When we belch we expect a rumbling gas to be pushed out of the mouth from the stomach but it can be distressing when there is a sour tasting fluid that comes up instead. It may cause a burning sensation in the chest, throat and even the mouth. This is what is sometimes referred to as acid burps and it can be a sign of some underlying digestive problem.
What is acid belching?
Acid burps or acid belching is a combination of belching and acid reflux. The gas expulsion that is part of normal burping may also allow stomach acid to reach the throat and mouth. This is more likely to occur in a person with gastroesophageal reflux disease (GERD) but can affect any person who overeats or consumes alcohol. It is also more likely to occur when large amounts of air is swallowed, carbonated drinks consumed or with gas production within the upper gut.
Although acid belching is not a serious condition, it can cause significant distress. The rise of the acidic stomach contents is not the same as vomiting. With vomiting the muscles of the upper part of the small intestine, stomach and esophagus contract strongly to push out the gut contents. The expulsion is relatively violent. With acid belching the expulsion is usually not as forceful. This type of regurgitation is propeled partly by the normal stomach contractions, gravity (when lying flat or bending over) and the eruption of gas in the stomach.
Therefore acid belching does not result in the stomach contents exiting the mouth in most cases. In severe cases a sour to bitter, warm and acidic fluid reaches the mouth. In milder cases the fluid may not be detected but instead a burning sensation in the chest (heartburn), throat and mouth accompanies the burp. Often acid burps are accompanied by other symptoms like bloating, nausea and a loss of appetite which are often collectively described as indigestion.
Read more on excessive belching.
Causes of Acid Burps
It is important understand that causes of acidic burps is due to two conditions – the first being belching and particularly excessive belching and the second being acid reflux. Belching is result of the accumulation of gas in the stomach. Acid reflux lies mainly with a problem in the lower esophageal sphincter (LES) that prevents stomach contents from entering the esophagus.
One of the causes of reflux and belching is a result of overeating. This impairs the lower esophageal sphincter (LES) and allows for the acidic stomach contents to be pushed out into the esophagus with ease. Given that overeating fills the stomach to capacity, and beyond, this is more likely to occur as the stomach contracts and churns the food.
Foods and Drinks
Several drinks contribute to belching and/or acid reflux. This includes alcohol, carbonated drinks like sodas and beer, and chocolate but various other foods and beverages may also be reponsible. While these foods and drinks can affect any person, it is more likely to lead to acid burps in a person with existing gastroesophageal reflux disease (GERD).
Air swallowing (aerophagia) is a common problem and is more likely to occur when eating fast, with chewing gum and talking excessively. The accumulation of air in the stomach is one of the major contributors of excessive belching. However, aerophagia on its own will not lead to acidic belching unless other factors contribute to simultaneous acid reflux.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a very common upper gut condition where stomach acid can flow backwards up into the esophagus. It arises with a weakening of the lower esophageal sphincter (LES) which normally prevents this backward flow. Acute GERD affects every person several times in life but chronic GERD is usually associated with obesity, advancing age, diabetes, hiatal hernia and other conditions.
Read more on GERD.
Acid reflux is common in pregnancy for several reasons. The pregnancy hormones can temporarily weaken the LES and the enlarging uterus further increases abdominal pressure. It is further exacerbated by overeating which some pregnant women indulge in often when it comes to satisfying cravings. The reflux often resolves after childbirth
The esophagus passes through a small hole in the diaphragm to join the stomach. If this hole widens then a portion of the stomach can then slide into the chest cavity. This is known as a hiatal hernia. It impairs the lower esophageal sphincter (LES) which then allows for stomach acid to flow upwards into the esophagus and higher up.
Several other conditions may also contribute to acid burps. These are conditions that cause both excessive belching and acid reflux.
- Delayed gastric emptying
- Intestinal motility disorders
- Small intestinal bacterial overgrowth
Remedies of Acidic Belching
It is important that the underlying cause of acidic belching is diagnosed by a medical professional. The appropriate treatment that is prescribed should be followed but a few dietary and lifestyle measures could possibly assist in reducing the severity or frequency of episodes.
- Opt for small meals more frequently rather than fewer larger meals within a day. Attempt to identify problem foods that should be avoided in meals.
- Minimize alcohol and caffeine intake especially when consuming main meals. Apart from affecting the LES, alcohol intake can also lead to overeating.
- Do not lie down or sleep immediately after a meal. Late night snacks must be avoided. Ideally a meal should not be consumed for at least 2 hours before bedtime.
- Stay away from sodas, beers and other gassy drinks. Rather stay with a neutral beverage like water. Drinking too fast can lead to swallowing air so rather sip on beverages.
- Try to be active after a meal. Strenuous physical activity like exercise should be avoided. Rather do household chores or take a brisk walk. Being sedentary and especially lying down can increase acid burps.
- Use antacids if necessary. These over-the-counter drugs will helps to neutralize stomach acid along with foaming medication that creates a foam layer above the stomach acid to minimize reflux.
- Acid suppressing drugs are also useful for reducing reflux. While some of these drugs are available over-the-counter, it should only be used after being assessed by a medical professional.