Burping, farting, bloating -- embarrassing, yes, but on the whole, it's no big deal. Whether suffering from late-night heartburn after one too many slices of pizza or sitting through a meeting with unbearably loud stomach rumblings, tummy trouble happens to us all.

A typical case of stomach upset isn't anything to worry about -- but if symptoms become more frequent and are disruptive to your daily life you may want to seek help. Serious stomach problems can cause both physical and emotional pain, and getting treatment is key to easing discomfort.

To help figure out if what's going on inside you, we turned to Dr. Desmond Leddin, head of Dalhousie University's gastroenterology division. Here are five of the most common causes of stomach pain and how to get relief.

1. Irritable Bowel Syndrome (IBS)
If you suffer from IBS, you're not alone. More than 6 million Canadians have it, and women make up more than 70 per cent of sufferers. People with IBS experience chronic symptoms including constipation, bloating, gas and diarrhea, and these symptoms are not being caused by a known gastrointestinal condition or disease. The key here is chronic, meaning your symptoms keep coming back. There are different levels of severity of IBS, but if your pain and discomfort are persistent, see your family doctor.

"There's no specific test for IBS, no X-ray you can take," says Leddin. Instead, your doctor should make a diagnosis by ruling out other conditions. "Other conditions, such as lactose intolerance and Crohn's disease can closely mimic IBS, and a doctor should first exclude these possibilities." Depending on the severity of your IBS, your doctor may refer you to a gastroenterologist. Dietary changes, medication, stress reduction, and alternative therapy can ease IBS symptoms.

2. Acid reflux disease/heartburn
It's the sour bile taste and the burning sensation in your throat and chest -- the feeling you get after eating too much spicy pepperoni. Acid reflux happens when stomach acid backflows into your swallowing tube (also known as your esophagus). "It's actually very common," says Leddin. "A lot of people have minor cases of reflux. Having occasional symptoms -- once a week, a few times a month -- isn't serious." It's when your heartburn becomes more frequent than once a week, or if food gets stuck in your swallowing tube, that acid reflux becomes serious.

"Avoiding alcohol and fatty foods can ease symptoms," says Leddin. If dietary changes don't work, there are medications your doctor can prescribe to minimize your stomach's acid production.

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3. Ulcers/Helicobacter pylori
Ulcers are small holes in the gastrointestinal tract (either in the stomach or small intestine). The major symptom of ulcers is a recurring, long-lasting (30 minutes or more) burning feeling in your stomach. The feeling is commonly mistaken for hunger or heartburn, so it's important to get recurring pain checked out by a doctor. "There are many causes of ulcers and treatment depends on the cause," says Leddin. "Ulcers can be caused by alcohol consumption or smoking cigarettes -- in which case the recommendation would be to stop. Obesity is another common cause -- the treatment would be to lose weight."

Another common cause of ulcers, says Leddin, is the bacterium Helicobacter pylori (or H. pylori) that finds it way into the stomach and small intestine -- a.k.a ulcerland. When H. pylori adapts to the stomach, it wiggles around and irritates stomach acid, which can eventually cause an ulcer. For H. pylori ulcers, antibiotics is the best treatment. Other treatments your doctor might suggest include antacids, and dietary changes.

4. Liver diseases
Like IBS, liver disease is a catchall diagnosis for diseases and disorders that cause the liver to function improperly or to not function at all. Under the umbrella of liver diseases, there are more common diseases such as hepatitis and cirrhosis. A lot of symptoms associated with liver disease, says Leddin, are general -- such as weight loss, loss of appetite and nausea. "Yellowish, itchy eyes are a symptom of liver disease," says Leddin. "Liver disease is often caught on routine blood tests." So make sure you get your blood work done regularly, and get any out-of-the-ordinary symptoms checked out -- with most forms of liver disease, catching it early is important for successful treatment.

5. Stomach flu
"Stomach flus are usually caused by a virus," says Leddin. "The virus can be passed on through direct contact, such as handshaking or kissing." Symptoms of the stomach flu (or viral gastroenteritis) include not-so-fun stuff like nausea, vomiting, stomach cramps, diarrhea, mild fever and more. There's not much to do for the stomach flu but wait it out. The good news, says Leddin, is that stomach flus "are usually self-limited, and usually last about 24 to 48 hours." That is, unless you fall victim to the dreaded bacterial stomach flu, which can be more serious and last longer.

If you've recently travelled somewhere with questionable water quality or your flu lasts more than a few days, your fever is high or there is blood in your stool, see a doctor right away. He or she can prescribe antibiotics or an IV fluid to help you heal.

It's not fun to talk about, and it's certainly not fun to experience, but the quicker you get to the bottom of what's going on in your tummy, the less often you'll have to excuse yourself from an important meeting to curl up in the fetal position under your desk. There could be a simple reason for your discomfort (no more cheese before bedtime for you!), or it could be a simple matter of antibiotic treatment or lifestyle changes. Either way, isn't it better to know the cause rather than making up excuses for those strange stomach rumblings?

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