What Causes Wind and Excessive Belching?

Passing wind and belching from time to time are part of the normal workings of the digestive system.

We swallow a certain amount of air while eating or drinking. The bowel bacteria also produce gas as they break down some of the food that cannot be digested. Part of the gas formed leaves the body through belching from the mouth, and part of it by passing wind from the bowel.

The problem arises when belching or passing wind becomes very frequent, hard to control, uncomfortable, or begins to affect daily life.

What causes belching?

A significant part of belching is air that has entered the stomach and gullet being expelled again through the mouth.

Eating quickly, drinking quickly and swallowing a lot of air while eating can all increase belching.

The following can also play a part:

• Fizzy drinks
• Chewing gum
• Drinking through a straw
• Smoking
• Talking a great deal while eating
• Eating very quickly
• Reflux symptoms, in some people

Does excessive belching always come from the stomach?

No.

In some people who belch very frequently in particular, the air is taken into the gullet without reaching the stomach and is immediately expelled again.

This is called supragastric belching.

This behaviour is mostly not carried out consciously by the person. It can increase during stress, become more marked while talking or when attention is directed to the belching, and generally disappears during sleep.

In this situation the problem is not “excessive gas building up in the stomach”.

Can reflux cause excessive belching?

Yes, reflux and belching can be seen together.

It cannot be said, however, that everyone who belches frequently has reflux.

In some patients belching can trigger reflux symptoms, or reflux symptoms can lead the person to swallow more air.

Where heartburn, a bitter or sour taste coming up into the mouth, or burning behind the breastbone accompanies it, assessment for reflux can be carried out.

How is bowel gas formed?

A significant part of bowel gas is formed as a result of bacteria in the large bowel fermenting certain carbohydrates.

This process is entirely normal.

Some foods are fermented more, however, and can therefore increase the formation of gas.

Which foods can cause wind?

Although it varies from person to person:

• Pulses
• Onion and garlic
• Cabbage, broccoli and cauliflower
• Certain fruits
• Certain grains
• Fizzy drinks
• Certain artificial sweeteners

can increase wind symptoms.

It is not right, however, to give everyone with wind a long list of forbidden foods.

It is more useful for the person to identify which foods increase their own symptoms.

Why does drinking milk cause wind?

The lactose in milk cannot be sufficiently absorbed from the small bowel in some people.

When the unabsorbed lactose reaches the large bowel it is fermented by bacteria, and this can result in:

• Wind
• Bloating
• Abdominal pain
• Rumbling
• Diarrhoea

This may be related to lactose malabsorption.

It should not be assumed, however, that everyone who has wind after consuming milk has lactose malabsorption.

Can constipation increase wind?

Yes.

In constipation, stool remaining in the bowel for a long time and changes in the passage of bowel contents can increase the sensation of wind and bloating.

Correcting the constipation can also reduce wind symptoms in some people.

Why is there more wind in irritable bowel syndrome?

Patients with IBS often complain that they “have a great deal of wind”.

Not every patient needs to have a genuinely excessive amount of gas in the bowel, however.

The bowel being more sensitive to normal amounts of gas and distension, the movement of gas within the bowel, and differences in the interaction between gut and brain can all cause the symptoms to be felt more intensely.

Are wind and bloating the same thing?

No.

Wind refers to the gas in the digestive system, or to the act of passing it.

Bloating is the person feeling fullness, pressure or tightness in the abdomen.

A person may have marked bloating and yet not have an excessive amount of gas in the bowel.

Is passing a lot of wind a sign of serious disease?

Mostly it is not.

The great majority of wind symptoms are related to eating habits or to functional disorders of the digestive system.

Where newly started and continual wind symptoms are accompanied by:

• Weight loss
• Anaemia
• Long-standing diarrhoea
• Blood in the stool
• Severe abdominal pain
• Persistent vomiting
• A marked change in bowel habit

the underlying cause should nevertheless be investigated.

What can help wind and belching?

It can be useful to review simple habits first:

• Eating slowly
• Chewing food well
• Avoiding swallowing excessive air while eating
• Cutting down fizzy drinks
• Reducing the use of chewing gum
• Identifying the foods that increase the person’s symptoms
• Treating constipation where it is present
• Taking regular physical activity

In people found to have supragastric belching, diaphragmatic breathing and behavioural treatments can be particularly helpful.

Do probiotics reduce wind?

Some people may benefit, but it cannot be said that all probiotics reduce wind and bloating.

The effects of probiotics can vary according to the species of micro-organism used and according to the patient.

The approach of “I have wind, so I must take a probiotic” is therefore not correct.

Is gastroscopy or colonoscopy needed for wind?

Generally, no.

Not everyone whose only complaint is wind or belching needs a gastroscopy or a colonoscopy.

Which investigations are needed is decided by assessing the patient’s age, how long the symptoms have lasted, the accompanying symptoms and any alarm features.

In some patients:

• Coeliac tests
• Tests for lactose malabsorption
• Gastroscopy
• Colonoscopy
• Other laboratory or imaging methods

may be required.

When should a doctor be consulted?

Wind or belching should be assessed if it:

• Is newly started and has become continual
• Markedly affects daily life
• Is steadily increasing
• Occurs together with severe or persistent abdominal pain
• Occurs where there is unexplained weight loss
• Occurs where there is long-standing diarrhoea
• Occurs where there is blood in the stool or black stools
• Occurs where anaemia has been found
• Is accompanied by persistent vomiting or difficulty swallowing

Remember

Wind and belching are normal parts of digestion.

Feeling a great deal of wind does not always mean that an excessive amount of gas is being produced in the bowel. In the same way, excessive belching does not always arise from disease of the stomach.

In some people who belch very frequently in particular, there may be a condition called supragastric belching, which can be treated by behavioural methods.

In symptoms that are long-standing or accompanied by other important signs, the aim is not merely to reduce the wind but to establish the underlying cause.