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27 years
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Whatever I eat, my body responds by burping a lot. This has been ongoing for a few months. An unpleasant feeling especially when lying on bed.
Jul 8, 2015
Opinion requested

Dr. Zakia Dimassi Pediatrics
Belching (or burping) is defined as the audible escape of air from the esophagus into the pharynx”. In medicine, belches are separated into 2 types: the so-called gastric belch and supragastric belch.

Gastric belching is the escape of swallowed intragastric air that enters the esophagus during a transient lower-esophageal sphincter relaxation (TLESR) – the lower-esophageal sphincter is a ring-like muscle structure that is found at the end of the esophagus (the swallowing tube) and which contracts to prevent food from migrating upwards from the stomach into the esophagus. Episodes of TLESRs allow relief of the stomach from any excess amount of air, thereby preventing bloating by minimizing the passage of large volumes of gas into the intestines. Gastric belches occur 25 to 30 times per day and are physiological; they are essentially involuntary and are
controlled entirely by reflexes.

In supragastric belches, the expelled air does not originate from the stomach. Rather, the air is ingested (swallowed) immediately before it is expelled again. Unlike gastric belches, supragastric belches are not a reflex but instead are the result of human behavior. Some patients complain of isolated excessive belching and describe episodes of frequent belching in which they may belch up to 20 times a minute. Almost without exception, such category of people suffer from excessive uncontrolled supragastric belching. These patients tend to have anxiety disorders; some patients also report that their symptoms increase during stressful events. Many patients can control their belching while speaking. It has also been shown that distraction also reduces the frequency of belching. On the other hand, focusing the attention to the belching behavior usually leads to an increase in belching frequency. Supragastric belching is never observed during sleep. Patients with excessive supragastric belching usually are free of any additional symptoms besides sometimes some symptoms of indigestion. The presence of weight loss, pain, dysphagia, heartburn, and regurgitation are not compatible with excessive supragastric belching and are an indication for further diagnostic evaluation.

It remain poorly understood what causes supragastric belching and what triggers patients to start this behavior. Some patients report that initially they belched purposefully to relieve a sensation of bloating or abdominal discomfort but that with time they lost control of the belching.
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