Burping

Burping is often misunderstood and proclaimed as a vile symptom involving air movement from the upper GI tract out of the mouth. This symptom often conjures images of Homer Simpson but can be the signs of underlying GI illness.

Burping or eructation is put air movement in reverse (retrograde). Many things can cause it, which as a gastroenterologist, I would breakdown into three main factors

• Dietary Factors
• Maldigestion
• Neurospychiatric causes

Let’s start with the first one. Certain foods will either contain air or produce more air when they react with the GI tract. Namely, carbonated beverages contain air, hence create more air via burping. Other foods such as brassicas (Brussel sprouts, cabbage, cauliflower), alliums (onion, garlic), and mushrooms will produce more air by interacting with your gut microbiome.

On the same vine, the microbiome can be an integral part of our second category, maldigestion. Maldigestion essentially means ingesting food, which does not fully break down into smaller pieces and is absorbed into the body to use as fuel. Food within the gut will then ferment. Dysbiosis or a shift toward harmful gas-producing bacteria can certainly cause burping, as can conditions like small intestinal bacterial overgrowth, wherein that bacteria live too close to the mouth. Other maldigestion conditions include Crohn’s Disease and Ulcerative Colitis, pancreatic exocrine insufficiency, gluten sensitivity, or celiac sprue, among many others.

Finally, there are neuropsychiatric conditions that can cause burping. People with anxiety, depression, or dementia may first manifest their underlying condition via aerophagia (involuntary air swallowing). Aerophagia is a problematic clinical condition to approach with patients as it is subconscious, and they are usually unaware of the underlying neurologic or psychiatric disorder that is brewing. Although this is not neuropsychiatric, aerophagia can also occur in those people who eat too fast. Sometimes practicing mindful eating by savoring your food or chewing 30 times as mom taught you to do will help.

Though often a fixable issue either through diet or mindful eating, persistent burping, debilitating burping or burping with other symptoms bloating, gas, weight loss, diarrhea, bleeding may be a severe condition and means to visit your friendly neighborhood GI doc. Until next time, I’m Doc Mok, here to maximize your health.