Indeed, belching is normal, but can be burdensome and unpleasant on occasion, and in fact may even indicate as a sign of something to be worried about. When one complains of belching frequently, one is burping or having eructation so often to the extent that  this normal physiologic response becomes irritating, and may even become a good reason for one to think that somehow he may have to pay his doctor friend a visit one time. 

Yet, actually, belching is nothing but the voluntary or involuntary physiologic passage of gas  through the mouth from way down the stomach, via  the gullet or esophagus. This is most frequently observed after meals, which is associated with the relaxation of the outlet or sphincter of the esophagus as a consequence of the distention of the stomach brought about by the presence of the food.

Under normal circumstances, some patients complain only of the passage of gas without other accompanying symptoms, but there are others  who relate some accompanying chest or abdominal discomfort, and even having noticed to have been farting excessive amount of flatus or gas. 

Nonetheless, such belching is still considered as normal human reflex and does not need to be suspected as a sign of development of dysfunction.  Everyone ingests air about 2-5 mL of air each time he swallows, so belching is a normal physiologic response needed to eliminate the unneeded amount of air accumulated.

There are, however, some factors that are known to enhance excess in the amount of air intake, therefore resulting in abdominal distention due to the development of flatulence or gas in the stomach and the intestines, and may be accompanied with

abdominal pain. The factors are more often blamed on patients’ habits or lifestyle. Air  swallowing usually increases more in patients who have the habit of eating rapidly,  who are fond of  chewing gum,  who frequently ingest carbonated drinks, and who are smokers. 

And still, there are patients who have psychological problems, with some even hospitalized for a long period, who have the habit of forceful air swallowing, called aerophagia medically. Aerophagia is part of the clinical manifestations of their psychological condition, and patients who have this usually

suffer the symptom of excessive belching chronically. The problems described are easily managed by simply basically addressing the personal habits and the psychological manifestations.

Unfortunately, there are occasions when belching can be an actual sign of some organic diseases. For example, if a disease process like stomach ulcer or a cancerous process partially obstructs the outlet of the stomach, the swallowed air is prevented from passing downward into the intestinal portions, resulting in the accumulation of the air within the stomach area; belching develops and vomiting and abdominal pain may accompany it. Then, it has been observed that for no clear reason, belching may be an accompanying symptom of stones within the gallbladder. 

And, when belching is accompanied with foul smell, especially one that approximates the smell of fecal materials, it is time to suspect the presence of  complicated cancerous process within the stomach or the nearby large intestine. The possibility of such clinical diagnoses of course necessitates an immediate help of a good doctor.

Māassalām.