What Are the Causes of Excessive Belching?

What Are the Causes of Excessive Belching?
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Belching is the escape of air from the esophagus or stomach into the pharynx -- the upper windpipe -- and through the mouth. Also known as burping, it's fairly normal to experience gastric belching, or the venting of air from the stomach, especially after eating a meal. However, excessive belching is not normal and is commonly caused by, or associated with, a variety of upper gastrointestinal or health disorders or from swallowing too much air. If you suffer from excessive belching, see your doctor to determine the cause and management.

Swallowed Air

Swallowing some air is normal and expected. When the stomach starts to bloat with excess air, belching is the body's way to release this air and prevent the stomach from getting overinflated. People who eat quickly, smoke, drink carbonated beverages, drink using a straw and chew gum are more likely to swallow excess air. However, extreme belching from swallowed air is more commonly associated with medical conditions, intentional behavior, anxiety, or psychological disorders.

Gastroesophageal Reflux Disease

Both gastric and supragastric belching -- where air is sucked into the esophagus then quickly expelled through the mouth -- are common in gastroesophageal reflux disease (GERD), a condition in which the stomach contents frequently flow up into the esophagus. As many as 49 percent of people with GERD may be bothered by belching, according to an August 2014 review in "The American Journal of Gastroenterology." Researchers link this excessive belching to an increase in swallowed air, which is sometimes habitual, along with intentional supragastric belching as a means to relieve symptoms. Unfortunately, sometimes this belching worsens the reflux symptoms.

Other Gastrointestinal Disorders

According to the "Practical Gastroenterology and Hepatology Board Review Toolkit," excessive belching can also be associated with other gastrointestinal conditions. Most conditions that affect the functioning of the gastrointestinal tract, such as the rate of digestion or the ability to properly digest foods, can increase the risk of belching. Examples include functional dyspepsia, which is the disordered sensation and movement of the upper gastrointestinal tract, or gastroparesis, in which nerve damage alters the rate of digestion. As with GERD, the cause of this belching is the venting of swallowed air, or intentional supragastric belching of air as a way to relieve other symptoms -- such as bloating or indigestion.

Treatment and Next Steps

If you suffer from excessive belching, your symptoms can be improved if the underlying problem is treated. In some cases, diet changes, such as eating more slowly or avoiding carbonated beverages, can help limit the amount of air that is swallowed. Taking over-the-counter (OTC) anti-gas medications such as simethicone, or prescribed medications for GERD may also lead to fewer episodes of belching.

But the cause of excessive burping is not consistently due to a gastrointestinal condition. Supragastric belching is often intentional or habitual, and behavioral therapy can be successful, according to the review in "The American Journal of Gastroenterology." Belching can also be related to your sleep apnea machine, and working with your medical team to adjust the pressure, settings or fit of your continuous positive airway pressure (CPAP) machine can help. Infrequently, excessive belching is related to serious medical conditions, such as heart or lung disease. See your doctor for an evaluation and treatment plan if the belching is persistent, excessive or associated with discomfort or pain.

Reviewed by Kay Peck, MPH RD

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