Eructation
Belching, Burping
Eructation, commonly known as belching or burping, is a natural way your body releases excess air from your digestive system through your mouth. While everyone experiences this occasionally, sometimes it becomes frequent enough to interfere with daily life and may signal an underlying health concern.
Table of contents
- What is Eructation?
- How Often is Normal?
- What Causes Eructation?
- Types of Belching
- When to See a Doctor
- How to Reduce Eructation
- Treatment Options
What is Eructation?
Eructation is the medical term for belching or burping. It describes the audible release of air from your stomach or esophagus (the tube that connects your throat to your stomach) through your mouth[1][2]. This is your body’s natural way of getting rid of air that has built up in your upper digestive tract.
When you swallow food or drinks, you also swallow small amounts of air. Each time you swallow, between 8 and 32 milliliters of air enters your stomach[3]. Your body needs a way to release this trapped air to prevent your stomach from becoming too stretched and uncomfortable.
The process works through a natural reflex. When your stomach becomes distended with too much air, this triggers relaxation of the lower esophageal sphincter (a muscle at the bottom of your esophagus)[3]. The air then moves up through your esophagus and exits through your mouth as a burp.
How Often is Normal?
Belching is part of everyday life and happens to everyone. Most people pass gas through their mouth 13 to 21 times a day[2]. Normal belching might happen between 10 and 20 times per day, and can occur up to 30 times daily[3][5]. These numbers represent typical, healthy belching that doesn’t cause problems.
However, belching can only be considered a disorder when the symptoms become frequent and distressing, particularly in social situations[3]. If belching happens so often that it significantly lowers your quality of life or interferes with your daily activities, this may indicate a problem that deserves medical attention[5][8].
What Causes Eructation?
The most common cause of excessive belching is swallowing too much air. This air most often never even reaches the stomach but instead builds up in the esophagus[1]. Several everyday habits and activities can lead you to swallow excess air.
You may swallow more air than usual if you eat or drink too quickly, talk while eating, chew gum, suck on hard candies, drink carbonated beverages, or smoke[1][8]. Some people swallow air as a nervous habit even when they’re not eating or drinking[1]. Wearing poorly fitting dentures can also cause you to swallow excess air when you eat and drink[1].
Certain health conditions can also contribute to excessive belching. Acid reflux or gastroesophageal reflux disease (GERD) can sometimes cause excessive belching by promoting increased swallowing[1][8]. Belching may also be related to inflammation of the stomach lining or to an infection with Helicobacter pylori, the bacterium responsible for some stomach ulcers[1]. In these cases, the belching is accompanied by other symptoms such as heartburn or stomach pain.
Other medical conditions that may cause belching include functional dyspepsia (a type of chronic indigestion), gastroparesis (a condition where stomach wall muscles move slowly), gastritis (inflammation of the stomach lining), peptic ulcers, lactose intolerance, and small intestinal bacterial overgrowth (SIBO)[8].
Stress and anxiety can also contribute to belching. When you’re anxious, your body can produce more stomach acid, and anxiety may cause you to swallow more air[12]. People with anxiety, obsessive compulsive disorder, or eating disorders may have excessive belching[5].
Types of Belching
Medical experts have identified two main types of excessive belching, which have different causes and characteristics[3][5].
Gastric belching is usually normal and involuntary. These belches result from air that has actually entered the stomach and is then expelled. When your stomach becomes distended with swallowed air, this triggers a reflex that allows air to move back up through a relaxed sphincter and be expelled through your mouth[3]. Normal gastric belches can occur up to 30 times a day[3].
Supragastric belching happens when air is involuntarily drawn into the esophagus and then expelled as a belch, without the air ever entering the stomach[5][3]. The cause of supragastric belching is not fully understood, but it is considered a disorder of the gut-brain interaction (DGBI)[5]. This means it results from faulty nerve communications between the gut and the brain. Supragastric belching is an unconscious learned behavior that can develop to self-treat symptoms of abdominal discomfort, indigestion, or bloating[5].
For people with supragastric belching, symptom episodes can happen often, with belching occurring in a repetitive way. These episodes are not related to eating and drinking. Symptoms are typically worse after meals and during times of stress, but less frequent when the person is talking or distracted[3][5].
Up to 1 in 100 people are thought to have belching disorders, though more research is needed to better determine this figure. Belching disorders are diagnosed more often in those designated male at birth and in young people[5].
When to See a Doctor
While occasional belching is normal and nothing to worry about, you should see your doctor if belching becomes excessive or painful, or if it interferes with your daily activities[1][8]. Persistent belching and burping could indicate underlying digestive system disorders that need medical attention.
You should discuss certain warning symptoms with your doctor. These include unintentional weight loss, low levels of iron in the blood, difficulty swallowing, loss of appetite, vomiting, bloody stools, or fever[5][8]. If belching is accompanied by other symptoms such as heartburn, stomach pain, or nausea, this may indicate a condition that requires treatment[1].
If your symptoms have been present for at least 6 months, happen more than three times a week, and are intrusive enough to affect your quality of life, you may have a belching disorder that would benefit from medical evaluation[5].
How to Reduce Eructation
You can reduce belching by making simple changes to your eating and drinking habits. Since most belching is caused by swallowing excess air, focusing on these behaviors can make a significant difference.
Eating and drinking slowly can help you swallow less air. Taking your time and making meals relaxed occasions is important, as eating when you’re stressed or on the run increases the air you swallow[1]. Try to avoid talking while you eat, as this can cause you to swallow more air[8].
Avoid carbonated drinks and beer, as they release carbon dioxide gas that can cause belching[1][8]. Skip chewing gum and hard candy, as these cause you to swallow more often than normal, and part of what you’re swallowing is air[1]. Don’t use straws when drinking beverages, as this can increase air swallowing.
If you smoke, stopping can help reduce belching. When you inhale smoke, you also inhale and swallow air[1]. If you wear dentures, have them checked to ensure they fit properly, as poorly fitting dentures can cause you to swallow excess air when you eat and drink[1].
Light physical activity after eating may help. Taking a short walk after a meal can assist with digestion and may reduce belching[1][11].
Managing stress through relaxation techniques like deep breathing or mindfulness may help reduce symptoms, especially if anxiety contributes to your belching[12].
Treatment Options
Treatment for excessive belching depends on the underlying cause. Belching is a natural process that typically doesn’t require treatment, but if you have excessive belching that doesn’t improve with lifestyle changes, your doctor can help determine if you have an underlying health condition[8].
For heartburn or acid reflux, over-the-counter antacids or other remedies may be helpful for occasional, mild symptoms. GERD may require prescription-strength medicine or other treatments[1]. Taking an antacid can help neutralize stomach acid and prevent heartburn, which can cause burping[11].
Anti-gas medications like simethicone (found in products such as Gas-X) may help. These work by binding gas bubbles together so you have more productive burps[11]. However, some studies suggest these products haven’t been proven to be helpful, though many people feel they work[1].
For supragastric belching, which is an unconscious learned behavior, simple reassurance and explanation of the symptom’s origin can sometimes be enough to help symptoms settle[3]. Psychological training can help break this habit[5]. Depending on the cause, treatment may include speech therapy, breathing exercises, and certain medicines[5].
Your healthcare provider may recommend dietary changes, such as avoiding certain foods and drinks that worsen symptoms. This might include carbonated beverages, foods high in carbohydrates, milk and other dairy foods (especially if you have lactose intolerance), or following a low FODMAP diet[8]. However, highly restrictive diets should only be used when medically appropriate.
Some natural remedies may provide relief, though evidence varies. Drinking ginger tea after eating may help relieve gastrointestinal irritation and prevent stomach acid from flowing back up the esophagus[11]. Some people find that chamomile tea helps prevent acid reflux[11].