Burping or belching is a normal bodily function, especially after a big meal. But what if your burping has become more than an occasional embarrassment?
Burping occurs when air is expelled from the stomach through the mouth. This usually happens when the stomach is filled with swallowed air. Burping is normal when you swallow air by eating too quickly or drinking a fizzy drink.
A quick overview of our expert forum, where readers ask medical questions, shows that there are indeed people who worry about burping.
When burping becomes excessive, you should pay attention to your body as there may be an underlying problem. Here are five possible causes of excessive burping.
1. A peptic ulcer
When burping is also accompanied by a chronic dull pain in the abdomen, you might have a peptic ulcer. This occurs when the protective mucus layer inside the stomach is compromised and damage is caused to the stomach lining, small intestine or oesophagus by stomach acids.
Burping is a symptom of a peptic ulcer, as a result of acid moving into the oesophagus.
When to seek medical help: When you're also experiencing abdominal cramps, nausea, vomiting and extreme bloating. Many symptoms caused by a peptic ulcer can mimic other underlying health conditions, therefore it’s important to get a proper diagnosis.
2. Irritable bowel syndrome (IBS)
IBS occurs when there is chronic irritation of the large intestine, causing diarrhoea, constipation, stomach cramps, nausea and excessive bloating. It is often hard to diagnose IBS as it can cause a wide array of symptoms. Excessive burping can signify that you have IBS, caused by excessive build-up of gas in the stomach.
When to seek medical help: You should seek help from your doctor if the burping, along with other symptoms, does not disappear after a month. If you suspect IBS, it’s important to keep track of the frequency of your symptoms and what foods you ate prior to their appearance.
3. Acid reflux or GORD
Gastro-oesophageal reflux disorder, or GORD, is a condition in which the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus) is too relaxed and allows acidic stomach contents to flow back or "reflux" into the oesophagus.
This condition causes excessive burping as your body is constantly trying to clear your oesophagus, or because you are swallowing more air in an attempt to neutralise the acid. You will likely also experience other unpleasant symptoms such as a burning sensation in the chest and throat, bloating, abdominal pain, difficulty swallowing and nausea.
When to seek medical help: It’s common to experience acid reflux from time to time, especially after eating a heavy meal or eating foods that tend to produce a large amount of acid. But if you frequently experience acid reflux, your doctor will need to check for GORD, which could require specialised treatment to manage the situation.
4. Coeliac disease
Coeliac disease is a chronic immune disorder where the small intestine is unable to process gluten.
Over time gluten may damage the lining of your small intestine, which can cause acid reflux, leading to excessive burping.
When to seek medical help: When you have any digestive symptoms that do not clear up on their own, especially severe abdominal pain after eating gluten, it’s important to keep a diary to establish a pattern. Your doctor will be able to diagnose coeliac disease with laboratory tests.
5. Another underlying metabolic disease such as diabetes
Burping can signify that your digestive system is sluggish and has trouble processing food, causing large amounts of gas.
Gastroparesis, which is delayed digestion, can be a common side-effect of both types of diabetes.
Other conditions such as hypothyroidism can cause a slowed metabolism, which makes it harder for your body to digest food. This can also lead to excessive burping.
When to seek medical help: If you experience burping and digestive trouble with other symptoms such as extreme fatigue and thirst, you need to visit your doctor for glucose tests. This may indicate pre-diabetes or type 2 diabetes.
Any other conditions such as thyroid disorders can be ruled out through blood tests.
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