Belching Pathophysiology

Dorot. Medical Center for Rehabilitation and Geriatrics, Netanya, Israel

*Corresponding Author: Michael D Levin, MD, Ph.D, Dorot. Medical Center for Rehabilitation and Geriatrics, Department of Pediatric Radiology of the 1-st State Hospital, Minsk, Belarus, Dorot. Medical Center for Rehabilitation and Geriatrics, Amnon veTamar, Netanya, Israel, Tel: 972-538281393, Email: [email protected]

Received Date: October 13, 2025

Published Date: October 29, 2025

Citation: Levin MD. (2025). Belching Pathophysiology. Mathews J Gastroenterol Hepatol. 10(3):35.

Copyrights: Levin MD. © (2025).

ABSTRACT

Introduction: Currently, it is believed that since a person swallows a large amount of air during a meal, belching is a normal phenomenon to get rid of it. Based on pH monitoring, a distinction is made between gastric belching (GB) and supragastric belching (SGB). Belching less than 13 per day is considered a physiological norm. However, pH monitoring defined normal limits by examining patients with typical GERD symptoms, where esophageal acid exposure time (AET) was <4%. Since the control individuals were not healthy, the results of pH monitoring diagnostics cannot be considered correct. Purpose & Methods: To increase the accuracy of determining the pathogenesis of belching, we conducted studies of the gas bubble size on chest radiographs in people of different ages, as well as determination of the belching frequency in people of different ages and its relationship with GERD symptoms using a questionnaire and comparing these results with literature data. Results: The height and width of the gas bubble are the same in children and adults, but over 60 years of age, a decrease in these parameters is observed, and radiographs appear without a gas bubble. The results of the questionnaire show that in the age group under 20, belching was noted in only 25% of cases and in these individuals, belching was combined with GERD symptoms. With age, the frequency of belching progressively increased. In the age group over 70, belching was observed in 90% of respondents and in all cases, it was combined with symptoms. Conclusion: Analysis of literature and our own research prove that belching occurs because of relaxation of the LES damaged by gastric chyme. Since belching does not occur in healthy individuals, it is a reliable sign of GERD. The absence of belching in healthy individuals indicates that air enters the intestines and is utilized in it. The pathophysiology of the so-called supragastric belching, which occurs as a more severe stage of GERD and is characterized by dilation of the esophageal lumen, is shown.

Keywords: Belching, Gastroesophageal Reflux Disease, Transitional Lower Esophageal Sphincter Relaxation, Pathophysiology GERD, Gas Bubble Stomach.