Excessive Burping: Causes and Solutions for GERD Symptoms - Gastroenterology and Hepatology

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Excessive burping, or belching, can be a common symptom associated with gastroesophageal reflux disease (GERD). In your case, it seems that you have undergone an endoscopy which revealed some reflux and minor ulcers in your stomach and duodenum, but you do not experience the classic symptom of heartburn. Instead, you are dealing with frequent burping and a sensation of something stuck in your throat.

Burping occurs when air is swallowed and then expelled from the stomach. This can happen for various reasons, including eating too quickly, consuming carbonated beverages, or even anxiety. In the context of GERD, burping can also be a result of the stomach's contents, including acid, moving back up into the esophagus, which can irritate the throat and lead to a sensation of discomfort.

Regarding your question about the frequency of burping, while it's normal for people to burp occasionally, excessive burping can be considered more than 10-20 times a day, depending on individual circumstances. Since you mentioned experiencing around 20 burps a day, this may be on the higher end of normal, especially if it is accompanied by other symptoms like the sensation of something stuck in your throat.

To determine whether your burping is related to reflux, you can look for additional symptoms. Common signs of GERD include:
1. Regurgitation: This is the sensation of acid backing up into your throat or mouth, which may not always be accompanied by heartburn.

2. Dysphagia: Difficulty swallowing can indicate that reflux is affecting your esophagus.

3. Chronic cough or hoarseness: These can occur if stomach acid irritates the throat.

4. Sour taste in the mouth: This can happen when acid reaches the throat.

If you do not experience these symptoms, it may be challenging to determine if your burping is due to reflux or other causes.
In terms of management, since you are already on a proton pump inhibitor (PPI) like Panzolec, which has helped alleviate some symptoms, here are additional strategies you might consider:
1. Dietary Changes: Avoiding trigger foods such as spicy foods, citrus, chocolate, caffeine, and fatty foods can help reduce reflux symptoms. Eating smaller, more frequent meals rather than large meals can also be beneficial.

2. Eating Habits: Try to eat slowly and chew your food thoroughly. Avoid talking while eating, as this can lead to swallowing more air.

3. Posture: After eating, remain upright for at least 2-3 hours to help prevent reflux. Elevating the head of your bed can also help reduce nighttime symptoms.

4. Hydration: While drinking water is essential, try to sip slowly and avoid drinking large amounts at once, as this can contribute to burping.

5. Avoid Carbonated Beverages: These can increase the amount of air swallowed and lead to more burping.

6. Stress Management: Since anxiety can contribute to swallowing air, practicing relaxation techniques such as deep breathing, meditation, or yoga may help.

If your symptoms persist despite these measures, or if you experience worsening symptoms, it would be prudent to follow up with your healthcare provider. They may consider further evaluation, such as a pH monitoring test, to assess acid levels in your esophagus and confirm the diagnosis of GERD.

In summary, while excessive burping can be bothersome, understanding its potential causes and implementing lifestyle changes can significantly improve your symptoms. Always consult with your healthcare provider before making any changes to your treatment plan.