Eructation

Marian Grosser studied human medicine in Munich. In addition, the doctor, who was interested in many things, dared to make some exciting detours: studying philosophy and art history, working on the radio and, finally, also for a Netdoctor.

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When belching (burping), for example, air or some solid stomach contents can get back up into the mouth. That is - in moderation - quite natural. If this phenomenon, called regurgitation in technical jargon, occurs more intensely, it can be very stressful. Find out how often belching is normal, what causes frequent burping and what can be done about it.

Brief overview

How much belching is normal? That is individually different and depends among other things. depends on the diet and personal feeling.
Causes of belching: e.g. hastily eating, talking a lot while eating, carbonated drinks, pregnancy, various diseases (gastritis, reflux disease, food intolerance, tumors, etc.)
What helps with belching? Sometimes a change in diet, smaller servings or slower meals help; if there is an underlying disease, the doctor will treat it, which usually also regulates the belching

How much belching is normal?

How much belching is normal varies from person to person and is always a question of how you feel. For some, it is perfectly normal to burp several times a day. Others find every burp uncomfortable.

Nonetheless, belching is often harmless and is simply a reflex of the body to reduce the feeling of fullness that occurs when gas builds up in the stomach.

In contrast to vomiting, the stomach does not contract convulsively when belching. The backward-facing muscle movement of the esophagus (peristalsis) also does not occur, which ensures that the stomach contents are transported outside in a gush when vomiting.

Belching: causes and possible diseases

(Frequent) belching can have various reasons. The most important are:

Swallowing air

Certainly the most common reason someone burps or burps is swallowing air while eating. Especially when someone is rushed to eat, a little air gets into the stomach with every bite. The same applies if you have a lively conversation while eating and talk a lot. Part of the air in the stomach then tries to find its way “outside” again by belching. The rest of them move on to the intestines.

This type of belching is completely normal. You should not suppress it, otherwise flatulence can develop, but at best let the air out discreetly behind your hand.

Ascending gases

In addition to normal breathing air, gas can also get up when belching. Sometimes it is gases that are produced during digestion. But even after drinking a carbonated drink, gas can collect in the stomach and then escape through belching. Both can also occur in combination: If you eat a dish with legumes such as peas or lentils and drink cola with it, you shouldn't be surprised about frequent belching.

In addition to legumes, onions, whole grain and yeast products, coffee and cream also have a flatulence effect.

Belching with solid or liquid stomach contents

If some porridge comes with the belching, it does not have to be pathological. The escaping air can "carry you away" when you eat something. Even if the stomach contents are sometimes acidic, this does not necessarily mean that there is a disease.

Only if this happens regularly, especially after eating fatty and sweet foods, could a reflux disease (reflux disease) be behind it. Rising stomach acid irritates the esophagus, which manifests itself as a painful burning sensation in the chest (heartburn). In the long run, the mucous membrane of the esophagus is damaged by frequent contact with the aggressive gastric acid, and the teeth also suffer when the stomach contents repeatedly rise into the mouth.

In rarer cases, other conditions are responsible for excessive belching:

Narrowing (stenosis) of the esophagus: If the food pulp that is pushed open is still undigested, this may be due to the fact that the esophagus is narrow (stenosis) and the swallowed food cannot or only partially reach the stomach. The narrowing can be congenital or, for example, due to a tumor.
Leaky stomach entrance: If the muscle loop (sphincter) at the junction between the esophagus and stomach does not close properly, air, gas and solid stomach contents can reach the top more easily. This can occur, for example, as a side effect of certain medications (psychotropic drugs, calcium channel blockers) or it can also be the case from birth.
Zenker's diverticulum: This is a bulging (diverticulum) of the muscle wall in the throat (hypopharynx), i.e. in the deep throat region, still above the esophagus. In the advanced stage, food pulp accumulates in this protuberance, which eventually gets back into the mouth through belching. The esophagus can also have diverticula.
Inflammation of the stomach lining: Inflammation of the lining of the stomach (gastritis) can also be a reason for frequent belching. Often the inflammation is due to a colonization with the bacterium Helicobacter pylori traced back.
Narrowing at the gastric exit: If the muscles at the gastric exit (gatekeeper) cramp, the accumulated food does not get into the duodenum. Occasionally, scarring after ulcers or tumors has a similar effect. The latter can also lie outside the stomach, for example in pancreatic cancer.
Intestinal obstruction (ileus): Very rare, but all the more frightening, is the belching of something that has already been heavily digested with a stool odor. The cause for this is usually an intestinal obstruction, which the chewed-on food pulp cannot push past. So it builds up and in extreme cases wanders back into the mouth.
Food intolerance: If the belching occurs especially after eating certain foods, there may be a food intolerance behind it, such as gluten intolerance (celiac disease) or lactose intolerance.

Belching in pregnancy

Pregnancy is a state of emergency for women. Your body changes in many ways - and many pregnant women also have more belching. The reason for this is the pressure from below on the stomach, which the growing fetus increasingly exerts. He pushes the stomach up, and the sphincter at the entrance to the stomach then often no longer holds tight.

Unfortunately, then not only air but also stomach acid have an easier time getting to the top. This is why pregnant women often get heartburn. However, it usually disappears at birth.

Belching: what helps?

Since belching is often caused by harmless causes, there are a few things you can do yourself to deal with the "imprecise deflation":

Eat slowly and chew adequately: To avoid swallowing too much air, you should take time to eat and chew enough. Then you probably don't have to burp afterwards.
Talking little while eating: You can limit swallowing air while eating if you don't talk too much while you are eating.
Avoid sweet, greasy and too much coffee: If you have frequent heartburn, you should avoid very sweet and greasy foods, as these aggravate the problem. It's the same with too much coffee.
Several small meals: It can also help against belching to eat several small meals throughout the day instead of overloading the digestive tract with a few large ones.
Non-carbonated: Instead of carbonated beverages, use still water more often. Then you should also have to burp less.
Do not smoke: Since smoking can reduce the tension in the gastric sphincter and thus cause heartburn, you should stop cigarette consumption if possible.

Belching: what does the doctor do?

First, the doctor needs to find the cause of the belching. The treatment is based on this.

Diagnostics for belching

First of all, the doctor will ask the patient exactly (anamnesis), for example when the person concerned has to burp, to what extent and whether there are any other symptoms (e.g. heartburn). Depending on the information from this initial consultation and the presumptions of the doctor, various examinations can follow. A gastroscopy, for example, is often helpful: the doctor can use it to search for possible causes of the increased belching in the esophagus and stomach (e.g. narrowing of the esophagus, gastritis).

Treatment of belching

Once the cause of the belching is found, the doctor will initiate appropriate treatment. Examples.

If protrusions or narrowing of the throat or esophagus turn out to be the trigger, a small intervention can sometimes be found during the gastroscopy. Otherwise, minor surgical interventions follow.
The doctor usually treats reflux disease and gastric mucosal inflammation with medication (proton pump inhibitors, antibiotics for gastritis).
An intestinal obstruction must be treated medically as soon as possible. Sometimes medication is enough, but most of the time the surgeon has to use the scalpel.
In the case of food intolerances, special diets are usually the only permanent solution.

Tumors require individual therapy with the available methods (e.g. surgery, chemotherapy, radiation).

Belching: When Should You See a Doctor?

As long as only air or gas comes to light during the belching, and this is not in excess, this is certainly not a reason for a doctor's visit. The perception here may be individual, but as a rule “the normal extent” can also be assessed by laypeople.

If you suddenly have to burp (without having significantly changed your diet), you should have this checked out by a doctor.For example, it could be a food intolerance.

A visit to the doctor is also advisable if the belching is accompanied by other symptoms (such as stomach pressure, heartburn) or if undigested food gets into the mouth when belching.

If you have an unusually foul smell when you belch or if you get a smell of food with a stool, you must consult a doctor as soon as possible. Intestinal obstruction is then suspected, and this is always a medical emergency!

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