The gut contains solids, liquids and gases which constantly enter and exit through the mouth and rectum. Most of the gas in the gut is air from the environment around us. It enters during swallowing food or beverages but also enters the gut while talking, chewing and breathing. Ths gas is eventually passed out as a belch (burp) or flatus (fart). Sometimes this gas buildup in the gut causes discomfort and needs to be treated.
What is Aerophagia?
Aerophagia is the act of swallowing air. This is when air enters the gastrointestinal tract (gut) rather than the lungs. Most of the air within our gut occurs during swallowing. The air may get trapped in the esophagus and/or stomach temporarily and may be passed with an eructation (belch or burp). It can also pass down into the lower gut and mix with other gases in the bowels to be expelled as flatus (fart).
Aerophagia is not a serious condition but may lead to gas bloating, indigestion and abdominal discomfort. The most noticeable symptom though is excessive belching. However, persistent swallowing of air will also increase the volume of flatus (fart). Sometimes the gas bloating, belching and flatulence can be uncomfortable and excessive to the point that it affects a person’s life. At this point it is considered a symptom.
Why does air enter the gut?
Breathing through the mouth is one route for gases to travel between the lungs and the environment. Normally this does not pose a problem as the opening of the epiglottis and the negative pressure created within the lungs during inspiration essentially “sucks” the air into the lungs. Similarly when exhaling the air is forced out of the lung and airways and quickly exit via the nose or mouth. The esophagus in these instances is usually collapsed so air will not easily enter it.
However, it is when air is moving and swallowing occurs or when there is insufficient food or liquid in the mouth at the times of swallowing that air is actually pushed into the esophagus. In other words, aerophagia (air swallowing) almost never occurs without actual swallowing. Since swallowing is a voluntary act (the first part), air swallowing can therefore be controlled and prevented when a person is conscious of their actions.
Causes of Excessive Aerophagia
We all swallow air throughout the day. This is usually in small quantities and causes little to no symptoms. Most of the time this air is swallowed while eating and drinking as well as during talking and breathing to a lesser extent. Therefore it is not uncommon to belch after eating. However, there are some instances where air swallowing occurs to a greater extent. The entry and accumulation of the air within the gut can then result in symptoms.
Due to a blocked nose, a person will breathe through their mouth. This increases the chance of air swallowing, especially when drinking and eating food. Nasal congestion may occur for several reasons including allergies as is seen in allergic rhinitis (hay fever) and infections like the common cold or flu.
Eating, Drinking or Talking Too Fast
Although small amounts of air enter the gut when drinking or eating, it increases drastically when a person drinks or eats too fast. The same occurs with talking too fast. People who have to speak loudly tend to take deeper and more frequent breaths and air swallowing may therefore increase.
Strenuous Physical Activity and Hyperventilation
Any physical strain that leads rapid breathing and mouth breathing will also increase air swallowing. This is seen when exercising, playing sport or even during daily activities that require physical dexterity. Even emotional stress that leads to rapid breathing or hyperventilation will aggravate air swallowing.
Chewing Gum and Tobacco Smoking
Air swallowing is also increased during activities like gum chewing and tobacco smoking. In gum chewing, the repeated chewing and swallowing without any food or beverages will allow more air to enter the gut. Deep inhaling with smoking may also lead to more entering the gut.
Incorrectly Fitting Dentures
Dentures and dental braces can also contribute to increased air swallowing. In part this leads to slight mouth breathing and greater air intake while chewing, drinking or talking. Even certain dental conditions like missing teething can increase air swallowing.
Other Sources of Gas in the Gut
There are other sources of gas in the gut which may not have entered via the mouth with the swallowing of the air. This should not be confused with aerophagia as it specifically refers to the act of swallowing air. Gas may enter the gut through carbonated beverages, bacterial action in the bowels and even some gas passes out of the bloodstream and into the gut. These gases may only enter or arise lower down the gut and is passed out with flatus.
Read more on excessive gas in the gut.
Signs and Symptoms
Every person swallows some air when eating and drinking. This is normal. However, these quantities of air are very small, quickly passed out with a belch and rarely cause any symptoms in such small quantities. Excessive air swallowing will causes symptoms such as :
- Excessive belching
- Indigestion (dyspepsia)
- Bloating (sensation of fullness)
- Excessive flatulence (uncommon)
- Abdominal discomfort
- Louder or more active bowel sounds
Treatment of Aerophagia
Aerophagia is not a serious medical condition. However, measures need to be taken in people who are experiencing abdominal discomfort due to gas buildup, excessive belching or excessive flatulence. Medical treatment for excessive air swallowing is usually not necessary but a few simple dietary and lifestyle measures may be helpful.
- Take time to eat, chew slowly and avoid talking while eating. Do not drink beverages with large gulps but rather sip slowly.
- People who talk for a living should take note of whether they are speaking too fast or breathing through their mouth only during talking.
- Carbonated drinks worsen the problem of gas accumulation in the gut and these beverages should be minimized or avoided altogether.
- Gum should not be chewed for long periods of time or repeatedly. Avoid chewing with an open mouth or too fast.