention for these symptoms.

Gas and Abdominal Pain Could Be Diverticulitis

Gas that strikes along with severe, sudden pain in the lower left area of your abdomen may be a warning sign of diverticulitis, inflammation of small sacks in your large intestine called diverticula.

Diverticulosis, which is the formation of the diverticula, often causes no symptoms, but it may trigger excessive bloating, abdominal pain, cramping, and constipation. When those diverticula are inflamed, diverticulitis kicks in. Without treatment, diverticulitis can trigger potentially serious complications.

Additional reporting by Jordan Davidson.