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GI Tract and Burping

 

Eructation, the medical term for burping, sounds serious.  Eructation is the intentional or unintentional, silent or vocal release of air from the stomach through the esophagus and mouth.

Some individuals have the talent – if it be called that – of being able to swallow air at will and burp various songs or literary works. I associate these performances with Boy Scout gatherings. And while there are some cultures in which burping, particularly after meals, is considered complimentary or at least acceptable, most patients in the US find burping a social embarrassment. Burping can move beyond a social issue to a medical one when it contributes to GI tract distress with indigestion and reflux.


Gas in the gastrointestinal (GI) tract comes from two sources:

  • the upper or the lower GI, roughly corresponding to either the stomach or the small and large intestines.
  • Once food passes from the stomach to the intestines, the GI tract propels its contents through regular coordinated muscle contractions called peristalsis.
  • These peristaltic movements allow us to drink water while we’re upside-down, and assure that digestion and elimination occur in the appropriate direction even in the absence of gravity.

We can swallow air as we breath or eat, or gas can be released in the stomach or intestines as food is consumed and digested. Carbonated beverages and antacids containing sodium bicarbonate each release carbon dioxide gas in the stomach.  This air, being in the upper part of the gastrointestinal (GI) tract, tends to rise and come out as the perhaps too familiar burp.

GI Tract

There are only a limited number of remedies for burping. Eating more slowly can decrease the air swallowed during eating and decrease the need to release the swallowed air by burping. The nonprescription ingredient simethicone acts by releasing gas from swallowed food, making it easier to burp.

On the other hand, there are a number of foods that can contribute to burping or to flatulence, depending on where gas is released in the GI tract.  Consumption of carbonated beverages such as soda or beer bring carbon dioxide gas that is released in the stomach and generally leads to burping. Other foods are digested or incompletely-digested a little further along the GI tract and can lead to either burping or flatulence, or both, depending on whether the natural tendency of gas to rise overcomes the natural movement of the GI tract toward the rectum.

Foods that generate gas, such as beans and dairy products, can do so because individuals lack the enzymes to fully digest certain substances in the foods.  Fortunately, there are enzyme supplements that can help, but they need to be taken appropriately. Beano™ is an enzyme that helps metabolize alpha-galactose present in many foods. Lactaid™ is an enzyme that helps break down lactose – milk sugar – found in dairy products.

To work best, these enzyme supplements must be taken just before or with the first food or dairy intake of a meal. The supplements also do not stay in your GI tract, so it is necessary to take enzyme supplements with each meal.

You are not alone if you suffer with gas and burping.  Your prescriber and pharmacist may be able to help you determine the causes so that you can adapt your diet or use supplements to minimize your discomfort or embarrassment. They can also recommend some nonprescription remedies that may help.

 

 

 

 

 

 

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.