constant belching...gerd causing aerophagia?

[wassupwassabi]

In early March, I started to get really nauseous after eating food.  Then about 2 weeks later, in addition to the nausea, I started producing gurgling-sounding belches which I feel in my chest and throat.  This belching would occur for hours after I ate anything.  I would "belch" every few seconds and it continued for several days, at which point I went to see a doctor.  The doc thought it was due to GERD (even though I hadn't had frequent heartburn) and gave me prilosec.  After using it for 2 weeks, my symptoms hadn't improved, so I had blood tests and stool tests done; the blood tests showed elevated bilirubin but otherwise normal (doc thought it was Gilbert's), and stool was normal.  Then I got referred to a gastroenterologist.  Took Aciphex for 2 weeks, also with no effect on the belching.  I also began to feel pain in my chest a lot and felt some difficulty breathing.  
I had an upper GI done then and it showed no stricture or hiatal hernia, but showed moderate reflux.  
Then he put me on Reglan (5 mg doses) and I got off Aciphex.  Reglan originally helped a bit but got less effective.  After about 2 weeks, the belches started to cause a burning in my throat.  In addition, Reglan caused very painful dry mouth so I stopped using it.
In early May, I went home to see my family doctor.  Then, I got on Protonix and reduced Reglan to 2x/day at most.  Like with Prilosec and Aciphex, I didn't have any heartburn but I still had constant belching, nausea, and feeling of chest tightness.  I don't think the chest tightness is a cardiac problem; I'm 21 years old, non-smoker, 150 lb, plus I had an EKG (normal).  I went to see another GI doc and had several more tests done:

Endoscopy - showed mild inflammation around lower esophagus and in stomach, biopsies were negative.  I'm surprised there was any inflammation because I didn't have any heartburn.
Stomach emptying scan - 86 minute halftime (doc said under 90 min was normal)
Chest x-ray and CT scan of chest and upper abdomen - normal
Esophageal manometry (results aren't in yet)

The belching/chest tightness now occurs all the time.  I belch well over 1000 times a day, even though I eat very little.  The only way to make it stop is to lie down.  The specialist said that since PPIs and Reglan haven't done very much I should consider having stomach surgery to fix it.  I went to get a second opinion and the doc noticed that a large amount of air was going through my esophagus when I breathe (not swallowing!), he said that's the only way I could be belching to such an extent.  Belching doesn't stop even when I breathe through my nose or clench a pencil between my teeth, techniques to control aerophagia.  I'm literally inhaling air into my stomach when I breathe and constantly belching it and I don't know how!  So frustrating!  Why? Does this mean both sphincters are busted?  Would a fundoplication help or would I likely have gas-bloat?  And would stretta or enteryx be effective/safer to try? Advice?

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation for your symptoms.  The other test I would consider would be a 24-hr pH study to document the severity of the reflux.  If there continues to be reflux despite appropriate medications, then surgery can be pursued stronger.  Regarding the stretta or enteryx procedure, that would be dependent on the severity of the reflux as well as the skill of your physician.  The data regarding these procedures are still emerging, and the long-term efficacy has not yet been established.

Another consideration would be irritable bowel syndrome - which can cause the sensation of increased bloating.  If the 24-hr pH study is non-revealing, you can consider optimizing treatment for IBS - such as antispasmodic agents.

These considerations can be discussed with your personal physician.

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

[Inanga]

i had a fundiplication for gerd and had gas bloating for a couple of years - was painful for a couple of months - gas working it's was DOWN and out. Eventuially the LES slackened up enoughto allow belching UP - a great relief. I had to learnt to chew very throuroughly and try not to swallow gas - but things are back to normal now. I would be sure to check out all the risks and side effects of the op before going ahead.

[versute]

So sorry to hear of your problems.  I think I can only be empathetic towards you, regarding the lack of the medical professionals to diagnose, and therefore be able to treat you.  

Six weeks ago, I myself have been experiencing trouble in my GI, starting in my throat, where I found it difficult to breath, like I would choke if I tried to eat anything.  I went to an internal medicine MD and he asked me what I went to him for, and have I seen a GI?  He didn't understand anything about not being able to swallow, and difficulty breathing.  All he did was accuse me of being confusing and not telling him what was the matter.

I had an endoscopy as well, which showed nothing.  Still, I couldn't eat.  So I continued losing more weight.  Everything else was fine-blood pressure/pulse, because I am ordinarily a strong, healthy person.  I dropped 30lbs in 1.5 months.  I was only 160lbs before, so I lost 30lbs of valuable, healthy muscle/body weight.  

Another GI looked at my tests and said, "The tests show nothing abnormal, so what's the matter?"  What a jerk!  That's why I am paying him $400, and I only got 4 minutes with him, before he just said I need more tests.

Now I'm having abdominal pain, yellowing of hands, tingling, which is coming from my losing weight, and not from the original problem.

So, now I have these other issues that have resulted from where  the doctors couldn't find original problem.

Modern medicine, even with all it's advancements, is still run by imperfect, not omniscient people, who most of the time can only treat what they see, and are poor investigators.

I'm just sitting here waiting for a gallbladder attack, or something worse, so the ambulance can get me in the hospital and someone will take seriously what I have been trying to tell them-that something isn't right in me!  

Good luck and God bless you.

[yoshi]

have you been tested for hector pylori bacteria??
you can get a simple breath test in doc office these days.
symptoms for too much acid and too little acid are similar,one happens right after you eat(not enough) and one happens 2 hours after you eat.

[wassupwassabi]

I'm pretty sure that the endoscopy biopsy checked for H pylori, which came up negative.  I haven't done a breath test, but I have tried health foods such as P73 oregano which are effective against many infections including h pylori.

[yoshi]

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[yoshi]

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[gasburger]

All I can say is that whoever commented how they can't get an answer could have been me.  I'm in the same bloat.  Extensive bloating, gas, belching has been going on for years and no-one has been able to get to the bottom of it.  I've had gallbladder removed and things are no better or no worse than before I had it removed.

[djtrackie]

You guys find the problem yet?  Because i think i have the same thing... i'm also aroudn the same age as you (22)

[raul1]

My belching started suddenly two years ago.  I am 52.  I have always been extremely fit, running from 40 to 60 miles per week and participating in ultramarathons regularly.  I tried avoiding food allergies, adding enzymes and hcl, changing eating and drinking habits, herbal remedies with little and only temporary relief.  My stomach is almost permantently distended now by gas, which is only relieved by fasting for 24 hours.  It frequently interferes with my running.  After hours of belching after dinner, I sleep normally only to awaken with more massive belching, and a residual feeling of bloated stomach.  If I skip breakfast and lunch, by afternoon the bloating is gone and my stomach is nearly as flat as it was in my late forties. I am sick and tired of hearing about "swallowing air".  I did not suddenly start swallowing air 2 years ago.  Nor did I change my diet.  Nor did I change my lifestyle.  I have never had heartburn or reflux or any sort of pain other than that caused by distension due to gas.  I have never had any surgeries or illness other than a cold every couple of years or so.   I am desperate to regain my normal feeling of health.  Please help.

[kimo78]

I am 36 years old and have been experiencing the bloating, constant belching and (seldom) nausea, for about six years now.  I do not know what it can acutally and truly be attributed to.  It does appear that it occurs when I eat certain types of food or the pace in which I eat.  However, it does occur intermittently with bland or plain food as well.  I got checked out and did a couple of procedures to see what was causing this but never received a straight answer.  It more or less ruled out certain illnesses but did not help my situation.  Tell me more as I am looking for feedback.

[Kees]

Hi to all

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. ˝ 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, relieved by belching. 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 experience the same symptoms more strongly and 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, more awareness in the throat (very uncomfortable). Pushing gas out (around navel and lower) induces belching-reflex with me. Belching now even 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.

As we seem to have a common problem, it could be very useful to see whether this is in fact the case. I thought I was the only one  and didn't know how to get in touch with others (saw closed threads before, so could not get in touch). Perhaps compare tests done, share experiences and so look more precisely whether we could have the same cause. I don't want to give all details here and it's a long story. My email address is tj.***@****.

[wassupwassabi]

Well, this post seems to be pretty popular... I just thought I'd update.  One of the docs I've seen put me on Zelnorm... it's more effective than Reglan for controlling the belching, but it apparently doesn't do much for the aerophagia as I still belch some and get more bloated.  I've tried acupuncture treatments as well but that hasn't really done much.

Since I seem to have stumped the medical field I contacted a "medical intuitive" who said that my problem is exacerbated by part of my thoracic spine being out of place which is pinching/disrupting nerve flow... she recommended seeing a chiropractor and this might help my problem.  I haven't tried it yet but I plan to... I just thought I'd post this for everyone who is struggling with this problem because it might be worth a look... if you go on chiropractic information websites you'll find that spine misalignments can cause digestive problems like heartburn and dyspepsia (maybe has something to do with reduced nerve flow causing the lower sphincter to weaken?)

[Kees]

As you're puzzled by the way aerophagia, some of my thoughts on that. I know little to nothing about how about HH or GERD indirectly or directly causes belching, so I have to be very modest and careful on that.

But apart from these in some patients being the cause of their belching, I'm rather skeptical about the fact that many people are diagnozed with aerophagia as the cause. Just read the threads on belching in this forum... Recent research showed that patients with bloating symptoms often have retention of gas in the small bowel, and even possibly reflux from gas in stomach. So, personally I think this could in many people be a cause of gas related symptoms.

I also have this chest tightness, increasingly after meals. When I inhale very deeply through my nose, it induces a belch, yes. Obviously I'm not literally swallowing air then, but there's a theory that while inhaling, air is sucked into the esophagus and into the stomach and is expelled immediately as a belch again. If I breathe in the same way many times after another, at some point there's usually no more belches coming... So, why suddenly no more? And there's relief of chest tightness/discomfort. For me I'm sure that this theory doesn't apply in my case.

In my case at some point it became very clear the belching was type of food dependent (carbohydrates and fats worse than veggies and proteines). I did a diet for a week and the belching was significantly less. This strengtened me in that it is not aerophagia.

Sometimes an up going movement of the larynx just before a belch is said to be an act of air swallowing. But each belch reflex is preceded by a rising of the larynx. That's part of the reflex because it makes the way clear for the up going content. Look in the mirror or put one hand on the larynx, and observe on what exactly happens in the here-and-now, without influencing... Then you'll observe it's a reflex and no strange maneuver or act of swallowing. The larynx goes up with swallowing, but also with belching, vomiting etc. (a cow is an animal, but not all animals are cows). Moreover, a swallow is much less ml than a burp.

I experience involuntary burps induced by many daily movements of my body or reflexes (bending forward, lifting my arms above my head, after coughing, after sneezing, pushing on my navel area etc.). By that I found out it has to be something with my abdomenal (abdominal) area. So no air swallowing or strange maneuvers that cause the belching, just involuntary reflexes in my case...

I hope this can help you in getting more clearity where the cause of your belching lies.

[bizzy]

This was certainly an interesting site to come across.  I have been dealing with the same excessive belching issue on and off for the past  6 years or so.  I have episodes 2-3 times a year that last 1-3 months. The most recent has been on since April.  When it first happened I had a range of tests like the rest of you- upper and lower GI, pelvic ultrasound, tested for H. pylori.  In the past Prevacid has helped but this time around it does not seem to be doing much.  Last the person in the last entry my condition is worsened by bending over or lifting. This makes me think there is something mechanical going on, i.e. not just chemical (digestive).  Also, if it was just about swallowing air why would lying down curb the symptoms?  Interestingly, I will have a day or here and there where it seems like things are back to normal and then the next day it starts up again.

I have a few questions for people who are experiencing this:

Does anyone believe any of this is stress-induced?

Is it postural for everyone? i.e. goes away when lying down and worse with a lot of bending?

Have people tried to omit coffee and does that help?

[Sazie]

I was very glad to find this site.  I have been belching for 2 weeks and am so frustrated.  I too have acid reflux and am on Protonix.  For some reason this started 2 weeks ago, and like some of you I have been belching non stop.  I can relate to the person who said they belch 1000 a day.  

Please everyone keep posting what the doctors discover for you.  I was a little take back to hear some of you have had this problem for years.

Tomorow I am going to call my dr and get a change for the medication.  I am alergic (allergic) to aciphex.

[bsain]

I am 61 years old. My symptoms started about a year ago. I always feel as if I just ate a very large meal and my stomach is uncomfortably full, even when I wake up in the morning. One cup of coffee produces instant belching.  

I've always had a flat, muscular stomach, but since the onset of my symproms I look like I have a "beer-belly". I've always been a breakfast eater but nowdays I have no interest in eating breakfast or lunch. I eat dinner not because I feel hungry but because I know I need the nourishment.

My doctor suspected I was infected by H Pylori and an Endoscopy revealed that he was correct. After four rounds of various antibiotics another Endoscopy revealed that the H Pylori is finally gone. But, I still have the constant bloated feeling.  Eating yogurt is helping to reduce the bloated feeling slightly.

The last round of antibiotics I had was two months ago and I've yet to notice any improvement in my condition.  Very annoying indeed! If anyone finds a magic cure please let the rest of us know about it.

[Kees]

In my case it's digestive I think. It's just that using the abdominal muscles (while lifting, bending) pushes on the intestine where gas has accumulated. Normally, in healthy subjects, any gas should be absorbed in small intestine or propulsed rather quickly towards large intestine (and evacuated). That's why healthy person can bend and lift normally, and doesn't burp... Even if one would swallow somewhat more air than normal, the gas should be transported and/or absorbed through intestine. Only swallowing air can sometimes leads to increased flatulence. More and more I'm convinced that, if people not swallow air in an extreme way, any symptoms like bloating, belching etc. could point to an intestinal disorder of impaired handling of normal amounts of gas. There is research on that.

At least I don't observe any variation with stress. I wish it did, so I could work with that. I practise meditation for 2o years, live non-stressful life etc. etc. Personally, in my case I think it is not stress-induced.

Omiting coffee doesn't give any relief either.

[maestro]

tears are swelling up in my eyes.  i thought that i was the one person who was experiencing the belching drama.  i am in my 6 years of trying to determine what is going on with me.  i've tried it all (diet, meds, chiropractor, meditation, accupunture), so I am waiting in my belching mode for relief that I am hoping will come from this forum.

[bizzy]

Most people in this discussion seem to be on some proton blocker (Prevacid, Nexium, etc).  One thing that appears to be effective is to take the pill first thing in the morning and then wait for at least an hour before you eat anything. I used to cut corners and only wait 15 or 30 min but I think giving it a chance to work without diluting it by food really helps.

Let me know if you try this and it work- as it appears we all have to work out our own treatment plan for this annoyance.

[burpmaestro]

Well, this is certainly interesting.  Sorry to hear you are all suffering from the same or similar thing I have been for about 4 years now but it's nice to know I'm not alone.  In my case, endoscopic exam showed evidence of hiatal hernia and mild acid reflux damage.  Doctor prescribed Prevacid but the problem isn't that I have an acid problem and I have since had my gall bladder removed as testing showed it to be 90% clogged - no help though.  My condition began with pain and fullness followed by a belching fit a couple of hours after meals and has deteriorated over the last four years to extreme muscle spasm on the left side of my chest [you'd swear you're having a heart attack!] and I can literally belch for hours now.  This appears to be some sort of diaphramatic spasm that results in literally inhaling air into my stomach.  I'm wondering if the catalyst wasn't the hiatal hernia in my case.  It is aggravated by carbs and starches - not so much by veggies and meats.  Sad thing is that I use to swim a mile Tues/Thur and lift weights Mon/Wed/Fri but I had to give it all up because upper body exertion aggravates the **** out of this bizarre condition too.  At times it gets so severe that I develop a really bad case of malaise.  I'm considering seeking out a laproscopic hiatus surgeon at this point.

[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. 1˝ 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.***@****.

[reader23]

For me, this just started last evening.  We were out to dinner and after having a roll, I started coughing.  I thought perhaps something might have gone down the wrong way.  Once we got home, I started belching but everytime I belched, some of the food would come up as if I was throwing up.

I woke up this morning and my throat felt awful.  I belched and instead of food coming up, I had heartburn.  I took two Rolaids.  Then I ate a bagel for breakfast and now I'm belching again and the bagel is coming up with each belch.  I have to work today and I can't imagine what I'm going to do all day as I belch and have food in my mouth that I will immediately have to spit out.

Please help if anyone has ever had this part of it.

[wassupwassabi]

Yeah, food comes up for me too... taking Reglan helps a "small" amount with the regurgitation but not significantly.  Although I've heard it's worked well for other people, you might ask your doc about Reglan.

[kezzira]

Hello all,

I never would've thought there would be so many out there with this belching problem. I've had this problem for 10 years now, with a diagnosis for H. Pylori in between and have tried various regimens of medications. Nothing has really worked so far. The closest thing however, was traditional Chinese medicine when I was in Asia. The DR took my pulse for 2-3 minutes straight in silence and told ME what my sypmtoms were, starting with "you have stomach pains when you wake up in the morning..." He prescribed a combination of herbal and western (I believe) medication combination that were pre-packed in "capri-sun" like pouches that you microwave or boil  and then sip from a straw once a day. The treatment is for 2 weeks and you follow up and see how much longer the treatment is going to take by your medication's response. Unfortunately, I only had one session worth and I had to come back to the States. But it did get rid of my gastric problems for couple of years! However, the problem has since regained strength and I would have to start allover with another regimen of wester medication until my next trip to Asia. I wish there would be a clear answer to this...

[samster]

Wow - glad I'm not the only one out there.  I've been experiencing excessive and repetitive belching for about 4 years now.  It started shortly after 9/11 and a doctor told me then it was just stress related and it would subside.  The belching did subside for awhile but has recently returned and lasts in spurts of a few days.  For me, the burps are very tiny and feel like the precursors to a larger burp...except they don't stop even after a larger burp.  

I have to wonder if there's a bit of mind over matter going on with me though because I can be having a burping spell while I'm all alone, but once I'm in the company of others or in my yoga class, the burping subsides and once I'm back alone it starts up again.  Does this occur with anyone else?  

Like a lot of the people on this post, I'm also young - 27 year old female, healthy, and a vegetarian.  I don't seem to have any other symptoms like others on this post though - no excess bloating, naseau, etc.  I haven't talked with a doctor or had any tests done yet and it doesn't seem like there are any doctors out there who have a clue about this.  If anyone does come across a diagnosis and/or cure, I'm sure we'd all love to hear it.  

Thanks.

[Mosey_NY]

I had constant belching and a feeling that something was stuck in my throat for two months.  Finally I stopped using IPSAB toothpaste and a week later it vanished.

I searched on the ingredients in this toothpaste because I could not believe something like toothpaste could cause me such misery.  Turned out the peppermint oil is an anesthetic - causes numbness.  So is spearmint and cinnamon - or so I read. Now I am afraid to brush my teeth with anything but baking soda.

I recently was given a cup of peppermint tea, and without a thought I drank it.  4 hours later all the symptoms came back.  At least now I am positive it was the peppermint.

How many people would suspect toothpaste?  I now take flavorings very seriously because even 'all natural' essential oils like peppermint are potent drugs/herbs and using them everyday in things like toothpaste may not be a good idea.  It sure wasn’t for me.  

Some of these flavorings (natural or otherwise) are cumulative and may not cause symptoms right away.  When I checked my food and all the products that I ingest I was disgusted how many contain ‘flavorings’ - which are concentrated who-knows-what.

Just some thoughts, I hope it helps.  It helped me.

[Phil Patrick]

Hello, I'm 29 years old and have been on Nexium for about a year to control my acid reflux and I have been fine.  For about a month now I have been extremely bloated, and belching constantly especially If I'm hungry.  I even have trouble sitting down because the pressure gets so bad around my waist.  Sometimes I experience tighteness in my chest, gurgling, difficulty in swallowing and a bad taste in my mouth.  A H.Pylori test was done last year and was negative, there isn't any heartburn, and I still have a relatively large appetite.  After I eat I usually feel better.  Recently I have also been slightly constipated and have been expelling less gas.  Thought maybe I had IBS.
Does anyone know why I can burp for 20 minutes straight without stopping, which usually relieves the pain?  Can I be swallowing too much air and not realizing it?  Any oponions would be great.

[chadly]

I'm 22 years old and I started burping excessively back in June of 2003 up until present day.  In Feb. of 2003 I had a bad case of the flu which I later cured with prescribed medicines.  Then in March I had a case of the shingles on the rear left side of my head which was also cured by a prescription.  I did start doing things slightly differently in my normal lifestyle back in the early months of 2003. I was working out every night and afterwards I would drink down about 3-4 cups of water quite quickly.  I felt good after I was cured of the flu and shingles and felt back to my normal self.  I think the flu weakened my immune system which lead to me getting shingles so soon after.  

Once the burping started in June I went to see my doctor.  At first, my doctor thought I had heartburn which I did not have.  He prescribed me to try Zantac 150.  I ended up taking two Zantac (Acid Reducer) 75 pills but no changes with the burping.  I also tried the chalky chewable reducers which included Maloxx Max and no changes.  I also tried Maximum Gel Gas-X tablets and still no changes.  

In April of 2004 I went to have a upper GI barium x-ray and I tested negative.  I also had blood tests done for H. Pylori along with stool sample tests done and still all my results came back negative.

With my burps I would describe them as dry and quiet most of the time.  I have gone for about 24 hrs. without eating or drinking anything and there are still no changes in my burping.  I don't really have a set pattern but it does seem when my mind is occupied or I am keeping really busy at something I don't even realize them at all.  I noticed though that almost immediately after I eat or drink anything (even water) I will burp.  The burping has been with my everyday since 2003.  

Whenever I go to sleep or lay down horiztonally the burping stops.  It only happens when I my upper body/torso is upright/vertical.  One odd thing I notice though that only seems to happen when I lay down to go to sleep at night is I can hear my stomach or other lower internal organs making different rumbling noises.  The noises that your stomach usually makes when you are hungry or digesting.  After a bit they do stop or I fall asleep.  

I don't really have any other symptoms than the dry burps.  I rarely do have a feeling where my stomach does feel bloated.  I did try clenching a pencil between by teeth (the aerophagia test) and is does seem like the burping stops or at least slows down.  I can only hold a pencil in my mouth for so long.  

Some other things that I have tried are taking Digestive Papaya Enzymes and they did not make any noticeable difference either.  I even ordered Tahitian Noni Juice online and tried drinking that but no difference either.  

My Mom currently has food intolerance problems herself.  She is on a strict gluten free diet.  She even had her gallbladder removed but that did not help her our much until she went on the diet.

That's about all I can think of for now.  I'm glad I found this form and I hope everyone finds relief.

[chadly]

I forgot to add that it does seem that after I eat or drink even after the initial burp that comes almost immediately afterwards.  I do tend to burp more than when I have not eaten or have drank anything for a while.  After about 20-30 mins. from eating the burping does seem to subside some.  The are still usually dry but may sometimes have the taste/smell of the food I ate recently.  

I am not overweight and when I have my blood pressure is also healthy.

[chadly]

I wanted to mention that my mom's problem deals with irritable bowel syndrome.  She has never had a problem with burping.

[bizzy]

I just read your comment that the burping stops when you are in a group and I have to say that is the same for me too.  I have no explanation but it does suggest that there is something conscious about the burping.  I can be in a meeting for 2 hr and not burp but get in my car to go someplace else and burp 20 times.  I have tried to pay attention to whether or not the burping actually makes me feel better i.e. relieves gas and it does. So, it makes sense there is a conscious component.  Unfortunately, that does not answer the question about what is underlying the behavior to begin with.

[jpc]

I find social situations do seem to inhibit the belching, and that getting in the car can bring it on - roads that are a bit bumpy make me worse. I've had this condition for 4 yrs now, since my last child was born. (I was very disappointed to find that the indigestion didn't end when the pregnancy did!)When I mentioned it to my GP she basically advised me to go away and eat bland, low fibre food for the rest of my life. But I think its time to have some tests done and see if there's a simple cause.

[samster]

I'd like to make a suggestion...I'm sure some of you have already done this but I think it would be helpful if we keep journals for a few weeks that document everything we eat, when the burping starts, when it stops, our activities, etc.  Then perhaps we can find a common link among us.  Anyone in?

From what I've read on this post, it seems that going to the doctor will only lead to a slate of pointless and negative tests or plain confusion on the doctor's part.  But maybe we'll be able to solve this puzzle on our own...this is frustrating!  

[bizzy]

I am in on our suggestion to keep a journal. I will start today. I think we need to pay attention to: when it starts, stops, what we eat, medications, also relation to physical activity.

[jpc]

I'm going to keep notes too.
btw I'm 42, pretty close to my proper weight, and am fit and healthy (apart from this problem). I don't get heartburn very often, unless I eat very unwisely and lie down too soon afterwards. Mostly I just belch furtively, even on an empty stomach. But certain foods definately make it worse for me. Also, someone else mentioned giving up swimming - I used to swim in a squad for an hour twice a week and had to stop because I'd get such bad stitches, even though I was careful not to eat for hours beforehand. Now I do brisk walking and workout on the weights machines at the gym, and both of these are ok.
I'm going to cut back on the things they say are bad for you if you have a weakened lower oesophageal sphincter (LES). This is what my doctor thought I have, based on my symptoms and the way it came on after my fourth pregnancy.
here's a quote from a web site on gastroesophageal reflux (GERD) "Eating foods or drinking beverages flavored with spearmint, peppermint, or other spices with strong aromatic oils causes relaxation of the LES and can contribute to symptoms in people with GERD. Chocolate also relaxes the LES and can cause heartburn.Acidic beverages like juices, coffee, and tea have also been linked to increased heartburn pain, as have carbonated drinks, alcohol, and milk."
Out of that list, its the coffee, tea and chocolate that I really resent having to give up!

[Kees]

My thoughts on the burping: conscious act or not? From what I have read and my own introspection. Correct me if necessary...

Burps are either involuntary or voluntary.

When I feel an uncomfortable sensation in my throat or in my abdomen, by an act of will power I can induce a burp, trying to get rid of the uncomfortable feeling. In my case this helps and relieves me of gas in my (as I recently discovered) in the intestine. This burp is called a voluntary burp, it's in fact a manoever, something done by an act of will power.

But quite often burps come out 'spontaneously' are a reflex. In some cases it happens so fast and strongly that you can't stop that belch. In other cases you feel/observe it happening, you could even surpress it if you would like... But it is still a reflex and not a conscious act of will to induce a burp!!! These kinds are all involuntary burps. It's like with sneezing: sometimes you sneeze very loud and forceful, you couldn't stop it... Other times you feel the itching and the sneeze getting on its way etc. If you wanted you perhaps could supress it, but that doesn't mean it's not an involuntary reflex. It's a chain of sensations, reflexes, but not a manoever by an act of will power.

I've seen many gastro MDs who don't distinguish and think all burps are voluntary. This is definitely not true/correct.

What happens when I'm with friends or teaching and with all my attention and very busy talking/teaching/explaining? Then there is no space to consciously feel the discomfort or sensations that I normally, when I'm alone, would feel - but without influencing it or inducing it - and that would lead to an involuntary burp, a reflex. Same would be with the sneezing. But if it would be very strong it can sometimes break through, and even when you're with others can lead to a burp.

Are you experiencing it in the same way?

[burpmaestro]

In my case, it's not a matter that I don't need to belch in public; I simply consciously suppress the belching in public because it's disgusting.  The bloating will build though until I literally have to go to the bathroom at work, sit in the stall, and have a few dozen belches.  I just spent the entire night out on the couch last Thursday night propped up on 3 pillows on my left side belching.  All I had for dinner that evening was about a half cup of beef stew, a couple of bites of potato casserole and a biscuit.  I'm 6' tall, weigh 180 lbs., and I don't tend to eat junk. Acid reducers only help from the standpoint of keeping acid down so when I belch there's less reflux to cause more problems.  I've had my gall bladder removed but still occasionally have the same pains that I had when I had the plugged gall bladder.  Journaling is always good but, aside from knowing that carbs will exacerbate the problem more than meats and veggies, I have found no particular food catalyst.  Eliminating carbs, dairy, or caffeine does not eliminate the problem.  Curious: Does anyone out there have yellowish bowel movements after you've had a really bad belching day/night?  I've read this can mean the pancreas is not functioning properly.  If that's true, then you wouldn't properly digest your food, and the food sits there and rots.  Sad thing is that when I share all this with doctors I get that "you're an engineer aren't you?" look followed by the "how's your stress level?" speech.  I know this is physiological though.  Problem is, how to prove it?  Or maybe my mother didn't breast feed me long enough when I was a baby so, now at the age of 46, I have chronic belching :>).

[bizzy]

You are very correct.  Now that you state the facts, it seems obvious. It is mostly voluntary.  When I an occupied I do not focus on the discomfort and therefore no belching unlike when I am alone, in the car, etc.  

I have only started to keep a journal but based on just a 24 hr observation, I feel carbs (particularly, sugars) are a trigger but it may be too early to be stating that.  

In any case, I am finding this dialog provides me good moral support.  Though the situation certainly is not life threatening, it is a definite quality of life issue.

[Kees]

To burpmaestro
I also experience quite often the need to belch in public and have to suppress it. But what I tried to say was that because you're e.g. very busy talking, your consciousness generally notices it later (than at home alone) that the gas is building up and with its uncomfortable feelings and the need to belch/burp... But at some point the you are experiencing the strong need to belch, and then (if in company) you suppress it... So I completely recognize what you write about belching in the bathroom, a few dozen belches, that - when I would have been alone - in my case have come out sooner already; not only because social reasons, but because of experiencing the sensations! BTW I don't have any stool changes like you describe, and in my case taking additional pancreas enzymes didn't have any effect... But I think it's true from what I've read and heard that a deficit of these pancreatic enzymes can be one of the causes of (bad digestion?) and burping.

To bizzy
It seems obvious, now... But it took me a long time, because literature and what gastro MDs say in daily practice or write about this is definitely 'not always' correct (this is an understatement). But I accept it is difficult because it's on the border of involuntary and voluntary. Normal illnesses are just there, although you perhaps can influence it with your mind. Anyhow, the fact that your burps are mostly voluntary (as with me) doesn't make the problem less real or 'in our head'. I'm 100% certain I have a gas problem (most probably in the direction of what I wrote in Comment 21) and not imaginary thing in my head.
Interesting other fact in this context: I noticed over the years that, immediately after experiencing strong pulling, nausea-like uncomfortable sensation in my throat, there's sometimes an extra involuntary reflexive inhalation, immediately followed by an explosive belch (like throwing up)... This is not sucking in air into the stomach while inhaling, as is suggested sometimes! I found a source (more neurologic/reflexive process description of gastrointestinal matters) which describes exactly what happens when you vomit, and e.g. food is transported back up in intestine (if not from the stomach) etc. Part of that reflexive process is a deep inhalation, which probably does a 'clearing-up' or so in the intestine when there's something 'stuck' there or has to come up out. Wonderful stuff isn't it, but complicated...

To bizzy & burpmaestro: I'm quite surprised you also seem to have more problems with the carbs, like me an only a few others reported in the threads I have seen here in this forum. That's interesting and hope giving! Because we share a common thing... I read your 'entire night on the couch last Thursday night' respectively 'definite a quality of life issue'.. Same here with me, so this is not a minor issue for us.

A guy NeverGivingUpNever - who posted some comments in the thread 'burping' in this forum - and myself, we both feel we have to start up something, to join hands, to get together. Like to share personal experiences and provide moral support, to share sources of information, and perhaps to formalize an association of patients with this same or similar problem, that might help us to obtain formal medical help in the future. We will probably coming up with some ideas shortly.

I hope we can stay in touch via this thread, or even if at some point this thread closes for comments. My email address is in a previous comment.

Take care, Ted

[bizzy]

I am now focusing on the carbohydate issue we have identified.  Checking further on the web I found the following:

As stated earlier, intestinal bacteria produce gas from food that is poorly digested and absorbed, particularly carbohydrates and fiber. The most common carbohydrates that are poorly digested are lactose (the carbohydrate in milk), sucrose (the carbohydrate in corn syrup), and sorbitol (a low-calorie sweetener). A reasonable first approach to the problem of excessive gas is the elimination of each of these carbohydrates. Avoidance of the offending carbohydrate should reduce the amount of flatulence and distention. Hydrogen/methane breath tests also can determine accurately which carbohydrates are poorly digested.






Gas accumulates in the stomach and intestines in only one of two ways. The gas is either air that is swallowed or it is produced by intestinal bacteria. Bacteria generates gas from food that is eaten but not digested and absorbed. The gasses produced by the bacteria are primarily hydrogen and methane.

People have excess gas because they have gas-producing bacteria that generate more gas than the bacteria of other people, have more of the gas-producing bacteria than other people, or have the bacteria in their small intestines. (When present in the small intestine, bacteria digest ingested carbohydrates before they can be digested and absorbed by the small intestine.)

What are non-drug treatments for gas?

For the rare person who swallows air to the point of discomfort, techniques are recommended that are supposed to reduce the amount of swallowed air. These methods include chewing particularly well and then swallowing with the mouth closed and sucking liquids only through a straw. It is not known if any of these techniques actually reduce air swallowing.

As stated earlier, intestinal bacteria produce gas from food that is poorly digested and absorbed, particularly carbohydrates and fiber. The most common carbohydrates that are poorly digested are lactose (the carbohydrate in milk), sucrose (the carbohydrate in corn syrup), and sorbitol (a low-calorie sweetener). A reasonable first approach to the problem of excessive gas is the elimination of each of these carbohydrates. Avoidance of the offending carbohydrate should reduce the amount of flatulence and distention. Hydrogen/methane breath tests also can determine accurately which carbohydrates are poorly digested. Another reasonable first approach is a low-fiber diet.

What over-the-counter medicines are there for treating gas?


Alpha-galactosidase: Alpha-galactosidase is a rather recent and novel approach to the problem of excess gas. Alpha-galactosidase (Beano) is an enzyme that breaks down carbohydrates and fiber. It is derived from a mold and is taken as a tablet or as drops added to food (after the food has cooled since heat inactivates the enzyme). By assisting with the digestion of carbohydrates and fiber, there is less for the bacteria to digest and convert to gas. Diabetics should use alpha-galactosidase with care since the carbohydrate digested by the enzyme is absorbed into the body and may increase blood sugar levels. Patients with galactosemia, a genetic disease in which blood levels of galactose (a carbohydrate) are elevated, should not use alpha-galactosidase because galactose may be formed by the enzyme in the intestine and then absorbed. This may further increase the levels of galactose in the blood. There is the potential for allergic reactions to alpha-galactosidase among patients allergic to molds.
http://www.medicinenet.com/script/main/art.asp?articlekey=10521


I have purchased and tried the Beano and with a very limited experience I can say it seems to be working.  You must take the supplement right before you eat and take it each time you eat.  I agree that the name of the supplement (Beano) is a bit off-putting but the rationale makes sense.  If you find it works it could get expensive so I found an internet site where you can buy a generic version.  Here is the link:http://www.bean-zyme.com/?referrer=Google.

Give it a try and let me know your experience.

[samster]

I definitely agree that there are two kinds of burps - the ones that you just can't stop (those to me, tend to be the kinds that are meal/food related and larger/louder) and then there are the ones that can be voluntary and these are the troublesome ones for me.  And yeah, for me too, I feel like there's a bubble or "mass" in my throat - near the base of my neck (does that make any sense?).  I know that I will voluntarily create a burp just to try to release that "bubble" in my throat.  But then there are plenty of burps that I do without thinking and I'm wondering if those are still voluntary, but that my mind/body has gotten so used to trying to release that feeling in my throat that it automatically knows what to do now.

As with the journaling, the only problem I'm finding is that the burps have become so common and ingrained in me that I no longer even notice that I'm burping.  And when I do realize it, I can't even remember how long I've been doing it.  And so far, the only thing that I've noticed that really increased my burping was chocolate...and I'm not giving up chocolate!  

I've also noticed too that if I do say to myself "hey, I'm not burping now" then a few seconds later I'll start burping again.  

So, for me, I'm coming to the conclusion that this weird feeling in my throat and consequent need to burp is always there.  That it's been there so long now - 4 years - that I've gotten so used to it and I can control it to a point, but not so much that it will go away for good.  

I am happy that we have this forum and hopefully, can try to get someone out there to take notice of us and help us out.  Like someone said, it's not a life or death issue, just a quality of life issue.

[Stopthisbelching]

Hi there, this is the first time I found this forum.   I have had this 'constant burping' for about 5 months now and I am now ready to see a Gastroentologist (sp?).    I couldn't believe there were so many others with this problem!!!!  :>O   It is driving me crazy (& my family as well).   It came on out of NOWHERE and I haven't a clue what is causing it.   No, I did not suddenly start "swallowing more air" at the ripe age of 51!   Nothing has changed in my life - except this constant belching.    I woke up this morning and the belching started again.    Can't take it anymore!
I too have noticed that when I am out with others or even sitting in the doctor's office of an hour, NOT ONE  BELCH, but the minute I am leaving work and walking home, the belching starts up again. HELP!!!!!!!!!!!!!!    

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