Summary about Disease
Excessive burping, also known as eructation, is the expulsion of gas from the stomach or esophagus through the mouth. While occasional burping is normal, frequent or excessive burping can be bothersome and may be a symptom of an underlying medical condition. It's generally not a serious condition in itself, but persistent excessive burping can impact quality of life and sometimes indicates a need for further investigation.
Symptoms
Frequent burping (more than considered normal for an individual, as "normal" frequency varies)
Abdominal bloating or distension
Abdominal discomfort or pain
A feeling of fullness after eating only a small amount of food
Nausea
Gurgling sounds in the stomach
Causes
Swallowing Excess Air: This is the most common cause. It can be caused by:
Eating or drinking too quickly
Talking while eating
Drinking carbonated beverages
Chewing gum or sucking on hard candies
Smoking
Wearing loose dentures
Hyperventilation
Nervous habits (like nail-biting)
Gastrointestinal Issues:
Acid reflux (GERD)
Gastritis (inflammation of the stomach lining)
Peptic ulcers
Helicobacter pylori (H. pylori) infection
Gastroparesis (delayed stomach emptying)
Irritable bowel syndrome (IBS)
Lactose intolerance or other food intolerances
Celiac disease
Small intestinal bacterial overgrowth (SIBO)
Medications: Certain medications can contribute to burping as a side effect.
Anxiety: Anxiety can sometimes lead to increased air swallowing.
Medicine Used
The medicine used depends on the underlying cause. Some common categories include:
Antacids: To neutralize stomach acid (e.g., Tums, Rolaids).
H2 Blockers: To reduce stomach acid production (e.g., famotidine [Pepcid], cimetidine [Tagamet]).
Proton Pump Inhibitors (PPIs): More powerful acid reducers (e.g., omeprazole [Prilosec], lansoprazole [Prevacid]).
Prokinetics: To speed up stomach emptying (e.g., metoclopramide). These have side effects and are generally prescribed with caution.
Simethicone: An anti-foaming agent to reduce gas bubbles (e.g., Gas-X).
Antibiotics: If H. pylori infection is present, antibiotics will be prescribed to eradicate the bacteria.
Enzyme Supplements: If lactose intolerance or other food intolerances are suspected, lactase enzyme supplements or other digestive enzymes may be helpful.
Is Communicable
Excessive burping itself is not communicable. However, if the underlying cause is an infection (like H. pylori), then the infection is communicable.
Precautions
Eat and drink slowly: Avoid gulping food or drinks.
Avoid carbonated beverages: These introduce extra gas into your system.
Avoid chewing gum and hard candies: These encourage swallowing air.
Identify and avoid trigger foods: If you suspect a food intolerance, try eliminating it from your diet to see if symptoms improve.
Manage stress and anxiety: Practice relaxation techniques like deep breathing or meditation.
Don't smoke: Smoking introduces air into the system and can irritate the stomach.
Review medications: Talk to your doctor about medications that may be contributing to the problem.
Smaller meals: Eating smaller, more frequent meals can reduce the amount of gas produced.
Upright posture: Sitting upright while eating and for a period after eating can aid digestion.
How long does an outbreak last?
The duration of excessive burping depends entirely on the underlying cause. If it's due to swallowing too much air, it may resolve quickly by changing habits. If it's due to a chronic condition like GERD or IBS, it may be an ongoing issue that needs long-term management. If it is due to an infection such as H. Pylori the length of time depends on the antibiotic treatement typically 10-14 days.
How is it diagnosed?
Medical History and Physical Exam: The doctor will ask about your symptoms, diet, and medical history.
Dietary Log: Keeping a food diary can help identify trigger foods.
Physical Exam: A general physical exam may be performed.
Upper Endoscopy (EGD): A thin, flexible tube with a camera is inserted into the esophagus, stomach, and duodenum to visualize the lining and take biopsies if needed.
H. pylori Testing: Blood tests, stool tests, or breath tests can detect H. pylori infection.
Lactose Intolerance Test: Various tests can detect lactose intolerance.
Gastric Emptying Study: To evaluate how quickly the stomach empties.
Esophageal Manometry and pH Monitoring: To assess esophageal function and acid reflux.
Imaging Studies: X-rays or CT scans are rarely needed but may be used in certain cases.
Timeline of Symptoms
The timeline of symptoms can vary greatly:
Acute: Sudden onset, often related to a specific event (e.g., eating a large meal, drinking a lot of carbonated beverages). Symptoms may resolve quickly.
Intermittent: Symptoms come and go, often related to specific triggers (e.g., certain foods, stress).
Chronic: Persistent symptoms lasting for weeks, months, or even years, often associated with an underlying medical condition.
Important Considerations
When to see a doctor: Consult a doctor if excessive burping is persistent, severe, accompanied by other symptoms like abdominal pain, weight loss, blood in stool, difficulty swallowing, or if over-the-counter remedies are not effective.
Self-diagnosis and treatment: Avoid self-diagnosing and treating the problem, as it can mask an underlying condition.
Lifestyle Modifications: Lifestyle and dietary changes are often the first line of defense.
Underlying conditions: It's important to identify and treat any underlying medical conditions that may be contributing to the excessive burping.
Psychological Factors: Consider the role of stress and anxiety in symptom management.
Medication Side Effects: Always consider medication side effects as a potential cause.