13 Causes Of Burping & Shortness Of Breath (Simplified By A Gastroenterologist).
How Burping and Shortness of breath can occur at the same time:
Burping (Bleaching) occurs when you expel the air inside your stomach. The air passes up from your stomach through the lower esophageal sphincter and esophagus.
Many mechanisms can cause you to burp:
- Swallowing of excess air (as with eating too fast or drinking carbonated drinks).
- Formation of excess air inside your stomach or small intestine (as with food intolerance and eating gassy foods).
- Abnormal motility of your stomach (as with gastroparesis).
- Abnormal function of the lower esophageal sphincter (as with GERD and hiatus hernias).
- Abnormal motility of your esophagus.
But how the shortness of breath can occur with burping: possible 4 mechanisms:
- Passage of air can stretch your esophagus:
Because the esophagus passes inside your chest, you can perceive esophageal pain as “shortness of breath” or “chest tightness.
But note, this is a temporary feeling during burping only.
- Other painful Esophageal conditions can also cause shortness of breath. For example, esophagitis and esophageal motility disorders as achalasia and diffuse esophageal spasms.
- Excess abdominal air (pressing on your lungs):
The presence of excess air inside your stomach, small intestine, or colon can press on your diaphragm.
This will result in shortness of breath as your lungs have no room to expand.
- A real chest disease: Shortness of breath can arise from a chest disease affecting your lungs or airways.
For example, Bronchial asthma can cause shortness of breath. At the same time, forceful breathing due to asthma can cause you to swallow more air and burp.
Gastro-Esophageal Reflux Disease is a long-term condition caused by the reflux of stomach acid into the esophagus.
This interesting study found that people with GERD Burp more than normal people (52 burps/day vs 7 burps/day in healthy people).
Also, GERD is linked to common respiratory symptoms including shortness of breath, wheezing, chronic persistent cough. This study suggests that 30 to 80% of people with asthma also have GERD.
So, GERD is a very common cause of chest tightness and shortness of breath (ref).
Symptoms (How to suspect GERD):
- Heartburn: a burning sensation in your chest after eating which can cause shortness of breath or shortness of breath.
- Regurgitation of food or sour liquid up to your throat.
- Epigastric and chest pain.
- A sensation of a lump in your throat.
- Burping, nausea, or vomiting can also occur.
2- Hiatus hernia.
One of the most common of GERD is a hiatus hernia. A hiatal hernia occurs when the upper part of your stomach bulges into your chest through the diaphragm.
The reason I listed it as a separate cause of Burping and shortness of breath because hiatus hernia can occur without GERD symptoms (ref).
Symptoms (how to suspect Hiatal hernia):
- Commonly cause heartburn (GERD), But it also can occur without heartburn.
- In cases of hiatal hernia without GERD, you may experience frequent burping and shortness of breath.
- Difficulty swallowing.
- Asymptomatic regurgitation of food and fluid into the esophagus and throat.
- Vomiting can occur, which may become persistent.
Functional dyspepsia (Indigestion) is a very common Functional GI disease. It affects about 11.5-14.7% of people.
We define functional dyspepsia as a sense of fullness or burning sensation after meals without actual gastritis or gastric ulcers (also called non-ulcer dyspepsia).
Functional dyspepsia is commonly associated with burping (bleaching) and shortness of breath (ref).
Symptoms of Functional dyspepsia:
- A sense of discomfort or burning at the upper part of your abdomen and lower chest.
- Early feeling of fullness while you eat.
- Burping (Bleching).
- Shortness of Breath or chest discomfort after eating.
- Nausea and anorexia can also occur.
4-Gastritis / H. Pylori infection.
Gastritis, Gastric ulcers, and H. Pylori infection commonly cause bleching (burping) and hiccoughs (ref).
Also, H. Pylori infection (an organism that infects your stomach and causes gastritis and peptic ulcers) is linked to excessive burping (ref).
This is because H. pylori can cause excess gas production inside your stomach. And can lead to shortness of breath with burping due to severe pain and irritation of the stomach.
Symptoms of Gastritis, peptic ulcers, and H. Pylori:
- Burning pain in the upper central part of your abdomen.
- Nausea and bloating.
- vomiting of food or even blood in severe cases.
- Excessive Burping.
- Shortness of breath, especially after meals.
- Anorexia (lost appetite), and weight loss.
5- Eating too fast.
Normally, you swallow small amounts of gas with foods and drinks. Faulty diet habits can lead to swallowing too much gas (ref).
The excess gas inside your stomach can cause frequent burping and shortness of breath.
- Eating too quickly,
- Drinking through a straw,
- Talking while eating.
- Eating while walking or running.
All these faulty eating habits can cause burping and shortness of breath after eating.
6- Eating Certain Foods.
Certain foods can lead to excess gas production inside your stomach and intestine. As a result, these foods can lead to excessive bleching (Burping) and shortness of breath.
- Beans and peas (legumes).
- Green leafy vegetables such as broccoli.
- Whole grains.
- Certain fruits that are high in soluble fibers.
- Lactose: some people have some degree of lactose intolerance, eating too much milk or milk products can result in excessive bloating, burping, and chest discomfort.
7- Gum and candies.
Another common cause of excessive gas swallowing is chewing gums and sucking on candies.
People who frequently consume gum and candies are more likely to experience burping and dyspnea from the excess gas.
Also, gums and candies can cause excess gas production due to their sugar content (ref).
8- Excess carbonated drinks and alcohol.
Consuming drinks that produce excessive amounts of gas can lead to excessive burping and shortness of breath.
- Sodas (soft drinks)
- carbonated alcoholic drinks.
Smoking can cause burping and even GERD by (ref):
- Swallowing of excessive air during smoking.
- Affects the tone of your lower esophageal sphincter and may cause GERD.
- Induce inflammation of the wall of your esophagus and stomach.
Also, Smoking is a leading cause of shortness of breath due to its destructive effects on your lungs and airways.
Smoking is a major risk factor for Chronic Obstructive Airway Diseases (COPD), bronchitis carcinomas (ref).
Gastroparesis is a motility disorder of your stomach. with gastroparesis, a hypomotility of your stomach causing delayed gastric emptying (ref).
this can cause bloating, epigastric discomfort, chest discomfort, and burping.
Gastroparesis is not uncommon. this is because of its high incidence in people with diabetes mellitus.
Some types of gastroparesis other than diabetic gastroparesis also exist. For example, Idiopathic gastroparesis, Post-surgical gastroparesis.
Symptoms of Gastroparesis:
- Feeling of fullness as soon as you start eating.
- Excessive gas and Burping.
- Chest discomfort and shortness of breath after meals.
- Nausea lost appetite.
- Vague dull pain may also occur in the upper part of your abdomen.
History of Diabetes with early satiety and bloating of the upper abdomen suggests gastroparesis.
11- Rare oesophageal diseases.
As I explained above, Many esophageal diseases and painful esophageal conditions can lead to burping and shortness of breath.
Any disturbance in the physiological contractions of your esophagus can lead to what so-called “Esophageal Motility Disorders”
Abnormal motility of the esophagus will lead to vague chest discomfort, shortness of breath, and bleching.
- Achalasia: Chronic spasm of the lower esophageal sphincter leading to difficulty swallowing, shortness of breath, bleaching, and regurgitation of food.
- Diffuse esophageal spasms.
- Eosinophilic esophagitis.
12- Bronchial asthma.
Bronchial asthma can lead to shortness of breath and burping by different mechanisms.
According to WebMD, Burping can be a sign of asthma. This is because the extra work of respiratory muscles can lead to excess air swallowing.
Also, some conditions such as GERD can lead to chronic regurgitation of gastric contents into the esophagus, then into your airways causing what is called “GERD Asthma” (ref)
Bronchia asthma is considered one of the Extra-esophageal symptoms of GERD
And this a common cause of combined Burping and shortness of breath.
13- Psychological factors such as anxiety.
The Mind-Gut connection is one of the hottest topics in Gastroenterology nowadays.
Many Functional and motility disorders of the gastrointestinal tract are linked to psychological factors.
- Irritable Bowel syndrome.
- Functional dyspepsia and heartburn (which can lead to shortness of breath).
- Chronic nausea.
- Recurrent hiccoughs, bleaching (Burping).
- Eating disorders such as anorexia nervosa, bulimia nervosa.
stress, anxiety, and depression can result in unexplained chest and stomach symptoms. Shortness of breath and burping are examples.
Suspect when the onset of shortness of breath and burping are related to stress or anxiety attacks.
When to see a doctor for Shortness of breath and burping:
- Severe, unexplained shortness of breath.
- Dyspnea is associated with unexplained chest pain.
- Dyspnea that increases while you lie flat.
- persistent or recurrent burping is not going away (affecting the way you live).
- unexplained fever.
- Presence of vomiting, sharp abdominal pain, diarrhea.
- Unexplained anorexia, weight loss.