Burping

What Is Burping (Belching)?

What Is Burping (Belching)?

Burping (belching) means expelling of the air or other gases from your stomach through your mouth. Many healthy people expel some non-smelling air after eating or drinking. Various health disorders can causes excessive burping.

What Are Sulphur Burps?

The smell of sulphur or rotten egg burps comes from hydrogen sulfide (H2S), a gas originating from sulphur-containing proteins in certain foods (see below) after they are broken down in the stomach or small intestine by sulphur-reducing microbes. These microbes may be normal intestinal bacteria or pathogenic bacteria.

Sulphur Containing Foods

Removing sulphur containing foods from the diet may reduce the smell of sulphur burps:

• Sulfur containing food preservatives, like guacamola, often used on dried fruits, salads in hotels, meat in fast-food restaurants or in pre-prepared canned foods
• Poultry
• Red meats
• Eggs
• Dairy products, especially milk
• Vegetables: asparagus, broccoli, cabbage, garlic, mustard, onions, pack choi, parsley, sweet potatoes, Swiss chard, tomatoes, watercress, yams
• Legumes: beans, peas, lentils, soy, carob, jicama, alfalfa
• Fruits: avocado, bananas, watermelon
• Grains, nuts and seeds: corn, sunflower seeds, oats, cashews, walnuts, almonds, sesame seeds, coconut.
• Tea and coffee
• Whey proteins
• Amino acids: cysteine, methionine
• Vitamins B1 (thiamine) and H (biotin)
• Certain medicines may contain sulphur (also check labels for amino acids cysteine or methionine that contain sulphur).

Sulphur Reducing Microbes

Examples of sulphur reducing bacteria and some other microbes that can use sulphur compounds from the food and yield hydrogen sulfide as an end product:

• Helicobacter pylori, a bacterium causing chronic gastritis, gastric or duodenal ulcer, upper abdominal bloating, heartburn and burping. H. pylori is diagnosed by urea breath test; treatment is by antibiotics.
• Giardia lamblia, a one-cell parasite, usually contracted by food or water poisoning, causing diarrhea, bloating, foul smelling burps or farts. For diagnosis and treatment read about human intestinal parasites.
• Intestinal bacteria that are part of normal intestinal flora but can cause bloating, burping, flatulence or diarrhea when they overgrow; condition is called small intestinal bacterial overgrowth (SIBO) . SIBO may be also present in lactose intolerance or fructose malabsorption. In certain diseases like celiac disease or Crohn’s disease, foods may not be digested completely and can be therefore broken down by sulphur reducing bacteria that produce hydrogen sulfide.

How To Get Rid Of Sulphur Burps?

1. Remove as much as possible sulphur containing foods from your diet. This may reduce sulphur smell of burps and gas in a day or two. After that, you will still need to find the cause of belching or gas themselves.
2. If you suspect you might have celiac disease, besides the low-sulphur diet, try a gluten-free diet (no wheat, barley and rye). If your symptoms disappear or lessen considerably within a week or two, this speaks for celiac disease.
3. If you have history of peptic ulcer, stomach burning, gastric reflux and heartburn, visit a gastroenterologist and ask for a breath test for Helycobacter pylori. This bacterium is a common cause of sulphur burps. Treatment is with 7 or 10 day course of antibiotics.
4. If you are bloated and have excessive foul smelling gas or loose stools with mucus, ask your doctor for a stool test for ova and parasites (O&P) since you may have infection with a parasite giardia. Treatment is with anti-parasitic drugs.
5. If you suspect Crohn’s disease - symptoms include low grade temperature, nausea, fatigue, blood in the stool, diarrhea, bloating - visit gastroenterologist and ask for appropriate tests that may include colonoscopy.
6. If all above tests are negative, ask for breath test for small intestinal bacterial overgrowth (SIBO) .
7. Gastric emptying test may reveal slow stomach emptying (gastroparesis).
8. Some people with gallstones reported that sulphur burps disappeared after gallbladder removal. Diagnosis of gallstones is with abdominal ultrasound or other gallbladder tests.

ADDITIONAL NOTES:

• To get rid of sulfur burps, sometimes you only need to remove some particular food(s) rich in sulfur, for example, Pina Colada, containing coconut cream.
• If you have sulphur burps but NOT sulphur gas (flatulence) the cause is probably in your stomach (H. pylori infection, gastroparesis). If you suffer from both sulphur burps and gas or only sulphur gas you may have small intestinal or gallbladder disorder.
• Pepto Bismol (bismuth subsalicylate), a popular antidiarrheal drug, binds hydrogen sulfide and removes it from the gastrointestinal tract thus reducing sulphur burps and gas. Pepto Bismol should NOT be used in children, and no longer then 2-3 weeks in adults. Pepto Bismol usually colors your tongue and stool black.