What is burping?

Burping (eructation or belching) is the release of air from your stomach or oesophagus (food pipe) through your mouth, which makes a noise. Burping is a normal part of daily life. You might burp up to 30 times a day. However, if you burp too much or it's painful, there may be an underlying problem.

There are 2 types of burping:

• Supragastric burping: Your body's response to an uncomfortable feeling in your abdomen, causing air to exit your oesophagus. It can be a reflex (involuntary) or voluntary. Sometimes it can become a habit.
• Gastric burping: The release of air from your stomach that stops swallowed air from becoming trapped.

What symptoms are related to burping?

Burping can be loud or not make a noise at all. You might feel an uncomfortable pressure in your abdomen, throat or chest before you burp. Burping can relieve this feeling.

Sometimes burping can cause food that you recently ate to rise into your throat.

Burping can also be associated with swallowing air, which is related to other symptoms, such as bloating and flatulence (gassiness).

Burping is a normal, everyday occurrence. It can also be a symptom of other conditions. You may experience the symptom of excessive burping if you have:

• food intolerance (for example, fructose or lactose intolerance)
• gastro-oesophageal reflux disease (GORD or 'reflux')
• indigestion

What causes burping?

Air that gets trapped in your stomach or upper digestive tract causes burping. The release of this air results in a burp.

Air is more likely to get trapped in your stomach if you:

• drink carbonated ('soft' or 'fizzy') drinks
• eat too quickly or too slowly
• chew a lot or not enough before swallowing
• have difficulty swallowing

You may also burp more if you:

• are pregnant
• have gastro-oesophageal reflux disease (GORD)
• have functional dyspepsia (indigestion)
• have a thyroid disease

Supragastric burping is a learned behaviour that can become a habit. Psychological conditions associated with excessive burping include:

• depression and anxiety
• obsessive-compulsive disorder (OCD)
• bulimia nervosa
• excessive stress

How is the cause of burping diagnosed?

To diagnose the cause of excessive or painful burping, your doctor will ask you questions about:

• how often you burp
• if you burp after eating or doing something specific
• how you feel before and after you burp

They may suggest that you keep a burping diary to keep track of your burping.

Your doctor will try to work out if you have another health problem that is causing your excessive burping. They might do a physical exam or a medical test known as impedance monitoring.

Impedance monitoring (also called oesophageal impedance testing or impedance-pH monitoring) measures the movement of liquids and gases inside of your organs. This can help find out if your burping is related to acid reflux. It can also check if your burping is gastric or supragastric.

Your doctor may refer you to a gastroenterologist for further testing — this is a doctor who specialises in the digestive tract.

When should I see my doctor?

If you are burping more often than usual or your burps are painful, see your doctor. If burping is getting in the way of your everyday life, it's a good idea to speak to your doctor for advice.

How is burping treated?

Depending on the type and cause of your burping, there are different ways to treat it. Most treatments are aimed at supragastric burping and treating the psychological behaviour associated with this habit.

Self-care at home

There are some changes that you can make to your diet and the way that you eat to reduce burping. These include avoiding:

• carbonated drinks
• chewing gum
• drinking through a straw

You should also eat slowly and chew with your mouth closed.

Medicines for burping

Medicines used for burping depend on the cause.

Proton pump inhibitors (PPIs) are commonly prescribed by doctors to treat GORD. There is evidence that they can reduce burping.

Baclofen is a treatment for reducing reflux symptoms and swallowing frequency. It relaxes muscles and can reduce the frequency of burps.

Other treatment options

If burping is supragastric and has become a habit, there are techniques you can use to reduce this learned behaviour.

A speech pathologist can help you manage this behaviour. Speech therapy can include breathing and vocal exercises, and an awareness of the intake of air.

Your speech therapist may teach you about diaphragmatic breathing. This type of breathing can help you open your lungs and breathe more efficiently. To breathe with your diaphragm:

1. Lie down and place your hand on your stomach.
2. Slowly breathe in through your nose and into your abdomen, keeping your mouth open.
3. Slowly breathe out and feel your stomach deflate.

Cognitive behavioural therapy (CBT) is another way to manage burping behaviours. Therapy involves understanding the psychological basis for your burping. Your psychologist can help you identify warning signals before you burp and learn exercises to control them.

What are the complications of burping?

A main complication of excessive burping is feeling uncomfortable burping in public. This can impact your daily life and make social situations difficult and, in severe cases, lead to anxiety and depression.

Other complications of burping include regurgitating your food and symptoms of reflux or heartburn.

Can burping be prevented?

Burping can be prevented if your burping is linked to specific behaviours or foods. You may be able to reduce burping by avoiding certain foods.

Some people find that stress can lead to excessive burping. Trying to manage your stress may help.

Learning techniques like diaphragmatic breathing or being more aware of your breathing can help you stop burping.

Resources and support

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Burping your baby is a way to help them get rid of excess air. You can read about burping in babies on the Pregnancy, Birth & Baby website.

If you have a gastrointestinal problem that is causing your burping:

• NPS MedicineWise has information about GORD.
• The Gut Foundation provides information about different GORD treatments.
• The Gastroenterological Society of Australia (GESA) has information on conditions that can affect your gastrointestinal system.

If burping is impacting your mental health, you can get support or information by:

• calling Lifeline on 13 11 14
• visiting the Beyond Blue website
• visiting the Black Dog Institute