Q: I've been having a problem with terrible, painful gas on a daily basis. Do I need to cut out certain foods, or is there a natural treatment I can try?

Dr. Wright: It's true that you could have gas because of what you ate last night, but the location and quantity of the gas can be clues to more serious problems.

For example, if most of the gas is located in your upper abdomen in the "V" between your lower ribs, it's in your stomach. Empty stomachs aren't supposed to have gas in them: Gas in the gastrointestinal tract is almost always the result of microbial fermentation, which means there are germs lingering there.

Since normal stomach acid kills all micro-organisms (except for Helicobacter pylori, the ulcer-causing bacteria), stomachs should be sterile. As one of my med school professors said, a sterile empty stomach is a "collapsed bag" containing no food -- and no gas, either.

So, if you have gas in your stomach when you haven't eaten, you very likely don't have enough acid even to kill germs, much less to digest all your food properly.

Excessive gas elsewhere in the abdomen could have several causes. It could be that your digestive enzymes are low, and you aren't properly digesting and absorbing a variety of nutrients. If that's the case, you should take digestive enzymes after meals.

Another possibility is that you have a food allergy. You could also have lactose intolerance or gluten-gliadin sensitivity, which is similar to allergies, but not exactly the same. Or maybe it's Candida overgrowth or other "unfriendly" microorganisms.

Nearly all of these conditions will interfere with normal digestion and assimilation to one degree or another, so it's important to find out which condition (or combination of conditions) may be causing all of this gas.

The best course of action is to make an appointment with a physician skilled in nutritional and natural medicine who can test you for allergies and sensitivities and measure your stomach acid and overall digestive function. To locate one in your area contact the American Academy of Naturopathic Physicians at (866) 538-2267, www.naturopathic.org or the American College for Advancement in Medicine at (800)532-3688, www.acam.org

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