How can I stop excessive burping?

DEAR DOCTOR K:

I burp constantly. What can I do to stop it?

DEAR READER:

Occasional burping usually results when foods produce gas during the digestive process and that gas escapes through your mouth. But if you’re burping frequently, it is almost certainly the result of swallowing air. Many people swallow air when they breathe or speak without even realizing it.

You can probably reduce your belching by making lifestyle changes to decrease the amount of air you swallow. For example, don’t drink through a straw or chew gum. If you smoke, quit. Getting properly fitted dentures can help too, since loose dentures can also cause you to swallow air.

One relatively common cause of burping and belching is lactose intolerance. Lactose is a type of sugar found in dairy products. Many people, particularly of African or Asian background, have low levels of lactase, an enzyme that digests lactose. As a result, not all of the lactose can be digested. Burping and belching result, along with diarrhea and passing gas. If you think you may have lactose intolerance, talk to your doctor and see if reducing dairy products improves your symptoms.

If you don’t think you’ve got lactose intolerance, try making some other changes to your diet. For example, avoid carbonated drinks and whipped desserts, both of which trigger burping. On the other hand, some people include brown rice, barley broth, papaya and pineapple in their diets to reduce their belching. I’m not sure there is scientific evidence of the benefits of such remedies, but some of my patients swear by them. And, in any event, these are all healthy foods.

Whatever you eat, make sure to chew foods slowly. Avoid washing food down with liquids. And try to eat smaller meals.

Take a brisk stroll after eating. Physical activity encourages food to move through your digestive tract, and it helps relieve bloating and discomfort. Sleep on your stomach or right side. These positions aid in the escape of gas and ease the feeling of fullness.

If belching remains a problem, talk to your doctor. He or she will probably ask about habits I’ve already mentioned, such as drinking carbonated beverages and chewing gum. Your doctor may also ask about lactose intolerance or other conditions that may cause excess gas.

Your doctor will also want to know about anxiety and psychological problems, since they can contribute to gastrointestinal symptoms. He or she will review your medications. Some drugs — especially those that contain the sugar alcohol sorbitol — can produce gas and bloating.

Your doctor may also refer you to a speech and swallow therapist. This professional can help you modify the way you swallow so that you take in less air. If lifestyle changes aren’t effective, a muscle-relaxant drug can help.

Burping and belching may not be a life-threatening problem, but it sure is embarrassing. And I’ve had patients become less socially active because of this embarrassment. I hope the advice I’ve given leads to a solution for you.