constant air in the stomach unable to belch

[djtrackie]

Hello, i am a 22 year old asian male.  5'10"  160lbs.  

Within the last year or so, ive been having trouble burping.  Many times (at least several times a week) I would feel a lot of air in my stomach - mostly after eating or drinking soda or whatever.  It was okay for a while, but I didn't think it was normal for me to produce that much gas in my stomach and for me to be unable to burp.  I would feel a lot of pressure in my stomach and pressure in my throat indicating a need to belch, but would be unable to do so.  It wasn't painful, but terribly unconfortable.  

I saw my doctor and she attributed it to too much acid in my stomach.  She said I was eating on time and that my stomach was producing acid and when food hit my stomach, gas would be produced and that's what would happen.  So she prescribed zantac 150mg and I took it for a couple of days.

Well, my symptoms have NOT improved - so i stopped taking zantac.  I take 150mg of zantac at day and night before meals.  No apparent change.  I stopped taking zantac for a couple of days and right now my symptoms are WORSE.

Lately, within the last week or so.. i have CONSTANT air in my stomach.  I go to school at 11:20am so I wake up at 10:30am to go to class.  By the time it is 12:30 or so (I haven't eaten by that time) I would start getting gas in my stomach.  And would feel a need to burp.  The gas will contiinue to build in my stomach until i am extremely uncomfortable, finally it will force it's way out my throat.  (not a real burp, more like a sudden let out of air).

This will continue throughout the day (ALL DAY long)... more and more gas builds up.  I feel gas and pressure in my stomach and throat as we speak.  There is no way i can voluntarily let out the air, and sometimes I feel as if i have to vomit.  Sometimes i actually cough like i'm about to vomit but nothing comes up except a loud cough.  

I called my doctor again and she presribed reglan.  I took it last night and instead of helping me, it made me extremely lethargic.  I slept like 16 hours yesterday (naps including).  I didn't want to take it again today because i have things to do.  

I find myself taking GAS-X (simethicone) and it helps a tiny bit.  It makes it slightly easier belch, but this doesn't address the problem!

I haven't been drinking any soda lately and I consider my diet to be fairly normal.  Today I had chicken and pasta for lunch, a smoothie as a snack, and steak and eggs for dinner.  I usually eat 4 meals a day.

Please help me, because this is seriously affecting my quality of life.

[Kevin Pho, MD]

There can be many reasons for increased gas in the stomach.  This can include the various causes of dyspepsia - such as ulcers, inflammation of the upper digestive tract, or GERD.  

Irritable bowel syndrome can given an increased sensation of gas.  So can various types of malabsorption syndromes.

You can work this up with an upper GI series or upper endoscopy - which can evaluate for the various causes of dyspepsia.  

More specialized testing can include blood tests for celiac disease - which can lead to increased gas.  

If the tests remain negative, you can consider treating irritable bowel syndrome with various types of antispasmodic agents.

These options can be discussed with your personal physician, or in conjunction with a GI evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[yoshi]

have you tried chewing gum,your own salive contains bicarbonate,it will neutralise the gas in your stomach?
drinking a glass of water with half a teaspoon of baking soda will do the same,but it has a lot of sodium.
extra strength GAS-X is more effective than just plain regular Gas-x.
Have you been checked for hector pylori bacteria,your doc can give you a breath test in his office .
stay away from soda,caffeine,grease,spice,peppermint,chocolate ,dairy products,tomato and tomato sauce.
you should also make appointment with a gastro doc if your symptoms do not go away.

[yoshi]

eating red delicious apple helps,try it.

[djtrackie]

can anyone tell me what an "upper gi series" is?  And regarding the upper endoscopy, has anyone had this done?  what is it like?

[Emalyn]

Upper endoscopy they go in through the mouth while you're on a sedatitive, pain killer and amnesiatic combo.  You won't remember much, although you might have a sensation of "waking up" while it's going on (although you're actually awake the whole time).  They'll have you lie on your stomach with your head to one side.  They'll hit you with the drugs and once you're "out" they'll put a tube in your mouth and down your throat.  There's a variety of things they can do during an endoscopy - they can do a lithotripsy (deep sound waves to break up something like gall stones) small surgeries, biopsies, etc.

When you wake up you'll have a sore throat fit to beat the band, but sucking on ice will help.  It'll fade in a day or so.

[Buf Montana]

I have a hiatal hernia and I have similar symptoms. I have a hard time belching and I get very bloated and uncomfortable. Gas-X only helps a little bit. You might want to consider having an endoscopy(camera down the throat)to see what's going on down there. It's not a bad test. They give you some good drugs and it's over before you know it.

[djtrackie]

I went to a GI doc today and an upper endoscopy is scheduled in two weeks.  I'm a little bit scared.

I will update when the results come in.  (2 - 3) weeks from now

thanks everybody for your advice.

[Kees]

I recognize a terrible lot in the accurate description of the building up of gas during the day and the feeling in your throat.

I started 7 years ago (within days after an extreme hard push on my abdomen during a massage) with this vague uncomfortable, pulling-like sensations in my throat from approx. ½ hour after meals for 2 or sometimes 3 hours. Prepulsid given by GP worsened sensations. Had soon gastroscopy: negative (only moderate amount of bile in stomach was mentioned). After approx. 9 months excessive belching started, but still same uncomfortable sensation in throat till today. All sorts of tests have been done over the years (Endoscopy, Gastric Emptying Test, Breath test for bacterial overgrowth of small intestine, Barium swallows for esophagus, etc.). All negative. Recently had DS-surgery because I had excessive amount of bile in stomach, and was thought that could explain symptoms. But this surgery worsened my symptoms. So bile in stomach definitely not the cause with me, but other (underlying) cause. Now, after surgery I hear gas going up from intestine (first thought that it came only from stomach), immediately followed by burp from stomach. So in my case gas seems to come from small intestine (‘wrong direction’, of course; should go down). Only now have definitely bloating sensation in lower abdomen especially when I gently touch it. Wasn't aware of that so much before. Belching now more and with all kind of everyday activities where abdominal muscles are used. Terrible.

In my case GEs often blamed the excessive belching on air swallowing, without proof and sometimes against my observations (type of food dependent etc.) which make it implausible or even impossible. Very frustrating and painful. It feels not being taken serious and respected. It concerns disabling symptoms, and poor quality of life. Anti-depressiva (first 30 mg later 60 mg) Remeron helped definitely a bit in my case; it is ‘anti-emetic’. Also Acupuncture by a MD, who worked on points for duodenum. And eating relatively less carbohydrates especially sugar helped for some reason.

I think there is relatively little research done on gas, bloating, and belching. But I have found some (almost all quite recent) medical articles on gas dynamics with patients with bloating symptoms. Turns out they often have retention of gas in the small bowel, and possibly reflux from gas in stomach. It is suggested that handling of normal amounts of gas is impaired in these patients. But this is scientific research, not yet everyday practice. No causes and cures yet. I’m convinced that in my case the cause lies in that direction; of course after all other more ‘common’ (classical) causes have been excluded.

Could be useful to share experiences and all different tests over the years, even when this thread closes. My email address is tj.***@****.

[cburnap]

Hi, I just came across your post and had to comment.  I am a 5'10" woman age 34 and have been having symptoms very similar to the ones you have described.  It has been about 5 years now and the gas problem seems to be slowly worsening for me.  For the first two years I saw alternative doctors (homeopathic, chinese herbalist, acupuncture, etc...) but had no luck.  I also worked with a nutritionist for a year eliminating foods and buying every supplement ever made-it seems.  The last 3 years I have been seeing MD/specialists and had every test they have to offer done with no results (I would list them all, but it would take too long).  The last specialist I saw-at a University said that they cannot offer me any more help-I have exhausted their tests/perscriptions, etc...He suggested tyrying alternative therapies-again.  
Basically the symptom is gas in my stomach (at least that's what it feels like).  I notice it can worsen sometimes with more fibrous food, but that is the only pattern.  Most days (on a scale of 1-10) it is about a "4-5", but several times a month it is about a "9".  It will usually flare up around 4:00pm and then the only thing that can help a little is to lie on my left side slightly "proped up" and then a little bit of gas will come up-but not much.  
I have found that people don't really get how uncomfortable this can be-I don't know what to do next, but can't give up.  My email address is ***@****
if anyone is interested in discussing this.

[Suziepie20]

Gluten

[DanDanger]

Same has been happening to me 21/m. Have had several blood tests, with nothing big coming back. Dr. said it could be ulcer, but I dont know.
Stomach keeps filling up with gas and i belch it up. I have had it for a week, my sympoms were different before. was taking previcid, and over the counter malox. Is worse some days, antidepressants seem to help a
little, along with fresh lemon juice delutted a little.what are symptoms of celic?Anything you can help me with would be apreciatted alot? thank u for what I already read.
Email me at ***@****

[DanDanger]

take a look at this site, if you are like me, I have nothing to lose. I have tried prescriptions and antiacids. When I took the DGL it worked good. Better than anti-acids. It is the only one I have tried, but I will have the rest today. I will post my results in 5 days to a week.DanDanger
http://www.treelight.com/health/healing/Indigestion.html

[Kees]

In my case for 7 years I’m burping, type of food dependent (carbs and fats worse than veggies and proteins). From what I observed I thought that the gas came from the stomach, After intestinal surgery I had (March 2005), the very same symptoms aggravated; and I actually heard ‘up going sounds of gas’ from my intestine, immediately followed by a burp. More prominent a sensitive (lower) abdominal area (bloating); gentle pushing around the navel would generate an involuntary burp. But also all kind of daily activities, where abdominal muscles are involved (changing a light bulb, bending forward, lifting etc.), would generate involuntary burps. And the smell of some foods (like salmon) up to 5 almost 6 hours after a meal… So after 7 years it turned out the gas comes from the intestine in my case!

I think the MD in this forum rightly suggests that - after all ‘common’ causes have been excluded and available tests are negative - irritable bowel syndrome (IBS) can be considered. IBS is a functional bowel disorder. For those of you for which, after all other possible causes are excluded, this diagnosis of IBS or functional bowel disorder could apply… Read the following! Until very recently I didn’t know that the handling of intestinal gas could be impaired and thus (why not?) could lead to excessive burping! Retention and possibly backflow of intestinal gas has been investigated in patients which are diagnosed with IBS or Bloating.

Functional bowel disorders are classified, according to the Rome II diagnostic criteria (see http://www.romecriteria.org/documents/GUTII/ibs997.pdf): “Few studies adequately separate bloating from IBS and other functional disorders (…)” It is worthwhile reading this document! In my case: I didn’t and don’t have any stool changes or problems at all. So for me, strictly speaking, IBS would not apply. Perhaps Functional Abdominal Bloating (which also mentions belching as possible symptom) is the appropriate diagnosis?

Two good sources of information, in my view, respectively on IBS and on Intestinal Gas:
1. Booklet on IBS by GESA (Gastroenterological Society of Australia). Quotation:
“Other functional gut symptoms are more common in IBS sufferers than the general population. These include heartburn, dyspepsia, globus, nausea and excessive belching.” (http://www.gesa.org.au/members_booklets/ibs/IBSGUIDELINES.pdf).
2. Article on Intestinal Gas - Belching, Bloating, Flatulence. (http://www.medicinenet.com/intestinal_gas_belching_bloating_flatulence/article.htm)

What is known about intestinal gas and related symptoms, where all other possible causes have been excluded? There is relatively little research done on gas, bloating, and belching in those patients. BUT THE HANDLING OF INTESTINAL GAS (the ‘gas dynamics’) CAN BE IMPAIRED IN THESE PATIENTS. Authors of University Hospital Vall d’Hebron (Barcelona, Spain) have published a lot on ‘gas’ and ‘gas dynamics’ over the years. Some relevant articles:

‘Intestinal Gas Dynamics and Tolerance in Humans’ (1998)
J Serra, F Azpiroz, J-R Malagelada
Gastroenterology, 1998;115:542-550
(free abstract: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=9721151&dopt=Abstract)
Intestinal gas is partly swallowed and in part originates from a series of chemical reactions of the foodstuffs within the gut. Most gases diffuse easily across the intestinal blood barrier, the resulting intestinal gas load is then transported and evacuated per anus. The small intestine does not contain much gas, because normally it passes through very rapidly to the colon. In some clinical conditions abdominal complaints (such as bloating, borborygmi, cramps, and sometimes distention) are attributable to altered dynamics of intestinal gas. However, in most cases it remains uncertain whether the symptoms are due to a gas overload, an impaired intestinal handling of gas, or a poor tolerance and increased perception. This study showed that intestinal gas handling in healthy subjects is a dynamic and efficient process. Intestinal gas tolerance is normally high, because expeditious gas transit and evacuation prevent gas pooling and symptoms. When this protective mechanism fails or is overcome, abdominal symptoms, predominantly bloating, and distention may develop.

‘Intestinal gas distribution determines abdominal symptoms’ (2003)
H Harder, J Serra, F Azpiroz, MC Passos, S Aguadé, J-R Malagelada
(free download: http://gut.bmjjournals.com/cgi/content/abstract/52/12/1708)
Quotation from this study: “Our data (…) explain gas related symptoms in patients with functional gut disorders. Abnormal gas transit and possible gas backflow in these patients may result in altered distribution of intestinal gas and symptoms …”

‘Origin of Gas Retention and Symptoms in Patients With Bloating’ (2005)
B Salvioli, J Serra, F Azpiroz, C Lorenzo, S Aguadé, J Castell, J-R Malagelada
Gastroenterology, 2005 Mar;128(3):574-9
(free abstract: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15765392&dopt=Abstract)
Patients reporting abdominal bloating exhibit impaired tolerance to intestinal gas loads. The aim of this study was to identify the gut compartment responsible for gas retention. In 30 patients predominantly reporting abdominal bloating (24 with irritable bowel syndrome and 6 with functional bloating) and 22 healthy subjects, gas was infused into the intestine for 2 hours while measuring rectal gas outflow. Conclusion: In patients reporting bloating, the small bowel is the gut region responsible for ineffective gas propulsion. In the upper gut, large quantities of gas are physiologically generated from chemical reactions. CO2 is produced when acid is neutralized by bicarbonate in pancreatic, biliary, or duodenal secretions. A meal could generate approx. 1½ liter CO2 per hour. Given its high diffusibility, most CO2 generated during normal digestion is absorbed along the small bowel, but still may theoretically overflow an incompetent intestine and become symptomatic. It is suggested in this study that the handling of normal, physiological loads of gas is impaired in these patients and leads to symptoms.

‘The role of intestinal gas in functional abdominal pain’ (1975)
RB Lasser, JH Bond, MD Levitt
The New England Journal of Medicine, September 11, 1975;293:524-6
(free abstract: http://content.nejm.org/cgi/content/abstract/293/11/524)
This study showed among other things, that more gas (infused in the small bowel) tended to reflux back into the stomach in patients (with complaints of excessive gas, abdominal pain and bloating) than in healthy individuals. But fasting patients didn’t have more gas in the intestinal tract than fasting controls. The authors suggested that complaints of bloating, pain and gas may result from disordered intestinal motility in combination with an abnormal pain response to gut distention rather than from increased volumes of gas.

In my case I have encountered in the Netherlands so much sceptical Gastro MDs, who would diagnose it as aerophagia. Probably because the belching and globus sensation were main symptoms and more prominent than the (lower) abdominal symptom of bloating. Can we, people with excessive belching in this and other threads, in some way ‘get to together’? I don’t exactly know how; but all these individuals, suffering this disabling condition… Any suggestions or reactions to tj.***@****.

[Carimari]

For some of you who have this condition of not being able to burp, they may be some relief, at least partially.  In my case it started about 10 years ago, and it happened right after I started to use an inhaler for asthma, and the feeling was so overwhelming that I thought I was having an asthma attack, but I guess I was just hyperventilating with the anxiety of the pressure I was feeling in my chest.  At that time I increased my intake of supplements, vitamins, and minerals that I was taking for the asthma, and the condition went eventually away.

Then, about six years ago, it came back again, kind of by surprise that I called 911 thinking that I was having a heart attack.  By this time, I had stopped taking most of the vitamins and minerals that I had been taking, so I went back to the regime, and I was able to live a normal life, eating frequently at restaurants, and only with an occasional gas problem.  But later, because I started to have some side effects that I attributed to the vitamins and supplements, I gradually stopped taking them.

Then again it hit me with full force in April of last year.  This time it was the worse case that I had experienced.  Before I was at least able to eat eggs and meats, but this time I had trouble even with those foods.  I was afraid to weigh myself because I was never fat, but I must have lost about 25 lbs.  Naturally, I went back to my vitamins an supplements regime, but also found some interesting information on the Internet about hypochloridia.  This is supposed to be a condition where there is a lack or not enough hydrochloric acid in the stomach, and the symptoms seemed to coincide with mine.  I started to take some hydrochloric acid in tablets plus some of the vitamins again, and I was doing fairly okay till last month, when I started to have some side effects from some of the supplements, so I stopped taking most of them, and now I almost went back to square one.  It seems that since most of the tablets and capsules I was taking have some extra ingredients in them, they were causing me to have some allergic reaction (my luck!)

Chapter IV -  I went back to the vitamins, especially the B complex since the B6 is supposed to produce the hydrochloric acid, and instead of the hydrochloric (HCL) tablets, I am taking instead apple cider vinegar.  Ah! before I forget, I am also drinking anise tea after each meal, and this is very good for burping.  I never thought that I would thank God for every burp, but those of us who have been through it, know what I mean.  Also, I have a book that has helped me a lot, and if any fellow-unburper wants more information and support you can e-mail me at ***@****.  

[Kees]

Together with some other person (NotGivingUpNever) who posted on 'burping' (perhaps it's already in the Archives now), we would like to 'join hands' and get people with belching and other gas related problems together (experiences, resources, identifying the problem, solutions etc.) We have created a website www.gaspatients.org. It's only a draft version now, but shortly we hope to improve it.

Good luck to all