Burping a lot, and I want to stop

Dear Tired of Burping,

You mean you haven't been practicing burping your full name to impress your friends? Just kidding — understandably, burping too much can be a real nuisance, and could be caused by a few different things going on in your body, including swallowing too much air and heartburn.

Swallowing too much air may be the simplest explanation for your all-too-often belching. There are a number of surprisingly easy ways a person can ingest too much air: eating quickly or gulping down food and drink, using a drinking straw, chewing gum, or swallowing a lot due to nervousness. Air in the stomach usually gets processed into gas (and comes out the other end), but excess air is released through the mouth via belching. 

Another likely culprit may be heartburn (as your doctor seems to think). Too much belching can be a symptom of heartburn, as can a burning or warm feeling in the upper abdomen that spreads upwards toward the throat. Heartburn is usually the result of certain eating habits, like eating large portions at mealtime or before bedtime, dining on acidic foods like onions, tomatoes, or spicy foods, or drinking citrus juices, alcohol, or caffeinated or carbonated drinks. Carrying a few extra pounds, smoking, wearing tight clothing, or lying down or bending over after eating are other factors that weigh in on heartburn.

Fortunately, making some adjustments to your lifestyle may improve your burping problem (especially since your heartburn medication hasn't helped you!):

• Pay attention to how much food you eat and when you eat, avoiding large meals and eating right before sleeping.
• Try eating more slowly to prevent ingesting excess air.
• Steer clear of foods you suspect may cause heartburn (and subsequently burping), like acidic or spicy foods and alcohol.
• Consider whether shedding a few pounds, which will lessen the pressure on your stomach, could help.

Burping more than normal may also be a symptom of a more serious condition. Gastroesophageal reflux disease, or GERD, affects about five to seven percent of the population, and while heartburn is the main symptom of GERD, belching can be another. Sometimes burping too much is also associated with peptic ulcers (sores in the lining of the stomach or intestines); in fact, having GERD may be a cause of stomach ulcers. For more information on GERD, sometimes called simply gastric reflux, check out Gastric reflux in the Go Ask Alice! archives.

It will be useful to pay attention to any ongoing symptoms you have (excessive belching or otherwise) and to continue the dialogue you've started with your health care provider. If your belching issue sticks around even after making some lifestyle changes, a follow-up appointment may be a good idea. Health care providers sometimes recommend having an endoscopy — inserting a lighted, flexible tube into the mouth to examine the esophagus and stomach — to look into the possibility of GERD. Keep in mind too that simple relaxation exercises have been shown to reduce heartburn and its accompanying ailments, including belching.

Good luck getting to the bottom of your burping blight. You are excused!