A hearty belch after eating a large meal or drinking a large soda is not unexpected. We belch (burp) many times throughout the day, and in many instances we do not notice the act. Most of the time these small burps occur after eating and it is considered normal. However, there are situations where some people belch constantly to the point that it can affect their life, appetite and social interactions.
Why do we belch?
Belching is a natural process to expel gas from the upper gut. Most of the time this gas is air. We unconsciously swallow air throughout the day and this air swallowing is known as aerophagia. The amount of swallowed air increases when we eat or drink. The gut has to get rid of this air and belching is the mechanism to do so. If the air passes to the mid to lower parts of the gut then it is eventually passed out with flatus.
This “normal belching” can sometimes be excessive. If air is entering the gut constantly or some process is causing gas production within the upper gut, then the body hs to expel it on a constant basis. This presents as constant belching. Since belching, especially without eating and if loud, is considered to be socially unacceptable, constant belching can adversely affect a person. In addition it can sometimes be uncomfortable.
Read more on excessive belching.
Signs and Symptoms
Constant belching is a symptom and not a separate disease. It may therefore be accompanied by a host of other signs and symptoms depending on the underlying condition. This may include:
- Bloating – a sensation of fullness in the stomach.
- Abdominal distension.
- Nausea, and sometimes vomiting.
- Abdominal pain.
Read more on sulfur burps.
Causes of Constant Belching
When belching is constant or excessive then it should be considered as a symptom of some underlying medical problem. It can sometimes be related to dietary, lifestyle and physiologic factors but in these cases it should be temporary. However, when it is due to pathologic (disease) causes then constant belching can be ongoing and even worsen over time.
Excess Air Swallowing
Eating and drinking too fast, talking excessively, chewing gum frequently and even smoking can cause excessive air swallowing. As a result this will lead to frequent belching. It may be worse in people who do more than one action simultaneously, like eating fast and talking while eating. These are all dietary and lifestyle habits that can be changed.
Foods and Drinks
It is well known that gassy drinks (fizzy or carbonated beverages) are more likely to result in belching, as is the case with drinking sodas or beer. Digestion also contributes to gas production within the gut due to the chemical processes that occur between foods and enzymes. Certain foods will also cause gassiness as it releases more gas than usual during digestion. However, this is more likely to lead to excessive flatulence.
Nasal congestion can also contribute to increased air swallowing. As a person with a congested nose has to breathe through their mouth, they will inadvertently swallow more air than usual. This is more likely to occur when talking, drinking and eating. Furthermore there may also be increased air swallowing when sleeping. As a result there will be excessive belching.
Belching is a symptom that may occur in gastroesophageal reflux disease (GERD), also known as acid reflux. This is due to a weakened lower esophageal sphincter (LES) that normally prevents the stomach contents from flowing back into the esophagus. It is not uncommon for people with acid reflux to constantly swallow air in an attempt to push down the reflux. Other common symptoms include nausea, heartburn and bloating.
Another common condition where belching may appear as a symptom is gastritis. It is often due to a stomach infection with the bacteria, Helicobacter pylori. This leads to inflammation of the stomach wall. Apart from common symptoms like a gnawing stomach pain, nausea, sometimes vomiting, bloating and change in appetite, belching may also occur with gastritis.
Excessive and constant belching may occur in the following conditions:
- Inflammatory bowel disease
- Peptic ulcer disease
- Small intestine bacterial overgrowth
- Bowel obstruction
- Overuse of certain antacids
Treatment and Remedies
There is no specific treatment for constant belching. Always consult with a medical doctor if constant burping is persisting for long periods, worsening over time or is accompanied by other symptoms. Various diagnostic investigations may be required. Where necessary, the underlying cause of constant belching should be treated medically. This may involve drugs, dietary changes and sometimes even surgery is necessary.
- Antibiotics are used to eradicate H.pylori bacteria which causes gastritis.
- Proton pump inhibitors help with reducing stomach acid production.
- Antacids neutralize stomach acid and eases irritation caused by the acid.
- Nissen fundoplication is a surgical procedure that is done only for severe acid reflux.
A few simple dietary and lifestyle remedies can assist with easing constant belching.
- Eat and drink slowly as these are major contributors to swallowing air. Avoid talking when eating. Allocate a set meal time and do not be distracted when eating like with watching television.
- Minimize gum chewing and stop smoking which also result in excess air swallowing. The latter can also worsen acid reflux and gastritis which are are major causes of air swallowing and therefore constant belching.
- Stay away from carbonated beverages. Both alcoholic beverages with gas and cola sodas may not only increase gas within the gut but can also aggravate acid reflux and gastritis.
- Do not leave nasal congestion untreated. Consult with a doctor and see a specialist if necessary to treat the underlying cause of nasal congestion.
- Antacids may help with conditions like acid reflux and gastritis but overuse of this medication can worsen gas production in the gut and therefore constant belching.
- Take a walk after eating as this can help with digestion by speeding up empting of the stomach. It also reduces the fermentation of food and gas production within the stomach which is passed out as belches.