Dear Dr. Garner,

I have a very tricky subject which I am embarrassed about discussing even with my own doctor. I seem to build up large quantities of gas in my stomach and bowels which often causes me great discomfort and shame.

This has really put a damper on my life, and I often avoid going to church and other public areas because of fear of embarrassment.

Is there anything that can stop this horrible affliction?

Excess Gas in Greenpoint

Dear Excess Gas,

First, let me assure you that a buildup of gas in the stomach and intestines is a natural part of life. Secondly, if the gas becomes excessive and embarrassing to you, then there are medications and lifestyle changes which can help lessen the symptoms.

The average person produces about two liters of gas a day, enough to fill a balloon — probably better to use your mouth for this. This results in air being passed out of the mouth or rectum about 15 times per day on average.

Certain people are more prone to gas buildup than others. Factors include breathing through the mouth, poor eating habits (i.e., not chewing properly or talking while eating), drinking carbonated soft drinks, digestive disorders and food intolerance.

There are foods known to be the main culprits in gas buildup. These include high-fiber foods like bread, bran, potatoes, fruit and vegetables. Garlic, onions, cabbage, beer, beans, red wine and milk may have the same effect. Even over-the-counter vitamins can aggravate the problem.

While excess gas is often more annoying than harmful, it is important to report this symptom to your doctor, as there are certain serious medical conditions that can cause this problem.

Your doctor will take a medical history to determine if the bloating is related to conditions, such as tumors, or enlargement of the abdominal organs. In addition, your doctor can test for maldigestion and malabsorption of food. There are breath tests that can be performed to help your doctor determine if there is a serious problem with digestion.

Treatment is aided by the afflicted person, who becomes a detective in determining which food or medicine is causing the problem.

Sometimes, a malabsorption problem is discovered in which the body’s intestines lack the ability to properly digest foods. Examples of this are lactose intolerance and celiac disease. Treatment is based on removing the offending agent from the diet, or by giving supplements by mouth to improve absorption.

Here are some treatment strategies you can try:

• Chew food carefully. Digestion begins in the mouth. Any work your teeth don’t do, your stomach will have to do later.

• Keep a list of your food intake and note when you have gas.

• A physician specializing in alternative medicine or nutrition can help modify your diet.

• Avoid meals with excess fat and protein. Eat smaller, more frequent meals instead of three large meals a day.

• Avoid foods that create gas, such as beans, Brussels sprouts, cauliflower, broccoli, peaches, pears, prunes, corn, oats and soft cheese.

• Limit the use of sugar substitutes.

• Take supplements to aid in lactose digestion if intolerant.

• Activated charcoal tablets help remove odor from the gas. Activated charcoal underwear can control odor.

• Avoid activities that cause you to swallow air, such as rapid drinking, chewing gum, using tobacco products, sucking on hard candy, drinking carbonated beverages, having loose dentures and hyperventilating in anxious people.

• Antacids contain simethicone, which makes gas more easily dissolve away.

I hope this response helps to show you that you are not alone in this often embarrassing situation and that there is help available to control it.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.