Brief overview
- How much burping is normal? This varies from person to person and depends, among other things, on your diet and how you feel.
- Causes of belching: e.g. eating in a hurry, talking a lot while eating, carbonated drinks, pregnancy, various illnesses (gastritis, reflux disease, food intolerance, tumors, etc.).
- What helps with belching? Sometimes a change in diet, smaller portions or eating more slowly can help; if there is an underlying illness, the doctor will treat it, which usually also regulates the belching
How much belching is normal?
How much burping is normal varies from person to person and is always a question of personal perception. For some, burping several times a day is completely normal. Others find every burp unpleasant.
Nevertheless, burping is often harmless and simply a reflex of the body to reduce the feeling of fullness that occurs when gas builds up in the stomach.
Unlike vomiting, belching does not cause the stomach to contract spasmodically. There is also no backward muscle movement of the oesophagus (peristalsis), which ensures that the stomach contents are expelled in a gush during vomiting.
Belching: Causes and possible illnesses
(Frequent) regurgitation can have various causes. The most important are
The most common reason why someone burps or belches is certainly swallowing air while eating. Especially when someone eats in a hurry, a little air gets into the stomach with every bite. The same applies if you have a lively conversation and talk a lot while eating. Some of the air in the stomach then finds its way “out” again via belching. The rest moves on to the intestines.
This type of burping is completely normal. You should not suppress it, as otherwise you may develop flatulence, but at best you should let the air out discreetly behind your back.
Rising gases
In addition to normal breathing air, gas can also rise when burping. Sometimes these are gases produced during digestion. However, gas can also collect in the stomach after drinking a carbonated beverage and then escape through belching. The two can also occur in combination: For example, if you eat a dish with pulses such as peas or lentils and drink cola with it, you should not be surprised by frequent burping.
In addition to pulses, onions, wholemeal and yeast products, coffee and cream also have a flatulent effect.
Burping with solid or liquid stomach contents
Only if this happens regularly, especially after eating fatty and sweet foods, could reflux disease (reflux disease) be the cause. In this case, rising stomach acid irritates the food pipe, which manifests itself as a painful burning sensation in the chest (heartburn). In the long term, the mucous membrane of the oesophagus is damaged by frequent contact with the aggressive stomach acid, and the teeth also suffer when stomach contents repeatedly rise up into the mouth.
In rarer cases, other illnesses are responsible for excessive belching:
- Narrowing (stenosis) of the oesophagus: If the chyme is still undigested, this may be due to a narrowing (stenosis) of the oesophagus and the swallowed food can therefore not or only partially enter the stomach. The narrowing may be congenital or due to a tumor, for example.
- Leaky stomach entrance: If the muscle loop (sphincter) at the junction of the oesophagus and stomach does not close properly, air, gas and solid stomach contents can pass upwards more easily. This can occur, for example, as a side effect of certain medications (psychotropic drugs, calcium antagonists) or can also be the case from birth.
- Inflammation of the stomach lining: Inflammation of the stomach lining (gastritis) can also be a reason for frequent belching. The inflammation is often caused by colonization with the bacterium Helicobacter pylori.
- Constriction at the stomach outlet: If the muscles at the stomach outlet (gatekeeper) tighten, the digested food does not pass into the duodenum. Scarring after ulcers or tumors occasionally has a similar effect. The latter can also be located outside the stomach, for example in the case of pancreatic cancer.
- Intestinal obstruction (ileus): Very rare, but all the more frightening, is the regurgitation of already heavily digested food with a stool odor. This is usually caused by an intestinal obstruction which the digested food cannot pass. As a result, it builds up and, in extreme cases, travels back into the mouth.
- Food intolerance: If belching occurs particularly after eating certain foods, it may be due to a food intolerance such as gluten intolerance (coeliac disease) or lactose intolerance.
Belching during pregnancy
Unfortunately, not only air but also stomach acid has an easier time getting to the top. This is why pregnant women often get heartburn. However, it usually disappears again after the birth.
Belching: What helps?
As burping often has harmless causes, there are a number of things you can do yourself to help with the “indiscreet release of air”:
- Eat slowly and chew sufficiently: To avoid swallowing too much air, take your time to eat and chew sufficiently. Then you will probably have to burp less afterwards.
- talk less while eating: Swallowing air while eating can also be limited if you don’t talk too much while eating.
- Avoid sweets, fatty foods and too much coffee: If you frequently suffer from heartburn, you should avoid very sweet and fatty foods, as these exacerbate the problem. The situation is similar with too much coffee.
- several small meals: It can also be helpful against belching to eat several small meals throughout the day instead of overloading your digestive tract with a few large ones.
- No carbonation: Instead of carbonated drinks, try to drink still water more often. You should then also have to burp less.
Belching: What does the doctor do?
First of all, the doctor must find the cause of the belching. The treatment then depends on this.
Diagnosis of belching
First of all, the doctor will ask the patient detailed questions (medical history), such as when the patient burps, to what extent and whether there are any other complaints (e.g. heartburn). Depending on the information from this initial consultation and the doctor’s suspicions, various examinations may follow. A gastroscopy, for example, is often helpful: this allows the doctor to look in the oesophagus and stomach for possible causes of the increased belching (e.g. narrowing of the oesophagus, gastritis).
Treatment of belching
Once the cause of the belching has been found, the doctor will initiate appropriate treatment. Examples
- If protrusions or narrowing of the gullet or oesophagus are found to be the cause, this can sometimes be remedied by a minor procedure during a gastroscopy. Otherwise, minor surgical interventions follow.
- The doctor usually treats reflux disease and gastritis with medication (proton pump inhibitors, antibiotics for gastritis).
- An intestinal obstruction must be treated medically as quickly as possible. Sometimes medication is sufficient, but usually the surgeon has to use a scalpel.
- Tumors require individual therapy with the available methods (e.g. surgery, chemotherapy, radiation).
Burping: When should you see a doctor?
As long as belching is only accompanied by air or gas, and not in excess, it is certainly no reason to see a doctor. Although the sensation may be individual, the “normal extent” can usually be assessed by laypeople.
If you suddenly have to burp frequently (without having changed your diet significantly), you should have this checked out by a doctor. It could be due to a food intolerance, for example.
It is also advisable to see a doctor if the burping is accompanied by other symptoms (such as stomach pressure, heartburn) or if undigested food pulp gets into your mouth when you burp.
If you develop an unusually foul odor when burping or if food pulp with a stool odor comes up, you must see a doctor as soon as possible. There is then a suspicion of intestinal obstruction, and this is always a medical emergency!
