Up to 4 out of 10 Americans experience acid reflux symptoms at some point making it one of the most common upper gastrointestinal conditions. It tends to become more common in people older than 40 years. However, acid reflux may not always present with the typical symptoms that most of us expect. Heartburn is considered to be a characteristic feature of reflux but there are instances where a person may not experience this symptom, and can sometimes be asymptomatic entirely. It is only with further attention that vague symptoms of reflux may become obvious. One of these is sour-tasting burps or acid burps.
Belching With Acid Reflux
Belching or burping is the expulsion of digestive gas through the mouth. It is an often unconscious act that occurs several times in a day. Most of the gas is air that was swallowed when eating, drinking and talking. While belching is considered to be normal, excessive belching can be a symptom of various diseases. However, in the vast majority of cases it occurs when excessive amounts of air is swallowed like with fast eating, gum chewing and so on.
Acid reflux is the backward flow of the acidic contents of the stomach. This includes foods or beverages that have recently been consumed along with gastric acid and strong digestive enzymes that are produced by the glands in the stomach wall. It arises when the lower esophageal sphincter (LES) that normally prevents backward flow malfunctions. It is further caused by increased abdominal pressure and to some extent by position.
Gastroesophageal reflux disease (GERD) which is a term used interchangeably with acid reflux is a more severe form that is often chronic and affects a person’s like in various ways beyond just the reflux symptoms. Belching is one of the symptoms that may occur with reflux, along with other symptoms like heartburn (burning chest pain), nausea, indigestion and regurgitation. The expulsion of digestive gas can also carry acid higher up into the esophagus giving rise to symptoms that may be termed as acid burps where there is a burning chest pain with belching, sour acidic taste in the mouth with a belch and a burning pain in the throat and mouth. It is the acid in the esophagus, throat and mouth that causes this burning sensation and sour taste.
Causes of Acid Belching
The causes for acid belching does not diverge significantly from the causes of acid reflux or excessive belching. Sometimes acid burps may also be referred to as sour stomach so it is worth considering the causes of this symptom as well. The cause of acid reflux is largely due to a dysfunctional LES but several factors can contribute to it.
Overeating and eating fast are two of the common eating habits that contribute to acid burps. It is further exacerbated when meals include food and/or beverages containing alcohol, caffeine and fizzy drinks. People who tend to breather through their mouth due to problems such as a congested nose, or talk excessively while eating are more likely to suffer with both excessive belching and acid reflux.
Alcohol, Caffeine and Fizz
Alcoholic beverages and caffeinated drinks can affect the normal functioning of the lower esophageal sphincter thereby contributing to acid reflux. Carbonated beverages are a common cause of excessive belching. The symptom of acid burps is further worsened when a carbonated beverage also contains caffeine or alcohol, as is the case with some cola sodas and alcoholic drinks like sparkling wine and beer.
Obese people tend to suffer with acid reflux more frequently for several reasons. Increased abdominal pressure due to a large girth may contribute to reflux. Overeating is common which also results in reflux. Furthermore a sedentary lifestyle that is common among obese people and higher incidence of diabetes may affect stomach emptying resulting in reflux.
Acid reflux and excessive belching is common in pregnancy. The increased intra-abdominal pressure from the growing uterus and the effects of the pregnancy hormones on the LES makes acid reflux a significant problem for most pregnant women. Shortness of breath often associated with pregnancy anemia and being easily fatigued also contributes to greater air swallowing. Most pregnant women will also eat quite freely without usual restrictions and therefore overeating just compounds the problem.
Smoking and Tobacco Use
Tobacco consumptions particularly with smoking and chewing contributes to acid burps through several ways. Firstly air swallowing (aerophagia) increases with both tobacco smoking and tobacco chewing. The stimulant effect of nicotine coupled with the other chemicals in tobacco may also weaken the LES and increase stomach acid production.
Acid reflux may arise with several diseases and disorders affecting the upper digestive tract. It is more likely to occur when there is a problem in the stomach itself, the band of muscles that make up the LES and in the first part of the small intestine duodenum. By not preventing the backward flow of stomach acid, delayed emptying of the stomach and/or excessive acid production may all contribute to acid burps. This is seen with conditions like:
- Hiatal hernia
- Pyloric stenosis
- Bowel motility disorders
Treatment of Acid Burps
The treatment of acid belching is largely the same as GERD treatment along with added measures to ease excessive belching.
- Antacids are one of the most widely used medication as it is easily available over-the-counter (OTC). It works by neutralizing stomach acid but the effect is usually short-lived.
- Acid-suppressing drugs like proton pump inhibitors and H2-antagonists block the production of stomach acid. It is a preferred option for sustained relief over hours.
- Raft barrier agents are another OTC product that may sometimes be combined with antacids. It works by floating on top of the stomach juices and acts as a barrier between the stomach acid and esophageal wall.
- Prokinetic drugs like metoclopramide work by speeding up gastric emptying. It is not commonly used for acid reflux but may be necessary in cases where there is delayed stomach emptying.
- Anti-foaming agents like simethicone help to relieve digestive gas buildup which may be compromising LES functioning and pushing acid into the esophagus.
Despite the various drugs that could be used for acid burps, diet and lifestyle management is equally important. It would include measures such as eating smaller meals more frequently, avoiding alcohol and caffeine, minimizing the intake of carbonated beverages, eating slowly and stopping tobacco use.