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For further information, see CMDT Part 15-05: Gastrointestinal Gas

Key Features

  • Belching (eructation) is defined as the involuntary or voluntary release of gas from the stomach or esophagus

  • A normal reflex, it does not itself denote gastrointestinal dysfunction

  • Occurs most frequently after meals, when gastric distention results in transient lower esophageal sphincter relaxations

  • When chronic and excessive, almost always caused by aerophagia, common in anxious individuals and institutionalized patients

Clinical Findings

  • Virtually all stomach gas comes from swallowed air

  • Distention, flatulence, and abdominal pain may result when excessive amounts of air is ingested (eg, with carbonated beverages, rapid eating, gum chewing, and smoking)


  • Evaluation should be restricted to patients with other complaints such as dysphagia, heartburn, early satiety, or vomiting


  • Referral to behavioral or speech therapist may be beneficial since most patients suffer from behavioral disorder (eg, aerophagia from causes listed above)

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