Sleeve gastrectomy is an effective weight loss operation. Many patients often report increased burping or beltching after the gastric sleeve. In this article I describe burping, its association with sleeve gastrectomy and ways to manage it.
What is Burping?
Burping is a normal physiological mechanism that help to get rid of ingested air from the stomach. During every swallow a small mount of air is ingested. The build up of air stretches the fundus (top part of the stomach) and results in a brief relaxation of the valve at the lower end of the oesophagus (gullet) resulting in venting off the trapped air. This is the classic gastric burping and it is the type that can increase after sleeve gastrectomy.
In addition to burping air from the stomach there is another type of burping called supragastric burping. In this type the vented air does not come from the stomach but instead it is sucked into the oesophagus just before it is expelled out. Ordinary individuals who suffer from excessive burping almost always suffer from excess supragastric and not gastric burping. This type of burping is not affected by sleeve gasterctomy.
Why Do I Burp More After Sleeve Gastrectomy?
Sleeve gastrectomy results in a reduced stomach capacity leading to a decreased in the size of the meals and earlier sense of fullness. In the first 6 months or so, while the stomach is healing and adapting to its new size, it is also stiffer and less expandable. As a result of this many patients notice increased burping after the surgery. This can be burping by itself or in association with heartburn caused by acid reflux. This is more noticeable in first 6 months and tends to improve as the stomach become softer and more pliable with time.
How to manage burping after sleeve gastrectomy?
- Don't drink when you eat. Delay drinking till 30 minutes after food.
- Don't talk during your meals. We swallow more air when we talk and eat at the same time.
- Don't have fizzy drinks.
- Don't use a chewing gum.
- Try peppermint tea. Many patients find it useful for bloating and intestinal gas but it may also help with burping as well.
- Be patient: The condition tends to get better as the stomach heals and become softer.