Why Do I Burp So Much? Causes, Sulfur Burps and When to Worry

A stray burp after a big meal is nothing to think twice about. But when burping happens constantly, smells like rotten eggs, or comes with pain in your chest or back, it's worth noting. Excessive burping can be your body's way of flagging something simple, like eating too fast or something that needs treatment, like an underlying digestive condition. Doug Purdy, MD, gastroenterologist with UnityPoint Health, wants you to know why it happens, what sulfur burps mean and when it's time to see a doctor.

Why Do We Burp?

Burping, also called belching, happens when air builds up in your stomach and needs to escape. When you eat, your stomach breaks down food and releases gas in the process, so some burping is normal.

What Causes Excessive Burping?

"Excessive belching can be broken down into three main categories: swallowing too much air, certain foods and drinks or an underlying digestive condition," Dr. Purdy says.

Swallowing Too Much Air

Medically, this is known as aerophagia. It's one of the most common and overlooked causes of excessive burping. "People may not even realize they're doing it," Dr. Purdy says.

Common culprits include:

• Anxiety or stress, which can lead to hyperventilating or swallowing air without noticing
• Chewing gum or sucking on hard candy
• Drinking through a straw
• Eating or drinking too quickly
• Sipping hot beverages
• Smoking
• Talking while eating
• Wearing loose-fitting dentures

Diet

Certain foods and drinks release more gas in the stomach and intestines than others. High-FODMAP (Fermentable Oligo-, Di-, Monosaccharides And Polyols) foods - beans, lentils, onions, cabbage, broccoli and whole grains - are common offenders because the small intestine doesn't absorb them well. Artificial sweeteners like sorbitol, xylitol and mannitol can also lead to extra gas.

Underlying Digestive Conditions

Upper gastrointestinal (GI) conditions can also cause excessive belching, including acid reflux (GERD), gastritis, peptic ulcer disease, H. pylori infection and enzyme deficiencies that make it hard to digest sugars like fructose or lactose. When those sugars aren't broken down properly in the small intestine, they travel to the colon, where bacteria ferment them - producing gas that leads to burping. Small intestinal bacterial overgrowth (SIBO) can cause a similar effect.

"If SIBO or a carbohydrate intolerance is suspected, your doctor may recommend breath testing. A lot of times, we treat SIBO with a particular antibiotic that's best for clearing it," Dr. Purdy says.

Is Burping a Sign of Pregnancy?

Burping alone isn't considered an early pregnancy sign, but it can become more noticeable later in pregnancy.

"Anything that puts pressure on the stomach is going to cause the lower esophageal sphincter to be overcome, and a little bit of air that's in the stomach could reflux up there and cause more belching," Dr. Purdy says.

Is Excessive Burping a Sign of Cancer?

Burping on its own - without any other symptoms - usually isn't worrisome.

That said, excessive burping paired with alarming symptoms can point to something more serious. Dr. Purdy says to watch for:

• Black, tarry or bloody stools
• Early satiety (feeling full after eating just a small amount)
• Persistent nausea or vomiting
• Severe abdominal pain that gets worse or won't go away
• Unintentional weight loss

Burping With Other Symptoms

Sometimes burping shows up alone, but it can be accompanied by additional symptoms, too. Paying attention to what else you feel helps your doctor figure out what's going on.

Chest Pain

Burps that hurt your chest are usually related to acid reflux. Pain while swallowing, called odynophagia, can be another sign of esophageal inflammation or ulcers related to reflux.

"When stomach acid moves up into the esophagus during a burp, it can irritate or worsen existing inflammation or ulcers there, causing more pain," Dr. Purdy says.

Nausea or a Sour Stomach

Nausea or a sour stomach alongside burping often suggests an upper GI issue like gastritis, peptic ulcer disease or GERD with esophagitis.

"Gastroparesis, a condition where the stomach empties more slowly than it should, is another possibility. There are a lot of different causes for it," Dr. Purdy says, pointing to diabetes, a lingering effect after a viral illness or GLP-1 weight loss medications, which are known to slow stomach emptying.

Acid Reflux, Chest Pain and Heartburn

Acid reflux, chest pain and heartburn commonly occur together. When stomach acid backs up into the esophagus, it can trigger extra swallowing - and extra air - along with classic GERD symptoms like heartburn, regurgitation, chest pain and nausea. Some people also experience less obvious reflux symptoms, such as a chronic cough, sore throat, a lump-like feeling in the throat, hoarseness or frequent throat-clearing.

Treatment often starts with lifestyle changes, like avoiding meals close to bedtime and cutting back on fatty foods, chocolate, alcohol and caffeine. Medications such as H2 blockers, like famotidine, or proton pump inhibitors, like omeprazole or pantoprazole, can also reduce stomach acid and ease symptoms.

Back Pain

Some people feel back pain when they burp, too.

"When you have pain in the esophagus, for whatever reason, some patients feel it more in the back than they do in the chest," Dr. Purdy says.

What Causes Sulfur Burps?

If your burps smell like rotten eggs, you're likely dealing with a sulfur burp.

"Sulfur burps are basically hydrogen sulfide," Dr. Purdy says. It's a gas that forms when certain foods are broken down in the digestive tract.

Foods most likely to trigger sulfur burps include:

• Broccoli
• Brussels sprouts
• Cabbage
• Cauliflower
• Eggs
• Garlic and onions
• Poultry
• Red meat
• Seafood

Because so many different foods and digestive processes contribute to sulfur burps, Dr. Purdy says it's hard to pin the cause on any one thing. Sulfur burps accompanied by diarrhea may point to a broader digestive issue, such as gastroenteritis, SIBO or gastroparesis - conditions that affect how well the GI tract moves food along.

How Long Do Sulfur Burps Last?

It varies quite a bit, Dr. Purdy says, since so many different mechanisms and foods can be behind them. For some people, they're a short-lived, food-related issue. For others, it may be tied to an ongoing digestive condition worth discussing with your doctor.

How to Stop Sulfur Burps

Because sulfur burps can have so many different causes, treatment usually means addressing what's behind them rather than the smell itself. A few options Dr. Purdy suggests:

• A low-FODMAP diet may ease symptoms for people whose burping is related to certain foods.
• Pepto-Bismol can help stop sulfur burps fast by binding hydrogen sulfide in the GI tract, which may help reduce both the odor and the amount of gas.
• Probiotics may help restore a healthy balance of gut bacteria. "If you have things like belching, bloating, diarrhea, where you think there may be an imbalance of the good flora in the GI tract, I think probiotics can be helpful," Dr. Purdy says.

How to Relieve Excessive Burping

Treatment for burping depends on the underlying cause, but there are a few go-to options that can help in the moment or over time:

• Enzyme supplements, such as lactase for lactose intolerance or Beano for hard-to-digest carbohydrates, can help if a specific food sensitivity is to blame.
• Simethicone products, like Gas-X or Phazyme, help break up gas bubbles so they can move through the GI tract more easily.
• Simple habit changes like eating more slowly, cutting back on carbonated drinks, not using straws and managing stress may also make a noticeable difference.

"Treating the underlying cause, whether that's acid reflux, gastritis, SIBO or an enzyme deficiency, is often the most effective long-term fix," Dr. Purdy says.

When to Worry About Excessive Burping

Occasional burping is normal, but it's worth checking in with your doctor if it becomes frequent, persistent or is joined by other warning signs. Your primary care provider or a gastroenterologist can help determine what's causing your symptoms and the best way to treat them.

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