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Understanding excessive belching: causes, concerns and a functional medicine approach presented by Dr. Paul.

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Video Summary

Understanding Excessive Belching: Causes, Concerns, and Functional Medicine Clinical Approach

Excessive belching is a common complaint I see in my practice, often occurring during or after meals. While occasional burping is normal, frequent and excessive belching can indicate underlying digestive issues that warrant investigation.

Potential Causes and Contributing Factors for Excessive Burping and Belching:

1. Low Stomach Acid (Hypochlorhydria)

Low stomach acid can significantly impact digestion, particularly protein breakdown. This condition can lead to:

- Incomplete digestion of food

- Increased gas production

- Pressure build-up in the stomach, resulting in belching

Factors contributing to low stomach acid include:

- Aging

- Chronic stress

- Certain medications (e.g., proton pump inhibitors)

- Nutrient deficiencies (e.g., zinc, B vitamins)

- Food sensitivities

- H. Pylori and other gut infections

- Excessive alcohol intake,

- Certain autoimmune conditions

- Hypothyroidism.

2. H. Pylori Infection

Helicobacter pylori is a bacteria that can:

- Colonize the stomach lining

- Affect parietal cells responsible for acid production

- Lead to chronic gastritis and reduced stomach acid over time

- Potentially increase risk of peptic ulcers and gastric cancer

3. Small Intestinal Bacterial Overgrowth (SIBO)

SIBO occurs when there's an abnormal increase in the bacterial population in the small intestine. This can lead to:

- Excessive gas production

- Bloating and belching

- Malabsorption of nutrients

- Constipation

- Diarrhea

4. Food Intolerances or Allergies

Certain food intolerances or allergies can cause excessive gas production and belching. Common culprits include:

- Lactose intolerance

- Gluten sensitivity

- Fructose malabsorption

5. Gastroesophageal Reflux Disease (GERD)

GERD can cause frequent belching due to:

- Increased swallowing of air to relieve discomfort

- Relaxation of the lower esophageal sphincter

6. Gastroparesis

This condition involves delayed stomach emptying, which can lead to:

- Feeling of fullness

- Nausea

- Excessive belching

7. Brain Fog and Stress

Psychological factors can contribute to excessive belching through:

- Increased air swallowing (aerophagia)

- Altered gut motility

- Heightened sensitivity to normal digestive processes

8. Gallbladder Dysfunction

Issues with the gallbladder can impact fat digestion, potentially leading to:

- Indigestion

- Gas production

- Belching, especially after fatty meals

9. Pancreatic Insufficiency

Inadequate production of digestive enzymes by the pancreas can result in:

- Poor digestion of fats, proteins, and carbohydrates

- Increased gas production

- Belching and other digestive symptoms

10. Certain Medications

Some medications can increase belching as a side effect. Dr. Paul will look into that with you at your initial appointment.

Understanding these diverse potential causes highlights the importance of a thorough approach. Each cause may require a different strategy, emphasizing the need for personalized plan in addressing excessive belching.

Clinical Approach:

I always emphasize with my patients the importance of a thorough approach:

1. Detailed Patient History: Assessing symptom patterns, dietary triggers, and stress factors.

2. Symptom Severity Rating: Patients rate their belching severity to gauge impact on quality of life.

3. Thorough Testing:

- Stool tests to evaluate digestive enzyme output and detect H. pylori

- Microbiome analysis

- Gallbladder function assessment: Markers that can provide insight into gallbladder function.

- Motility Assessment (We can see signs on a stool test that may correlate with slow motility/constipation)

Or other tests based on a detailed history and understanding of triggers.

Targeted Approach to Resolving the Symptoms: Based on identified causes, which may include:

- H. pylori eradication

- Addressing low stomach acid

- Enzyme supplementation

- Stress management strategies

- Dietary adjustments

- Other approaches based on test results

Potential Risks of Excessive Belching

1. Complications from Untreated H. pylori Infection:

H. pylori, a common cause of excessive belching, can lead to several serious complications if left untreated:

- Chronic Gastritis: Long-term inflammation of the stomach lining

- Peptic Ulcers: Sores in the stomach or duodenum

2. Risks Associated with Chronic Low Stomach Acid:

Persistent low stomach acid can result in:

- Nutrient Deficiencies: Particularly B12, iron, calcium, and zinc

- Increased Risk of Infections: The stomach's acid barrier helps protect against ingested pathogens

- Small Intestinal Bacterial Overgrowth (SIBO): Low acid can allow bacteria to proliferate in the small intestine

3. Complications of Untreated GERD:

If GERD is the underlying cause and remains untreated, it can lead to:

- Esophagitis: Inflammation and damage to the esophageal lining

- Barrett's Esophagus: Precancerous changes in the esophagus

- Esophageal Strictures: Narrowing of the esophagus due to scar tissue

4. Malnutrition and Nutrient Deficiencies:

Chronic digestive issues causing excessive belching can result in:

- Malabsorption of essential nutrients

- Weight loss or difficulty maintaining weight

- Fatigue and weakness

- Compromised immune function

5. Psychological and Social Impacts:

While not a direct health risk, excessive belching can have significant psychosocial effects:

- Social Embarrassment and Isolation

- Discomfort in social situations

- Reduced quality of life

- Potential impact on personal and professional relationships

6. Risks Associated with Gallbladder Dysfunction:

If gallbladder issues are the underlying cause:

- Increased risk of gallstones

- Potential for acute cholecystitis (gallbladder inflammation)

- Risk of biliary colic (abdominal pain)

7. Complications from Pancreatic Insufficiency:

Untreated Pancreatic Insufficiency can lead to:

- Chronic malnutrition

- Fatigue

- Anemia

- Low Bone Mineral Density (Osteopenia, Osteoporosis)

8. Risks of Self-Treatment and guessing:

Without proper diagnosis, individuals might:

- Overuse over-the-counter antacids, leading to electrolyte imbalances and nutritional deficiencies.

- Inappropriately use acid-suppressing medications, potentially worsening underlying conditions

- Delay seeking necessary medical attention for serious underlying causes

10. Chronic Stress and Its Effects

If stress is a significant factor in excessive belching:

- Increased risk of various stress-related health issues

- Potential exacerbation of existing health conditions

- Negative impact on overall well-being and mental health

Conclusion:

Understanding these risks underscores the importance of proper and thorough testing and individualized approach for excessive belching. While the symptom itself may seem benign, it can be indicative of or lead to more serious health issues if the underlying cause is not addressed.

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What can you expect in working with Restorative Health Solutions?

At Restorative Health Solutions, we strive to get to the root cause of the symptoms/condition and help patients reach their optimal health. We also guarantee to replace the one-size-fits-all approach with a personalized plan for you!

How we dramatically lower the recurrence of your symptoms:

1. Our comprehensive initial assessment with you.

2. State-of-the-art lab testing that we use strategically to eliminate the guessing and to get to the root cause of your symptoms.

3. Our functional medicine and functional neurology combination approach, is comprehensive and gets to the root cause(s) of the problem. The result of this approach is that our patients have a better chance at being healthier long-term with much lower recurrence rates of the problem. For example, we find that SIBO patients experience about a 70% recurrence rate, but with our approach we have seen less than 10% of SIBO patients have their symptoms return after the initial symptom-free timeframe.

If you or a loved one are having any strange GI symptoms, or interested in getting a thorough and complete work-up, we’d be happy to help. If you are already working with another doctor or practitioner we're happy to coordinate care with them. Please don't hesitate to ask questions or to get a second opinion.

We look forward to helping you Restore Your Gut Health, and your quality of life!

Sincerely,

Dr. Paul Deglmann, DC, DACNB, FACFN and Dr. Kyle Warren, DC, CFMP

Owners at Restorative Health Solutions- Edina, MN

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FAQs:

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At Restorative Health Solutions we offer both in-person and virtual consultations. Feel free to share your preference with our front desk when you reach out. *We do not work with patients that live outside of the United States.

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How many visits will I need?

This of course, depends on your unique situation and plan for recovery! Typically, our follow-up visits are every 3-6 weeks in the initial phase of the protocol and every 3-6 months for maintenance or wellness visits. Telehealth options are also available.

Do I need a doctor referral to come see you?

No, you do not! We see people referred by doctors, friends and family, and those that are taking charge of their own health.

I am not sure what tests have been run by my MD already? Will you be willing to talk to them on my behalf?

Yes, absolutely! We routinely look at the previous testing you have already run. Please share as much as you can and we will take it from there.

I am already taking supplements or antibiotics? Can what you do still help me?

Yes, absolutely! Managing your gut microbiome while on Antibiotics is crucial! We can review all your supplements with you. Please note, it's not just about taking the supplements. Taking the right supplements, in the right sequence, and the right way is crucial for long-term improvement. If you do it right, you shouldn't need to be on supplements forever! Bring them for your first visit and we will review them together!