Q&A: Belching, bloating and flatulence

Insights from Young Choi, MD

Woman with an upset stomach
Q: Is belching really caused by swallowing air?

Yes, that’s the most common cause. If you eat quickly, you swallow more air, and that air gets pushed down into your stomach along with the food you’re eating. Once it hits your stomach, the stomach expands. If the pressure reaches the point of discomfort, a sensor in your stomach triggers an impulse to relieve the pressure — and a burp does the trick.

Other things that might lead you to swallow extra air include drinking carbonated beverages, wearing loose-fitting dentures and chewing gum. Most sugar-free gums also contain sugar substitutes, such as sorbitol or xylitol. These hard-to-digest sweeteners tend to act as laxatives, causing even more bloating and belching.

Q: What causes extra gas at the other end?

Most flatulence happens when food passes into the colon before it’s been fully digested in the small intestine. Bacteria in the colon finish breaking it down, producing gases in the process. Foods that are harder to digest cause more gas for everyone. These include fatty processed foods as well as nutrient-dense foods such as beans, cabbage and onions.

Certain people also have more difficulty digesting specific foods. Those with lactose intolerance, for example, have trouble digesting milk, which ferments in the colon and causes gas.

Less commonly, some digestive conditions, such as celiac disease, cause similar digestive symptoms, but have more significant health consequences. The physician’s role is to help differentiate between benign issues and those that could be more harmful.

Q: What can you do to reduce gas?

Avoiding foods that seem linked to your gas is a simple first step. Over-the-counter remedies such as Beano and Gas-X also can quell occasional episodes, but if you find yourself reaching for them frequently, there could be something else going on.

Q: What’s a normal amount of gas, and what’s not?

Everybody’s different. Anything that’s out of the ordinary for you, such as new, bothersome or worsening symptoms, could be abnormal. On the other hand, if you’ve had an undiagnosed condition like celiac disease all your life, problematic symptoms might seem very normal to you. If family members or friends make comments about the frequency of your bathroom trips, pay attention.

Q: When should you see a health care provider?

The examples above are worth a visit. Related symptoms — such as weight loss, abdominal pain, vomiting, diarrhea, constipation or bleeding from the GI tract — definitely require attention. Our intestines are extremely efficient at processing food, so when symptoms like these arise, they need to be checked out.