In ancient times, the unavoidability of belching was recognized both by scholarship and by imperial decree. The great physician Hippocrates wrote, “Belching is necessary to well-being.” The Roman Emperor Claudius decreed that “All Roman citizens shall be allowed to pass gas whenever necessary.” Unfortunately, no such authorities ease the social pain of uncontrollable belching and burping in public settings today.
Physiologists studying the phenomenon of belching frequently refer to it as “gas without gas,” since dozens of studies have failed to yield a consistent explanation of the condition. Although it would seem logical that belching is the release of swallowed air, x-rays of patients with chronic belching problems frequently reveal flat bellies and no gas. Swelling of the peritoneal cavity in conditions such as ascites and extreme obesity would seem to be a likely cause of belching, but it is not. And patients with mechanical bowel obstruction and gas problems that are visible on x-rays usually complain of cramps, not gas.
What physiologists know about the condition is that the average audible belch releases between 20 and 80 milliliters (1/10–1/3 cup) of air and that people who have a problem with belching belch from 40 to 200 times a day. Making a belch requires a simultaneous contraction of the abdominal muscles and relaxation of the sphincter at the top of the stomach. Suppressing a belch, or the sound of a belch, requires leaning forward. This is more difficult while wearing a seatbelt or shoulder harness. Obese people find suppressing belches more difficult than thin people, but are less likely to have them.
What can you do about belching and burping?
∆ Use Angostura bitters, caraway, chamomile, cilantro (coriander leaf), cinnamon, cloves, dill, fennel, ginger, juniper berries, orange or lemon zest, parsley leaf, parsley seed (in teas), peppermint, radish, rosemary, sage, spearmint, star anise, and turmeric as desired in cooking or teas.
∆ Drink peppermint tea made with 1 teaspoon of peppermint or 1 tea bag in 2/3 cup of hot water allowed to steep in a closed container for 10 minutes.
If you see a doctor about belching, he is likely to order a breath test for the presence of hydrogen. Because bacteria are largely responsible for the production of gas, an increase in exhaled hydrogen in the breath test will suggest a food intolerance, usually to milk sugar. When foods are not digested, bacteria ferment them and produce excess gas. Food intolerance suggests that belching is not due to swallowed air or eating too fast, rather it is due to an inability to digest a food.
Breath testing is simple, noninvasive, and relatively inexpensive. It can be done at home or in the doctor’s office. But if finances are a barrier to taking this test, another approach to the problem of belching is eliminating and then testing various foods. In a food challenge test, it is necessary to completely eliminate the test food from the diet for 4 days. Then make a meal of that food and nothing else and note the results. Since milk is the most frequent cause of belching, it is the first food that should be tested.
Belching is occasionally a symptom of a serious health condition. It may be caused by chronic cholecystitis (gallbladder inflammation), GERD (gastroeso phageal reflux disease), hiatal hernia, or peptic ulcer. In rare cases, belching set off by drinking cold beverages can induce irregular heartbeat. Seek medical help if belching accompanies loss of breath, racing pulse, chest pain, repeated vomiting, or abdominal pain.
Various carminative (gas-relieving) herbs have been used for centuries to relieve belching, bloating, and flatulence. These herbs include Angostura bitters, caraway, chamomile, cilantro (coriander leaf), cinnamon, cloves, dill, fennel, ginger, juniper berries, orange or lemon zest, parsley leaf, parsley seed (in teas), peppermint, radish, rosemary, sage, spearmint, star anise, and turmeric. Any of these herbs used in cooking or teas is likely to reduce gas formation and therefore reduce belching. Of all the carminative herbs, the best scientific evidence for the relief of belching exists for peppermint. Scientists at the Cedars-Sinai Medical Center Burns and Allen Research Institute in Los Angeles have made extensive tests on the usefulness of peppermint oil in treating esophageal spasms, the uncoordinated muscle movements that make belches possible. Using a pressure gauge called a manometer, the research team measured pressure at the bottom and at the top of the esophagus before and after participants took peppermint oil. The scientists found that peppermint oil eliminated simultaneous contractions—muscle movements that allow the escape of air through the mouth—in all patients. Peppermint oil made contractions of the esophageal muscles more uniform and relieved chest pain in 2 of 8 patients in the test.
Peppermint is the best-documented natural remedy for belching, but not everyone should take peppermint. Peppermint stimulates the release of bile, so it should be avoided by people who have gallstones, gallbladder inflammation, or severe liver damage. Anyone who has an allergy to menthol should avoid peppermint. If you cannot take peppermint, try increasing your use of other carminative herbs.
What else helps with belching and burping?
∆ Eat slowly to avoid swallowing air.
∆ Don’t drink carbonated beverages or any beverages through a straw. This will reduce the amount of air getting into your stomach.
∆ Avoid chewing gums sweetened with sorbitol or xylitol. These sweeteners contain complex carbohydrates that are not absorbed through the lining of the intestine. Instead, they remain in the gut where they are fermented by intestinal bacteria. The action of chewing gum also causes the swallowing of air, increasing the volume of gas.
∆ Contrary to common belief, drinking beer does not cause belching. Hops, in fact, relieve stress-related digestive problems, although they are more effectively taken as an herb than in beer.
∆ The Southwestern herb marrubio (horehound) is a bitter that relieves belching caused by eating fatty foods. Marrubio is traditionally taken as a tea, made by steeping 1 teaspoon of the chopped herb in 1 cup of hot water in a closed vessel for 10 minutes. The tea is strained before it is drunk.
∆ Peppermint liqueurs also relieve belches and burping. Prepare a homemade peppermint liqueur by leaving 8 ounces of peppermint leaves in a bottle of vodka for 10 days, shaking the bottle every 2–3 days. Strain the mixture before storage. Take 1/2–1 teaspoon of the liqueur between meals.
∆ Lactaid is an over-the-counter product that may reduce belching caused by eating or drinking dairy foods and other products containing milk sugars, including convenience foods and medications. It treats an enzyme deficiency for milk sugar rather than an allergy to milk. To determine if Lactaid may be helpful to you, eat a normal breakfast and include a large, 12-ounce glass of milk of any kind. Over the next 6 hours, keep track of any discomforts you may have. (If you experience any kind of severe reaction, consult a physician.) The next day, prepare an identical breakfast with another 12-ounce glass of milk. Swallow a Lactaid tablet with your first sip of milk. If your symptoms are not as bad on the second day, Lactaid may be beneficial for you.