eructation

Eructation, commonly known as belching, is the expulsion of gas from the digestive tract through the mouth. It is a normal physiological process that relieves intragastric gas pressure. The gas originates largely from swallowed air (aerophagia) and from digestive processes that produce carbon dioxide; most belches involve air that has accumulated in the stomach or esophagus. The process is usually voluntary but often occurs reflexively after meals or when swallowing air during speaking or drinking.

Mechanism: Gas collects in the stomach; the lower esophageal sphincter opens briefly, allowing gas to escape upward. Belching commonly occurs after consuming carbonated beverages, rapid eating, chewing gum, smoking, or anxiety. Frequent belching without other symptoms is typically benign; however, persistent or excessive eructation may indicate an underlying condition such as gastroesophageal reflux disease, gastritis, peptic ulcer disease, Helicobacter pylori infection, gastroparesis, or aerophagia (air swallowing) common in certain psychiatric or developmental conditions.

Diagnosis: Primarily clinical. If belching is persistent, associated with reflux symptoms, weight loss, persistent vomiting, difficulty swallowing, or abrupt changes in bowel habit, further evaluation may be indicated, including endoscopy, pH monitoring, or gastric emptying studies.

Treatment: Most cases require no treatment. Lifestyle measures include eating slowly, avoiding carbonated drinks, reducing air swallowing (chewing with mouth closed, avoiding straws), avoiding smoking, and limiting chewing gum. Treat underlying conditions with appropriate therapy (acid suppression for GERD, antibiotics for H. pylori, etc.).