Belching, gas and bloating: Tips for reducing them

Belching or passing gas, also called flatus, is natural and common. Excessive belching or flatus, along with bloating, pain or swelling of the belly, can sometimes interfere with daily activities or cause embarrassment. But these symptoms usually don't point to a serious underlying condition and are often reduced with simple lifestyle changes.

When belching, gas or bloating interferes with your daily activities, there may be something wrong. Find out how to reduce or avoid gas and gas pains, and when you may need to see a healthcare professional.

Belching is commonly known as burping. It's your body's way of pushing out excess air from your upper digestive tract. Most belching is caused by swallowing excess air. This air most often never even reaches the stomach. Instead, it builds up in the esophagus.

You may swallow excess air if you eat or drink too fast, talk while you eat, chew gum, suck on hard candies, drink carbonated beverages, or smoke. Some people swallow air as a nervous habit even when they're not eating or drinking.

Acid reflux or gastroesophageal reflux disease (GERD) can sometimes cause excessive belching by promoting increased swallowing.

Belching often also may be related to inflammation of the stomach lining or to an infection with Helicobacter pylori, the bacterium responsible for some stomach ulcers. In these cases, the belching is accompanied by other symptoms, such as heartburn or stomach pain.

You can reduce belching if you:

• Eat and drink slowly. Taking your time can help you swallow less air. Try to make meals relaxed occasions; eating when you're stressed or on the run increases the air you swallow.
• Don't drink carbonated drinks and beer. They release carbon dioxide gas.
• Skip the gum and hard candy. When you chew gum or suck on hard candy, you swallow more often than normal. Part of what you're swallowing is air.
• Don't smoke. When you inhale smoke, you also inhale and swallow air.
• Check your dentures. Poorly fitting dentures can cause you to swallow excess air when you eat and drink.
• Get moving. It may help to take a short walk after eating.
• Treat heartburn. For occasional, mild heartburn, over the counter antacids or other remedies may be helpful. GERD may require prescription-strength medicine or other treatments.

Gas in the small intestine or colon is usually caused by the digestion or fermentation of undigested food by bacteria found in the bowel. Gas also can form when your digestive system doesn't completely break down certain components in foods, such as gluten, found in most grains, or the sugar in dairy products and fruit.

Other sources of intestinal gas may include:

• Food residue in your colon.
• A change in the bacteria in the small intestine.
• Poor absorption of carbohydrates, which can upset the balance of helpful bacteria in your digestive system.
• Constipation, since the longer food waste remains in your colon, the more time it has to ferment.
• A digestive condition, such as lactose or fructose intolerance or celiac disease.

To prevent excess gas, it may help to:

• Eliminate certain foods. Common gas-causing offenders include beans, peas, lentils, cabbage, onions, broccoli, cauliflower, whole-grain foods, mushrooms, certain fruits, and beer and other carbonated drinks. Try removing one food at a time to see if your gas improves.
• Read labels. If dairy products seem to be a problem, you may have some degree of lactose intolerance. Pay attention to what you eat and try low-lactose or lactose-free varieties. Certain indigestible carbohydrates found in sugar-free foods, such as sorbitol, mannitol and xylitol, also may result in increased gas.
• Eat fewer fatty foods. Fat slows digestion, giving food more time to ferment.
• Temporarily cut back on high-fiber foods. Fiber has many benefits, but many high-fiber foods are also great gas producers. After a break, slowly add fiber back to your diet.

• Try an over the counter remedy. Some products such as Lactaid or Dairy Ease can help digest lactose. Products containing simethicone (Gas-X, Mylanta Gas, others) haven't been proved to be helpful, but many people feel that these products work.

  Products such as Beano, particularly the liquid form, may decrease the gas produced during the breakdown of certain types of beans.

Bloating is a sensation of having a full stomach. Distension is a visible or measurable increase in belly size. People often describe stomach symptoms as bloating, especially if those symptoms don't seem to be relieved by belching, passing gas or having a bowel movement.

The exact connection between intestinal gas and bloating is not fully understood. Many people with bloating symptoms don't have any more gas in the intestine than do other people. Many people, particularly those with irritable bowel syndrome or anxiety, may just have a greater sensitivity to stomach symptoms and intestinal gas.

Nonetheless, bloating may be relieved by the behavioral changes that reduce belching, or the dietary changes that reduce flatus.

Excessive belching, passing gas and bloating often resolve on their own or with simple changes. If these are the only symptoms you have, they rarely represent any serious underlying condition.

Consult a healthcare professional if your symptoms don't improve with simple changes, particularly if you also notice:

• Diarrhea.
• Persistent or severe belly pain.
• Bloody stools.
• Changes in the color or frequency of stools.
• Losing weight without trying.
• Chest discomfort.
• Loss of appetite or feeling full quickly.

These symptoms could signal an underlying digestive condition. Intestinal symptoms can be embarrassing — but don't let embarrassment keep you from seeking help.