FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

LESS "GULPING" OF AIR MIGHT LESSEN READER'S BELCHING PROBLEM

Question: Please tell me what I can do to stop burping. I'm drinking water like it is going out of style, but it only gives very temporary relief. I burp so much that it disturbs my sleep. Help!

Answer: Everyone burps occasionally, but what you describe is certainly more than normal. Burps are the result of gas building up in the stomach and upper digestive tract, because these are the areas from which it can be expelled through the mouth instead of passing it as flatulence.

Before I continue, let's pause for a short vocabulary lesson. In common usage, burps are the expulsion of a small amount of gas from the mouth -- like burping a baby. Belching is a louder sound produced by the forceful expulsion of a larger amount of gas. As an example, pre-adolescent boys purposely do this because they have recently discovered how to and also because it annoys their parents. Eructation is the medical term that describes either. In reality, these three terms can be used interchangeably.

Eructation (I'm a doctor, remember) can be produced from chemical reactions that occur in the stomach -- principally a reaction of bicarbonate with stomach acid. When you were a kid, didn't you put baking soda and vinegar into a bottle and quickly put a cork in the top only to have it forcefully blown out by the resulting gas pressure? If not, you may have made a model volcano that you caused to erupt by this same mechanism. Regardless of your childhood chemistry experiments, a similar reaction within the stomach produces gas that distends the stomach. Burping relieves the resulting pressure.

Another common cause of burping is the consumption of carbonated drinks. The "fizz" that makes these beverages more interesting than ones that have been open so long that they have become "flat" is caused by dissolved carbon dioxide gas. When the beverage is removed from its bottle, can or keg, the extra carbon dioxide begins to escape, thereby causing the "fizz." When you drink one of these "fizzing" beverages, some of this dissolved gas remains in the drink long enough to reach the stomach. There it is released. This volume of CO2 can be large enough to cause burping. Have you been drinking carbonated drinks along with the water you reported?

Some of the gas that is within the stomach is normally passed on down the digestive tract. Problems that prevent or delay this from happening often cause burping. This could include certain stomach problems and blockage in the duodenum -- the first part of the intestines just below the stomach.

The most common cause of burping, however, is due to swallowing air while eating or drinking. We all take in a small amount of air with each bit of food, drink or saliva we swallow. Anxiety, poorly fitting dentures, and eating rapidly can increase the amount of air consumed with each swallow. This larger volume of air creates a hefty bubble within the stomach. The resulting pressure can be sufficient to become uncomfortable. The only way to have quick relief is to burp. Perhaps this is what is causing your burping.

The treatment for frequent burping starts with a careful evaluation of the things you consume. Are you drinking carbonated beverages or consuming foods with excessive baking soda in them? If so, eliminating these may stop your burping problem. More likely, however, is that your "drinking water like it is going out of style" is the underlying cause. You are swallowing enough air with each swallow of water to recreate the stomach bubble you just relieved with your last burp. Try to drink your water more slowly instead of "gulping it down." This way you should swallowing less air. 

Try these simple things. You should see your doctor if your burping persists.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.