Burping, bloating and flatulence

Burping, bloating and flatulence are common natural body functions; however, they can interfere with some daily activities, are not always considered polite in social company, and may be associated with some health disorders. When burping is in excess, bloating is uncomfortable and flatulence just out of control, there are some natural solutions to help. 

What is burping, bloating and flatulence?

• Burping, also known as belching or eructation, is the release of gas from the upper digestive tract (stomach and oesophagus) through the mouth.
• Bloating, distended stomach and discomfort can often accompany excess burping, and is due to excessive swallowing of air, or from gas released during the process of digestion -  bacteria that has fermented in the gastrointestinal tract (GI tract).
• Flatulence is the term for passing wind/gas from the digestive system through the anus.

Causes of Burping

Burping is often due to an excessive swallowing of air. The medical term of this is aerophagia and may occur from such things as eating too fast, chewing gum, carbonated drinks, talking whilst eating, sucking on lollies, drinking through a straws, nervous swallowing, and smoking. Motion sickness can also result in increased burping.

Medical conditions which may be associated with excess burping:

• Gastric reflux disease (GERD) - a condition in which stomach acid reflux’s back into the oesophagus causing irritation. This can result in excess swallowing and frequent burping.
• Acid reflux can also result from drinking or eating certain beverages or foods - such as coffee, alcohol, chillies, spicy food, tomatoes, chocolate and fatty foods. These can irritate the oesophageal sphincter allowing acid to reflux back into the oesophagus. Eating too much at one time can put pressure on the oesophageal valve resulting in weakening and reflux, as can being overweight and pregnancy. Other causes include smoking, stress and anxiety. Reflux promotes frequent swallowing.
• Functional dyspepsia – a kind of chronic indigestion with symptoms of stomach pain, feeling of fullness or bloating during and after meals, with no obvious symptoms.
• Hiatal hernia occurs when a part of the stomach bulges through the diaphragm and into the chest cavity. Symptoms include excessive burping, reflux, trouble swallowing and chest pain.
• Helicobacter pylori infection can cause symptoms of excess burping. Helicobacter pylori (H. pylori) is a bacterium commonly found in the stomach where it can reside without causing any symptoms or sickness, however it may be the cause of gastric ulcers, gastritis and cancer. Symptoms include abdominal pain, nausea, bloating and loss of appetite. 
• Gastritis, Irritable bowel syndrome, and Chronic idiopathic constipation are other common disorders which may be associated with excessive symptoms of burping, bloating and flatulence.

Causes of Bloating

Swallowing air whilst you eat and drink can cause oxygen and nitrogen to accumulate in the digestive tract. Swallowing air is generally harmless, however air trapped in the stomach can cause bloating, severe pain and discomfort. 

The symptoms and mechanisms which cause bloating are complex, but important factors of bloating include impaired gas management and hypersensitivity. Bloating may be associated with altered bacterial flora, small intestinal bacterial overgrowth (SIBO), and abdomino-phrenic dyssynergia (a gastrointestinal disorder due to abnormal brain-gut reflex).

Causes of Flatulence

Flatulence can be due to accumulated gases like methane, hydrogen, and carbon dioxide, produced from digestion. Eating carbohydrate-type foods can result in excessive gas.

Foods which have been found to increase flatulence include beans, cabbage, brussel sprouts, asparagus, onions and broccoli and foods high in sorbitol or fructose. You may find yourself with excessive flatulence after consuming more fruit, wholegrains, processed foods, baked foods, dairy foods and sweets. Protein foods may produce gas which is odourful.

Bacteria in the colon also release gas in the process of food break down. The gas produced can result in flatulence.

Medical conditions which may be associated with flatulence:

• Constipation
• IBS, ulcerative colitis and Crohn’s disease
• Gastroenteritis
• Food intolerances
• Celiac disease
• Diabetes
• Gastroesophageal reflux disease (GERD)

Natural solutions to reduce burping, bloating and flatulence

Reducing symptoms often requires avoiding some common practices.

Avoid

• Eating and drinking too fast - instead savour the texture and taste of your food by eating it slowly and chewing it well. 
• Large meals
• Talking whilst eating. As much as eating can be a social event, if you talk whilst you eat you risk swallowing more air.
• Carbonated drinks
• Eating whilst stressed
• Drinking through a straw
• Chewing gum
• Smoking

Foods high in starch, sugar, and fibre can cause abdominal gas. These include: lentils, broccoli, cabbage, cauliflower, and onions; sweeteners – sorbitol, mannitol, fructose and xylitol.

Foods which may cause reflux include caffeine, tomatoes, citrus and alcohol.

Already burping, bloating and passing wind?

Natural solutions to neutralise stomach acid to prevent reflux, and dispel digestive gas include:

Ginger (Zingiber officinale) offers carminative effects on the gastrointestinal system. It can decrease pressure on the lower oesophageal sphincter, reduce intestinal cramping and prevent dyspepsia, bloating and flatulence.

Peppermint (Mentha Piperita) offers carminative properties on the gastrointestinal system reducing spasms. Enteric-coated peppermint oil capsules are a safe and effective therapy for the relief of abdominal pain and other symptoms associated with IBS.

Papaya is a tropical fruit which can help digestion. It contains an enzyme called papain which breaks down proteins and has been shown to reduce heartburn, bloating and constipation.  

German Chamomile (Matricaria recutita) - the relaxant effects of chamomile has been known and valued for hundreds of years. It offers a spasmolytic action on the digestive tract and, as a sedative, it can calm the mind in times of anxiety.

Fennel seeds (Foeniculum vulgare) are helpful for relief of flatulence, indigestion, cramps and bloating.

Aloe vera is effective in significantly reducing the frequencies of all GERD symptoms such as reflux.

Marine alginate, an extract of seaweed, is suggested to mitigate GERD symptoms due to its raft-forming mucilage properties.

Slippery Elm (Ulmus rubra) bark offers a demulcent, emollient, and nutritive action on the digestive system - beneficial for oesophagitis, colitis, gastritis, peptic ulcers and diarrhoea.

Probiotic bacteria can offer a normalising effect on the bowel and improve digestive function.

Burping, bloating and flatulence are a normal part of body processes. In excess they can indicate some minor or more significant digestive, or health concerns. Avoiding some foods, including some foods, and supplements can help with common symptoms of digestion.

The information provided is not intended to be used for diagnosis or treatment. If you are experiencing any health concerns, please consult your doctor for advice.

References

1. Gas, Bloating, and Belching: Approach to Evaluation and Management https://www.aafp.org/pubs/afp/issues/2019/0301/p301.html
2. Motion sickness: an overview https://pubmed.ncbi.nlm.nih.gov/32158479/
3. Functional dyspepsia Functional dyspepsia - Australian Prescriber (nps.org.au)
4. Abdominal Bloating: Pathophysiology and Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816178/
5. Ginger in gastrointestinal disorders: A systematic review of clinical trials Ginger in gastrointestinal disorders: A systematic review of clinical trials - PMC (nih.gov)
6. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data https://pubmed.ncbi.nlm.nih.gov/30654773/
7. Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839470/
8. Papaya preparation (Caricol®) in digestive disorders https://pubmed.ncbi.nlm.nih.gov/23524622/
9. Fisher, Carole; 2009, MATERIA MEDICA OF WESTERN HERBS, Vitex Medica, New Zealand