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Am Fam Physician. 2019;99(5):online

See related article on gas, bloating, and belching

What causes gas, bloating, and belching?

Most people have had excess gas, bloating, or belching. Sometimes these symptoms can cause problems or pain.

Bloating is a sensation of belly fullness. Sometimes your belly looks bigger, but not always. People with bloating do not necessarily have too much gas in their stomach, but they are often much more sensitive to stomach symptoms.

Belching (or burping) is usually caused by swallowing too much air, eating or drinking too fast, drinking carbonated or caffeinated drinks, smoking, or a nervous habit.

Flatulence [FLAA-chu-lentz] is the release of excess gas in the colon. It is usually related to your diet.

Most of the time, one or more of these disorders—irritable bowel syndrome, dyspepsia, or chronic constipation—are the cause of gas, bloating, and belching.

Gas, bloating, and belching are not typical symptoms of cancer or other dangerous conditions, even if you also have abdominal pain, diarrhea, or constipation. However, you should let your doctor know if you are losing weight, having fevers, or bleeding. These symptoms can be more serious.

Although anxiety, depression, and stressful life events do not cause these conditions, they may make the symptoms worse and harder to treat.

How are these symptoms treated?

Even severe symptoms usually improve over time with diet and lifestyle changes. Your doctor can help you decide which treatments are best for you.

Diet: Eat and drink more slowly to swallow less air. Limit fatty and spicy foods. Avoid caffeine, carbonated drinks, and artificial sweeteners. Avoid common gas-causing foods, such as beans, peas, lentils, cabbage, onions, broccoli, cauliflower, and whole grains. Try removing one food at a time from your diet to see if your gas improves.

Fiber: Fiber has many benefits, although too much fiber may increase the amount of gas in your intestines.

Exercise: Regular daily exercise often reduces symptoms in the stomach and intestines.

Laxatives: Over-the-counter laxatives, such as polyethylene glycol (one brand: Miralax), may help with constipation but probably not with stomach pain.

Antidiarrheal medicines: Over-the-counter loperamide may help with diarrhea but probably not with stomach pain.

Probiotics: Probiotics are found in some over-the-counter supplements and yogurts. Common probiotics are Lactobacillus and Bifidobacterium.

Where can I get more information?

Your doctor

AAFP's Patient Information Resource

International Foundation for Gastrointestinal Disorders

Mayo Clinic

National Institute of Diabetes and Digestive and Kidney Diseases

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