Belching is the act of expelling air from the stomach through the mouth. It usually occurs when the stomach distends (expands) due to too much swallowed air, with the belching releasing the air to reduce the distention. Other names for belching include burping and eructation.
Belching occurs when the stomach fills with swallowed air. There are a number of reasons why more air than normal may be swallowed, but the most common are:
- eating or drinking too quickly
- drinking carbonated drinks
Babies and young children may swallow large amounts of air without realizing it. This is why babies are burped shortly after drinking breast milk or formula—to expel the excess air that was swallowed during feeding.
It is possible to belch when the stomach is not full of air. This is usually because belching has become a habit or a tool to try to reduce abdominal discomfort. While belching will only relieve discomfort associated with swallowing air, it is not uncommon for people to attempt to relieve other abdominal discomforts in the same way.
Aerophagia is the voluntary or involuntary swallowing of air. Swallowing excessive amounts of air can happen when eating or drinking too quickly, as noted earlier. It can also occur when:
- talking and eating at the same time
- chewing gum
- sucking on hard candies
- drinking through a straw
- wearing poorly fitted dentures
- having an anxiety attack
- breathing through your nose
Some foods and drinks can also cause more frequent belching. These include carbonated drinks, alcohol, and foods high in starch, sugar, or fiber that cause gas. Common culprits include beans, lentils, broccoli, peas, onions, cabbage, cauliflower, bananas, raisins, and whole-wheat bread.
There are a number of different medications that may lead to belching or to the disorders that cause belching. These may include acarbose (commonly used to treat type 2 diabetes), laxatives like lactulose and sorbitol, and pain medications like naproxen, ibuprofen, and aspirin (excessive use can lead to gastritis, a condition that can cause belching).
Some medical conditions may also cause belching as a symptom. However, as belching is a natural response to abdominal discomfort, there must be other symptoms present to make a diagnosis.
Conditions that may cause belching include:
- gastroesophageal reflux disease (GERD): disorder that causes acid from the stomach to flow upward into the esophagus, or food pipe
- gastroparesis (also called delayed gastric emptying): disorder in which the muscles in your stomach wall are weakened. This causes a delay in digestion, as stomach muscles are essential to pushing food through the digestive tract.
- gastritis: disorder that causes inflammation of the stomach lining
- peptic ulcers: sores on the esophagus, stomach, and upper part of your small intestine
- lactose intolerance: inability to properly digest lactose, an ingredient found in dairy products
- fructose or sorbitol malabsorption: inability to properly digest the carbohydrates fructose and sorbitol
- Helicobacter pylori (H. pylori): bacteria that cause stomach infections, which can increase belching. They can also cause gastritis, peptic ulcers, and GERD.
Less common causes of belching include:
- celiac disease: an intolerance to gluten, an ingredient found in many flour-rich foods like breads and crackers
- dumping syndrome: a disorder that causes your stomach to empty before its contents have been properly digested. This disorder is most common after gastric bypass surgeries or surgeries to remove part of your stomach.
- pancreatic insufficiency: the pancreas is not able to release enzymes needed for digestion
Belching as a single symptom (unless frequent or excessive) is not usually cause for concern. However, if your stomach has been distended for a long period, and belching does not relieve the distention or if the abdominal pain is severe, seek medical attention immediately.
Normal belching does not require any treatment. However, if belching becomes excessive, it is advisable to contact a medical professional to explore possible conditions that may be causing the problem. Treatment will depend on the cause.
If you are belching excessively or if your stomach is distended and you cannot expel the air, lying on your side usually helps. Adopting a knees-to-chest position can also be helpful. Hold the position until the gas passes.
It is advisable to also avoid eating and drinking quickly, drinking carbonated beverages, and chewing gum if you are experiencing excessive belching. These may make the problem worse.
If your belching has become excessive, it is important to speak to your doctor. Your doctor will gather information on your symptoms by asking questions that center on when the excessive belching began and if it has happened before. You will be asked about patterns, such as whether the belching occurs due to nervousness or after consuming a particular food or drink, and you may be asked to keep a food diary for a few days.
Make sure you mention any other symptoms you have, even if you do not think that they are relevant. This will help your doctor build a full picture of the problem, which will help him or her find the most likely solution.
The doctor may examine you physically and could order further tests such as abdominal X-rays or gastric emptying studies. Other options include MRI, CT and ultrasound scans, maldigestion tests, and hydrogen/methane tests. These will give your doctor a clear view of your digestive system, which will better allow him or her to make a diagnosis.
Normal belching does not require any treatment and has no consequences.
However, if belching has become more frequent due to a digestive system problem, it is possible that the symptoms will worsen if left untreated. You may also begin to suffer from other symptoms until the problem is diagnosed and treated.
Belching is a natural action, but it can be controlled by avoiding items that are more likely to make you belch. If you want to prevent belching, you should:
- Sit down and eat each meal slowly.
- Avoid chewing gum or sucking on hard candies.
- Avoid carbonated beverages and alcohol.
- Stop consuming any foods or drinks that make belching more frequent.
- Take probiotic supplements to aid in digestion.
- Avoid anxiety-inducing situations that may cause hyperventilation.