Belch. Advantage. Whatever you call it, we all burp occasionally. It is a completely natural process in which your body gets rid of excess air from your upper digestive tract.
After eating, your stomach stretches to accommodate the food you just swallowed. Part of the gut's natural ventilation mechanism is to allow the lower esophageal sphincter, the valve between the esophagus and the stomach, to relax. These relaxations, also known as TLESR (transient lower esophageal sphincter relaxations), are normal in the post-meal period. But with the opening of the valve, some gas escapes and causes belching.
How much burping is normal? Believe it or not, a lot. The average person burps between one and four times with each meal . This can vary greatly from person to person, depending on how quickly and how much air is swallowed, consciously or unconsciously, when eating, drinking, speaking, or even breathing through the mouth.
If you burp a lot and it doesn't bother you, then there is nothing to worry about. But if so, here are some of the most common causes and what you can do to treat them.
Why do you burp? Common causes of burping
You're swallowing a lot of air
This is the most common cause. Aerophagia, or swallowing air, can occur when you chew gum, drink through a straw, or even talk when you eat, all things you may not even notice. This can be easily fixed with a few simple lifestyle measures:
- Slow down when you eat so that you swallow less air with your food.
- Avoid carbonated drinks and beer, which release carbon dioxide.
- Skip gum and hard candy, which make you swallow more often than normal (so you swallow more air)
- If you smoke, stop smoking: When you inhale smoke, you also inhale (and swallow) air.
You are breathing with your mouth
If you are chronically congested due to allergies or a deviated septum, this can force you to breathe through your mouth, which in turn increases your chances of swallowing air.
Also, it can cause postnasal drip, when mucus builds up in the back of your throat, leading you to swallow a lot more to get rid of it.
You can try an over-the-counter steroid nasal spray for a couple of weeks to see if it clears your nose (and relieves your belching), but if it doesn't, consult an ENT doctor to get to the underlying source of your congestion.
You have lactose or fructose intolerance
Almost two-thirds of all adults have trouble digesting lactose. This means that foods that contain dairy cannot be fully digested. Instead, lactose sticks to your belly and produces gas that makes you burp.
Your burp may be due to lactose intolerance if it occurs within a couple of hours after consuming dairy products and is combined with other symptoms, such as stomach pain, bloating, and farting.
The good news is that you don't have to completely eliminate dairy from your diet – most people can still eat dairy products like cheese or yogurt without discomfort, as they are made through fermentation processes that break down much of the lactose in milk.
If you notice burping after drinking fruit juice, it may be due to fructose intolerance. It can help simply to cut down on this type of drink, as well as any product that contains high fructose corn syrup.
You're stressed
When you're nervous or anxious, you can hyperventilate, which in turn can lead to repetitive direct ingestion of air. People with anxiety disorders are also prone to certain types of belching, known as "supragastric belching." These occur when the person initiates the burp by drawing air into the chest and then rapidly 'pushing' it out, leading to the 'burp'.
If your doctor suspects this, he or she will perform a test known as esophageal manometry, which measures the pressure along the inside of your esophagus. This condition is difficult to treat because it is a learned behavior. You may need speech or behavior therapy.
You have acid reflux
If you have acid reflux, acid from your stomach begins to flow back into your esophagus. This causes you to swallow more air, making you feel bloated and burp a lot.
Most people have some degree of reflux, but it is when this reflux causes pain or discomfort or secondary complications, such as difficulty swallowing or coughing, that we consider it abnormal.
Chronic belching can also be related to inflammation of the stomach lining caused by Helicobacter pylori, the bacteria responsible for some stomach ulcers. In these cases, other warning symptoms are heartburn and abdominal pain.
When should you go to the doctor?
Burping usually resolves on its own or with simple lifestyle changes. If you don't have any other symptoms, it is rarely a sign of more serious conditions.
But if it bothers you, it's worth getting checked out. In most cases, this is a benign and completely reversible condition that will improve with the right interventions. You should also go to your doctor if belching is accompanied by:
- Diarrhea.
- Persistent or severe abdominal pain.
- Bloody stools
- Fever.
- Involuntary weight loss
- Chest discomfort.
- Loss of appetite or feeling full quickly.
These signs and symptoms could indicate an underlying digestive condition, such as irritable bowel syndrome or Crohn's disease.
