What causes excessive burping? Related conditions and treatments

Overview: What does excessive burping look/feel like?

Burping is normal. It happens when people swallow air, commonly when eating or drinking. People also swallow air when they’re not eating. People who breathe too fast often swallow air down their esophagus. When people swallow air, it either builds up in the stomach or esophagus until it’s pushed out as a belch. People belch about 30 times a day, usually after eating or drinking. They don’t notice it very much. Excessive burping—belching much more than normal—is noticeable and can cause significant distress or embarrassment. Like normal burping, it’s usually due to swallowing air, but doing it more than normal. Fortunately, it’s usually not a cause for worry unless accompanied by other more obvious and concerning symptoms.

What causes excessive burping?

Excessive burping occurs to rid the upper gastrointestinal tract of excess air. When air enters the stomach, it builds up until it’s released. This is called gastric belching. When air enters the esophagus, it is released before it can enter the stomach. This is called supragastric belching. 

Gastric belching—the build-up and release of gas in the stomach—is often by swallowing too much air when eating or drinking. Causes include:

• Eating quickly

• Gulping liquids

• Drinking gaseous beverages such as carbonated drinks or beer

• Chewing gum

• Sucking on candy

• Use of antacids

• Excessive swallowing due to postnasal drip

• Air swallowing (aerophagia)

Supragastric belching is due to a subconscious habit of tightening the diaphragm or the base of the tongue, which quickly sucks air into the esophagus. The excess gas is then quickly expelled in a belch. It is considered a voluntary and learned response to painful or unpleasant feelings in the stomach area or chest. Supragastric belching is most commonly associated with:

• Gastroesophageal reflux disease (GERD)

• Indigestion

• Gastritis

• Stomach ulcers and Helicobacter pylori infections

Many of these conditions also increase swallowing, so people with these conditions also swallow more air, feeding into the excess burping cycle. Aside from burping, all these conditions will have other symptoms, such as stomach pain, chest pain, or other symptoms.

Some intestinal disorders can have belching as a symptom, but excess intestinal gas usually manifests as abdominal distention (bloating), pain, and flatulence (farting). All will have other more obvious symptoms, such as constipation, cramping, or diarrhea. Intestinal conditions associated with excessive burping include:

• Irritable bowel syndrome (IBS)

• Small intestine bacterial overgrowth (SIBO)

• Lactose intolerance, or other food intolerances=

• Insufficiency of the pancreas

Should I be worried about excessive burping?

Excessive burping is nothing to worry about unless it’s a chronic problem interfering with daily functioning, causes distress, or reduces a person’s quality of life. It is not a sign of a serious illness alone unless other symptoms coincide, including stomach pain, weight loss, or trouble swallowing. In that case, see a healthcare professional. If there are serious symptoms, such as chest pain, chest tightness, or trouble breathing, then get emergency treatment.

How is the cause of excessive burping diagnosed?

The goal of diagnosis is to find and treat the cause. The healthcare provider will start with a medical history and physical examination. The clinician will be particularly interested in how often belching episodes occur and how long they occur. The clinician will want to know about other symptoms, such as bloating and flatulence. Any intestinal issues will be initially suspected from the symptoms, most of which will be more obvious and concerning than burping. If it’s an intestinal problem, burping is probably not why you see a doctor.

If the cause of excessive burping is apparent, such as eating too fast, chewing gum, drinking a lot of sodas, or anxiety, testing may not be necessary. Tests can help make the diagnosis more precise. 

Manometry determines whether the esophagus muscles are working properly when food is swallowed. Also called an esophageal motility study, a tube is inserted through the nose into the esophagus. A pressure-sensing device measures the pressure of the various muscles moving food through the esophagus and opening and closing the valve to the stomach.

Impedance monitoring is considered the best test for diagnosing whether belching is due to stomach gas or gas in the esophagus. Normally used to diagnose GERD, an impedance test involves inserting a measurement device attached to a catheter through the nose into the lower esophagus. It will remain there for 24 hours. Not only does it measure any fluids moving into the esophagus from the stomach, such as stomach acid due to reflux, but it can also monitor the movements of air and identify excessive supragastric belching. 

How long does excessive burping last?

Depending on the cause, excessive burping can be resolved quickly or may take a few weeks or longer. There is no magic pill. Some underlying conditions associated with excessive burping, such as GERD or dyspepsia, can be treated with drugs that can rapidly relieve symptoms. However, excessive burping is due to voluntary or learned behaviors, even if there’s an underlying medical condition such as GERD. Changing those behaviors can be difficult and will require the patient's full cooperation.

How to stop excessive burping

Excessive burping is usually due to voluntary behaviors. Some of these behaviors may be unconscious, but they are learned behaviors and can be unlearned.

Gastric burping is due to swallowing air while eating is a normal bodily function. Excessive burping after eating or drinking is treated by slowing down eating and drinking and avoiding foods with a high gas content, such as carbonated beverages.

Air swallowing when not eating is also normal, but excessive air swallowing can be treated by avoiding gum, avoiding hard candy, or treating an underlying condition such as anxiety.

Supragastric burping—belches originating in the esophagus rather than the stomach—is also normal. People experience about 11 supragastric belches daily and probably don’t know it. However, excessive supragastric belching is due to subconscious learned behaviors often associated with symptoms of underlying problems like GERD or ulcers. 

On the one hand, treating the underlying disorder will help reduce excessive burping. Proton-pump inhibitors and H2 blockers reduce stomach acid production and so help decrease the frequency of acid reflux episodes. Antacids can help reduce the incidence of dyspepsia. Relieving anxiety through anti-anxiety medications will also help tame the behaviors that cause excessive belching. 

However, the recommended treatments for excessive supragastric burping are speech and cognitive behavioral therapy. Speech therapy trains people to know their air-swallowing behaviors and teaches proper breathing techniques. Cognitive behavioral therapy trains people to recognize triggers and warning signs and intervene with breathing techniques to prevent belching. These two therapies have been shown to be the most effective treatments for excessive belching.

Living with excessive burping 

While some conditions associated with excessive burping can be controlled medically, the preferred treatments are lifestyle changes and behavioral changes. Here are some tips to reduce the frequency of burping episodes or to help control them when they happen:

• Chew food slowly and completely

• Don’t eat in a hurry or when on the run

• Eat with your mouth closed

• Don’t talk when chewing food

• Don’t gulp drinks

• Avoid using straws when drinking

• Avoid or cut back on fizzy drinks

• Avoid chewing gum

• Avoid hard candy

• Quit smoking or vaping

• Pay attention to swallowing when not eating and train yourself to swallow less often

• Make sure dentures are fitted properly

• Manage stress

• When stressed or worried, practice deep breathing techniques

• If using a CPAP machine, check with a healthcare provider to make sure it’s properly fitted and that the pressure is properly adjusted

• Learn to breathe with your diaphragm

• If a belching episode starts, lie on your side with your knees drawn up until the episode ends

FAQs about the causes of excessive burping

Can being worried cause burping?

Anxiety, tension, and worry can cause people to swallow air. The only place for that excess air to escape is in a burp. The more air a person swallows, the more they burp. Anxiety isn’t the only culprit, however. Air swallowing is a common symptom of many mental health conditions, including depression and obsessive-compulsive disorder (OCD). We don’t know why. One way to prevent air swallowing and burping when anxious is to practice certain breathing techniques and use them when feeling stressed or distressed.

Can silent reflux cause excessive belching?

Silent reflux is a type of acid reflux in which stomach contents flow up to the voice box or nasal passages. Called laryngopharyngeal reflux, it is anything but symptomless. People with any type of reflux swallow more air than other people. Excessive air swallowing will lead to excessive belching. 

What medications cause excessive burping?

Any antacid that contains sodium bicarbonate, such as over-the-counter medications like Alka-Seltzer, will cause some burping. Bicarbonates react with stomach acid to produce carbon dioxide, a gas. The only way for that gas to escape is by being burped out.

What’s next? Additional resources for people with excessive burping

Test and diagnostics

• 24-hour ph-impedance testing, Johns Hopkins Medicine

• Chronic burping and belching, Current Treatment Options in Gastroenterology

• Esophageal manometry test, Cleveland Clinic

• Gas, bloating, and belching: approach to evaluation and management, American Family Physician

• Symptoms and causes of gas in the digestive tract, NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Treatments

• Behavioral therapy effective for belching if patients accept mechanism, Gastroenterology & Endoscopy News

• Belching disorders, UCLA Health

• Belching: is it normal?, International Foundation for Gastrointestinal Disorders (IFFGD)

• Chronic burping and belching, Current Treatment Options in Gastroenterology

Scientific studies and clinical trials

• Aerophagia as the initial presenting symptom of a depressed patient, The Primary Care Companion to the Journal of Clinical Psychiatry

• Speech therapy as a treatment for supragastric belching, Dysphagia

More information on related health conditions

• Gastritis treatments and medications, SingleCare

• GERD treatments and medications, SingleCare

• Ulcer treatments and medications, SingleCare