Belching (eructation) is the return of gaseous and liquid contents into the oral cavity from the lower sections of the digestive tract. Usually has a physiological origin. It can be observed in diseases of various parts of the gastrointestinal tract, diaphragm, less often in cardiopathology, neurotic conditions. Endoscopic, ultrasound, X-ray, electrophysiological, laboratory methods are used to determine the causes of the symptom. In order to reduce the severity of belching, correction of eating habits, herbal decoctions, silicone derivatives, and prokinetics are recommended.
Belching is perceived as a sudden entry into the oral cavity of gastric contents with the appearance of a characteristic sound. For most people, the mouth opens slightly when burping, and sometimes there is a feeling of constriction in the epigastrium. Belching gases usually have a neutral taste and smell, except when eating strong-smelling foods and drinks (garlic, onions, alcohol). During the erection of liquids, a sour taste of varying intensity often occurs, and bitter or putrid contents are less often burped.
Eructation is more common after eating or drinking, especially after eating foods that promote gas formation. Sometimes belching is preceded by heaviness, bursting in the epigastric region with relief after the passage of air or liquid chyme. Normally, the symptom occurs up to 15-3 times a day. With its more frequent occurrence, the predominance of a liquid component with an intense sour, bitter or putrefactive taste in the belching contents, a combination of belching with hiccups, nausea, vomiting, pain in the abdominal cavity, it is recommended to visit a gastroenterologist.
The main starting point for the formation of belching is an increase in the volume of the stomach, primarily due to air, carbon dioxide, and other gaseous substances. Normally, the cavity of the stomach always contains a certain amount of gases (gas bubble) that stimulate gastric secretion and peristalsis. Usually, their excess is absorbed into the bloodstream, enters the intestines, or is imperceptibly excreted in small portions. The accumulation of gases in the stomach is facilitated by swallowing air when eating, drinking, smoking, emotional conversation.
With the use of certain products (legumes, cabbage, fresh bread), carbonated drinks, increased gas formation is observed, leading to stretching of the gastric wall. It is extremely rare that with the failure of the obturator structures that separate the sections of the gastrointestinal tract, gases enter the stomach cavity from the intestines. Regardless of the mechanism for increasing the volume of the gas bubble, when the gastric wall is stretched, the musculature of the organ reflexively contracts, the cardiac sphincter relaxes, and belching occurs in the form of a sharp release of gases into the esophagus and further into the mouth.
A similar mechanism is the formation of erection with an increase in the volume of the stomach due to overeating, slowing down the evacuation of chyme from the cavity of the stomach, but in this case, both gases and liquid gastric contents are usually burped. The reflex contraction of the stomach with the occurrence of belching during contraction of the abdominal muscles during physical exertion, the displacement of the internal organs towards the diaphragm during pregnancy contributes to an increase in abdominal pressure.
Less commonly, the leading mechanism for the development of erection is gastroesophageal reflux caused by insufficiency of the obturator function of the cardia. In a number of pathological conditions, the sphincter that separates the esophagus from the gastric cavity is weakened. As a result, even with normal intragastric pressure, not only gaseous, but also liquid contents of the stomach are thrown into the esophagus. The occurrence of belching can also occur with an increase in the contractile activity of the gastric muscles due to a violation of autonomic regulation.
When determining individual variants of belching, the connection of the symptom with painful conditions, the organoleptic features of the incoming gastric contents are taken into account. There is a physiological form of belching that occurs in healthy people, and pathological, which is provoked by diseases of the gastrointestinal tract, less often by diseases of other organs and systems and is usually combined with other manifestations of dyspepsia in children or adults. In diagnostic and prognostic terms, the classification of erection is important, taking into account the characteristics of the burped content:
In addition to reflex gastric erection, a supragastric variant of the symptom is isolated with regurgitation of gases accumulating in the esophagus. Such an eructation is characterized by conscious control on the part of a person: the removal of air occurs intentionally with an arbitrary tension of the muscles of the pharynx and tongue. Violation of the awareness of muscle contractions during supragastric erection, combined with anxiety, are characteristic of neurotic disorders.