When you’re dedicated to losing weight, eating right, and exercising, yet your stomach still isn’t in the shape you want, it may be time to see what else is going on. There can be hidden or obscure reasons a flat stomach eludes you.

Some of the more common causes of discomfort, pain, or bloating include food allergies, ulcers, endometriosis, lactose intolerance, stomach virus, even a urinary tract infection. But one of the most prevalent issues is outlined in this video:

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Irritable bowel syndrome, or IBS, has come up only lately, though an estimated 10 to 15 percent of the U.S. adult population suffers from symptoms. It’s the most common disease diagnosed by gastroenterologists, according to the American College of Gastroenterology, and one of the most common disorders seen by primary care physicians. Yet only 5 to 7 percent of adults have been diagnosed with it. And the condition affects women more commonly than men.

Some of the most common triggers include:

1.) Certain foods or food allergies. Chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages, and alcohol are just a few of the foods to try cutting back on, say the experts at the Mayo Clinic.

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2.) Stress. Work-related problems, finals week during college, or trouble at home often sets off the signs and symptoms of IBS. While stress may aggravate symptoms, health experts caution it doesn’t cause them.

Related: The Stress Fighters That Can Save Your Life

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3.) Hormones. “Because women are twice as likely to have IBS, researchers believe hormonal changes play a role in this condition,” the Mayo Clinic states on its website. Many women find that signs and symptoms are worse during or around their menstrual periods.

If the symptoms sound familiar — and your goal is to feel well, live well, and still rediscover that flat stomach — it may be time to talk with your physician.