STI: Ask the experts

March 26, 2009

Ask the experts

 

DAD HAS LONG BOUTS OF BELCHING

 

Q: I am writing on behalf of my father, who is in his 50s and has been plagued with a feeling of bloatedness for some time. He also often has prolonged bouts of belching or burping and this has been going on for two years.

 

We have consulted many doctors over the past two years and the eventual diagnosis was gall bladder stones. The stones were subsequently removed but my father continues to experience the prolonged bouts of belching.

 

He belches at night but not in the day and it seems to get worse after he has had a bath. It is affecting his sleep and his health in general. Is there a solution?

 

A: Belching results from the accumulation of air in the stomach, which causes the stomach wall to induce a reflex to release air upwards. From my clinical experience dealing with patients who complain about belching, I would usually categorise the problem into the following types:

 

Postprandial belching. This is a normal form of belching which occurs during and after a meal - about three to five belches within 30 minutes to an hour.

 

Aerophagia (literally meaning swallowing too much air). It results from a repetitive pattern of ingesting air and then belching it out almost immediately, even before it reaches the stomach. This can sometimes be an unconscious act unrelated to meals and presumably is a learnt habit.

 

Behavioural therapy or logopaedic speech therapy (a form of speech therapy that focuses on relaxation and breathing) can help.

 

The third and clinically important type is excessive belching from gastroesophageal reflux disease (Gerd) and conditions of dyspepsia. Often, there would be other symptoms such as heartburn - which can be worse at night during sleep (for Gerd) - and upper abdominal discomfort/distension (for dyspepsia). However, belching in itself can be an isolated symptom.

 

A gastroscopy is useful to assess for Gerd and the causes of dyspepsia. Your father should undergo this procedure if he has not already done so.

 

Treatment would be targeted at the condition detected. For Gerd, this would include proton pump inhibitors, a kind of acid blocker. Meanwhile, your father could take some over-the-counter medication such as simethicone to help reduce air in the stomach.

 

Dr Dede Selamat Sutedja is a senior consultant gastroenterologist and hepatologist at Gleneagles Hospital.