Now I belch after coughing - unsure why

[simon43]

I should comment that I have visited my doctor in Phulet about my concerns, but chest/lung x-rays have not shown any abnormality.

Background:

I contracted Aspergillosis in the UK (fungal spores in the lungs), about 15 years ago, which was the reason why I relocated to Phuket (hot and humid climate), a climate which seems beneficial to my condition.

Aspergillosis shows its presence by mild asthma, bronchitus, pneumonia, general malaise etc.

Pneumonia is a dangerous condition for me and I have had a pneumonia vaccination a couple of years ago, with no bouts of pneumonia since.

The mild asthma is just that ==> no big deal.

The bronchitus is to be avoided ==> I try to exercise regularly to keep my lungs clear.

Usually, I am in good health, and take itraconazole whenever I feel my lungs 'under the weather'.

About 3 months ago, I had a bad chest/bronchial infection that lasted about 1 month. When I started to recover/feel better, I found that whenever I coughed, I also belched. This was never the case prior to that chest infection.

I also found that my itraconazole no longer had any beneficial effect on my malaise.

I was sufficiently concerned about the belching to visit my local private hospital to request a lung x-ray, to see if there was any visible change in my lungs. Nothing untoward was found.

Now I am back in reasonable health, but still belch whenever I cough. Since I cough a lot, I am belching a lot! (I never cough up blood, just clear mucus when 'well' and yellow mucus when not so well).

I asked Dr Google about this, but only came up with GERD. This doesn't seem right - my belching doesn't seem related to food/time of day etc, no stomach acid in my throat.

Any suggestions as to why there has been (in my mind), a distinct change in my lung condition.

BTW - I am trying other '..ozole' medicines, but none of them is having a positive effect on my Aspergillosis, which is not good news

[cardinalblue]

Could you have a bacteria intestinal infection like e-coli?

[simon43]

Could you have a bacteria intestinal infection like e-coli?

I did have Giardia around that time, but that was treated and my stomach/digestive system seems fine. My belching is just air, no foul smell.

But your suggestion is interesting, because it could tie in with the Giardia. I will have a word with Dr Google again.

[kovaltech]

Many times, the belching comes from an bacterial infection which can last much longer ...

Normally your cold or bronchitis comes from a viral infection...

( simple version as my doctor in the homeland explained to me on the phone )

[Tywais]

Unhelpful post and reply removed.

[moojar]

Stomach ulcers? I haven't been able to eat capsicum for many years, gives me indigestion (which could be called "belching" I guess.) I've just had a camera-down-the-throat procedure done, and it turns out I have stomach ulcers. They ran tests and did a biopsy. No cancer, but I do have 'helicobacter pylori' bacterium present which I'm now being treated for.

The reason I mention it is I reckon I acquired my little traveling companions in Thailand - reading between the lines it seems to be a 'third world' / developing nation type of thing - contaminated / unclean water. I also had a brutal case of food poisoning in Bangkok 20-odd years ago, I may have acquired it then.

On the other hand, can you belch God save the Queen? Might be worth the odd free beer.

[arjunadawn]

First you should consider glottis patency and discuss this with your doctor; endoscopy or other imaging should be able to evaluate this. Belching air is not simply the release of air but also the entry of air into the esophagus- it therefore comes out by the very manner it is gaining entrance- epiglottis. It does not mean you have GERD.

You have this for sometime but you dont mention a local competent doctor who is following you. What you describe has a few different presentations and all can have some management concerns; you should really be followed by a specialist for this. You mention itraconazole but not steroids; often the combination enhances treatment. After 15 years TV is not where you should be today. You should be seeing a respiratory specialist or pathologist. You should have a work up to include chest films and airway. You should not put this off. Also, odd that hot and humid improves your feeling? I hope it aids your healing.

[Suradit69]

Two types of belching. The latter, described below, may be a reaction to air sucked in while coughing.

Nonetheless, you should see another doctor if you are worried.

Gastric and Supragastric Belching

Belching is the audible escape of air from the esophagus into the pharynx. The medical term for belching is eructation. We distinguish 2 types of belches: the so-called gastric belch and supragastric belch.^[1] Gastric belching is the escape of swallowed intragastric air that enters the esophagus during a transient lower-esophageal sphincter relaxation (TLESR).^[2] TLESRs are triggered by distention of the proximal stomach and allow venting of air from the stomach, thereby serving as a gastric decompression mechanism and preventing passage of large volumes of gas through the pylorus into the intestines. TLESRs therefore sometimes are referred to as the belch reflex.^[3,4]Once in the esophagus, esophageal distention caused by the refluxed air initiates reflexogenic relaxation of the upper-esophageal sphincter (UES) through which the air can escape the esophagus.^[5,6] Gastric belches occur 25 to 30 times per day and are physiological. Gastric belches are involuntary and are controlled entirely by reflexes.^[7]

In supragastric belches the air does not originate from the stomach but is ingested immediately before it is expelled again. Supragastric belches are not a reflex but instead are the result of human behavior. Studies with simultaneous impedance monitoring and high-resolution manometry reveal the underlying mechanism of this behavior.^[1,8]A contraction of the diaphragm creates a negative pressure in the thoracic cavity and the esophagus, subsequent relaxation of the UES, resulting in inflow of air into the esophagus (Figure 1). The air thus is suctioned into the esophagus where it is expelled again immediately in a pharyngeal direction using straining. A minority of subjects that express supragastric belching use a different technique. They inject air into the esophagus by a simultaneous contraction of the muscles of the base of the tongue and the pharynx. The subsequent expulsion of air out of the esophagus in retrograde direction is induced by straining and goes through a similar mechanism as in patients who apply suction to move the air into the esophagus.

http://www.medscape.com/viewarticle/776875_2

Edited June 14, 2015 by Suradit69

[Brian Robson]

As with all advice, check with your doc!

After all the testing, this sounds like a simple mechanical trapping of air in the esophagus either from your lungs via the epiglottis, or via the pyloric sphincter, leading to a burp. So long as no acid reflux occurs (burning) it shouldn't be a problem.

[atyclb]

have you looked up all the side effects of medicines you are taking?

[Sprigger]

Said, lady Jane whilst at tea young man do you fart when you pee ? I replied with much wit do you belch when you shit ? And I though that was one up to me

[ggt]

Because I smoked in my early years and have developed allergies since then...I am prone to bronchitis, phenomena, and have trouble sleeping at night if I do not treat me condition...

I have found something that works for me...as a preventive medicine to keep me from developing breathing conditions...

It is MEPTIN...a small pill...I was taking 2 ea. 50 mg per day...then 1 per day...now I take 1/2 per day to maintain good breathing...

This med is design to keep your lungs free of mucus and the airways open...just what I needed...

I am not a doctor and am not offering advice...just sharing my experience...

Good Luck!

[Phaeton]

Stomach ulcers? I haven't been able to eat capsicum for many years, gives me indigestion (which could be called "belching" I guess.) I've just had a camera-down-the-throat procedure done, and it turns out I have stomach ulcers. They ran tests and did a biopsy. No cancer, but I do have 'helicobacter pylori' bacterium present which I'm now being treated for.

The reason I mention it is I reckon I acquired my little traveling companions in Thailand - reading between the lines it seems to be a 'third world' / developing nation type of thing - contaminated / unclean water. I also had a brutal case of food poisoning in Bangkok 20-odd years ago, I may have acquired it then.

On the other hand, can you belch God save the Queen? Might be worth the odd free beer.

This happened with my father. He had an ulcer, which leads, if I remember, for some reason, to pressure in the abdomen, which then lead to him belching.

The idea of you getting your stomach checked is a good thought. Ulcers, and even worse stomach problems, are relatively easy to treat, but if things get out of hand down there, it can get bad.

[oslooskar]

I suggest you Google both "Aerophagia" and "Belching and anxiety". Also, I should mention that some years ago I had a problem with belching and air getting stuck in my throat. However, my problem eventually resolved itself after I stopped kayaking so much. Therefore, my condition may have simply been caused by overly tight muscles in my upper back.

[kerrysum]

Maybe your belching is from sucking in air while coughing... ???? Do not know if you can get it where you are, but I have been using Natural Apple Cider Vinegar/ that contains mothers. Just use one teaspoon with 8oz of water, 3 times a day. It pretty much helps everything, and does help my lungs and coughing....

best of luck!

[Sheryl]

Coughing increases intra-abdominal pressure, if there is any gas in your stomach the need to expel it will increase, hence the belch. As to why so much gas, that is usually down to what and how fast you eat.

[Beetlejuice]

Coughing increases intra-abdominal pressure, if there is any gas in your stomach the need to expel it will increase, hence the belch. As to why so much gas, that is usually down to what and how fast you eat.

Sheryl, you are on the right track.

I have had the same symptoms for years. Normally if I cough hard, it creates a huge build up of gas in my stomach that extends to the bottom of my throat and is like a choking feeling. Sometimes this happens when I am asleep, then suddenly wake choking my lungs up.

The only way to relieve it is with a good belch or several belches to expel the air.

I would like to ask Simon, does he suffer from acid reflux, chronic indigestion or heartburn?

[AyG]

There's a valve (cardioesophageal sphincter) at the entry to the stomach that is designed to keep the stomach contents, including swallowed air, in the stomach. (The air eventually passes out the other end of your body.)

This valve can become weakened so is a less effective seal, and air in the stomach can come back the wrong way as a belch.

A doctor can put a device down your throat to measure the tightness of the sphincter to confirm that this is the problem in your particular case.

[Sheryl]

This sphincter tends to weaken as people age hence the rising incidence of GERD etc in older people. Being at all overweight exacerbates things. So does caffeine.

OP does not mention any heartburm or other sign of GERD so I'm not sure endoscopy would be called for in his case.

[AyG]

This sphincter tends to weaken as people age hence the rising incidence of GERD etc in older people. Being at all overweight exacerbates things. So does caffeine.

OP does not mention any heartburm or other sign of GERD so I'm not sure endoscopy would be called for in his case.

I have the belching problem, but no acid reflux or heartburn.

In my case it came on very suddenly immediately after a scuba dive. My ascent was rather uncontrolled, and I think that's what brought it on. However, the consultant said that was purely coincidence. Anyway, for me it started when I was in my mid-30s - not that old.

[simon43]

..does he suffer from acid reflux, chronic indigestion or heartburn

No, no and no.

I assume that when I cough, I involuntarily inhale some air and then that causes the belching. But it is rather strange that

this condition has only appeared after a bad bronchial/cough/cold episode of 1 month, after which my Aspergillosis medication failed to work...

One comment about my Aspergillosis. It has been effectively 'in remission' for many years, only appearing if I move from Phuket to a slightly cooler climate. I only need to take Itraconazole when I develop an involuntary cough after visiting/living in those cooler locations. (So when I worked in Yangon and Luang Prabang [north Laos], my Aspergillosis started to appear and was controlled by Itraconazole until I returned to live in Phuket).

I do have annual lung checks to see if any shadows or Aspergillosos 'balls' have appeared in my lungs, but to date they are all fine.

[Sheryl]

It may be more than you already have air in your stomach and the increased intra-abdominal pressure from coughing forces you to let it out. Possibly you did occasionally have this before but only occasionally so that it did not really register.

Any change recently in your weight, caffeine intake, or diet (what it consists of, or how often/howfast you are eating?)?

[simon43]

Any change recently in your weight, caffeine intake, or diet (what it consists of, or how often/howfast you are eating?)?

No, all as before, no change.

Every time that I have a check-up and chest x-ray, (the most recent was about 1 month ago), no problems are found with my lungs (shadows etc).

Maybe I'll go back to Phuket Int Hospital and ask for a more comprehensive check, if only to reassure me that there is not some undiagnosed condition.

[mommysboy]

Who doesn't?

With a severe coughing spasm, I puke too.

I see you have the lung aspect well covered.

IMHO, just living in Thailand is enough to cough more than usual for a variety of reasons, including excessive dryness caused by heat, and polluted air.

[Sheryl]

Any change recently in your weight, caffeine intake, or diet (what it consists of, or how often/howfast you are eating?)?

No, all as before, no change.

Every time that I have a check-up and chest x-ray, (the most recent was about 1 month ago), no problems are found with my lungs (shadows etc).

Maybe I'll go back to Phuket Int Hospital and ask for a more comprehensive check, if only to reassure me that there is not some undiagnosed condition.

Just asking for a "more comprehensive check" will result in a package containing all sorts of costly and unnecessary things not even vaguely connected with the issue at hand.

If you want to be sure the belching is not related to some undiagnosed condition you specifically want a complete GI workup.