The simple breathing trick that could stop you burping and the diet that can tackle flatulence: DR MEGHAN ROSSI’s simple steps for gut health

Burping, belching, breaking wind — everyone does it. And more often than you might think: the average person burps 30 times a day; and with passing wind, while eight to 15 times is average, anything up to 25 times is perfectly normal.

In both instances it might be so subtle that you don’t notice it. But for some people, it can be a problem, typically because it’s too frequent, uncontrollable or pungent!

However, there are steps you can take to curb these problems.

First, burping: this is essentially the body’s way of getting rid of the excess air that gets taken down into the food pipe rather than the airway.

We all do this to some extent when eating or speaking, but some people swallow too much. This is called aerophagia.

Fast eaters are prone to this. Ill-fitting dentures can also cause it, as you take in more air when you swallow food, as can chewing gum.

However, excess burping can also be a sign of an underlying health condition.

Inflammation of the stomach lining can cause more belching, and studies suggest that people who suffer with acid reflux or indigestion also tend to swallow more air, and belch more as a result. This is because these uncomfortable sensations in the gut trigger altered breathing mechanisms that cause people to take in more air.

One way to combat this is with diaphragmatic — or belly — breathing. It takes as little as five to ten minutes a day and works by using the correct muscles when you breathe, to prevent air being diverted into the food pipe.

In a study published in the journal Clinical Gastroenterology and Hepatology in 2017, 80 per cent of patients with acid reflux and excess belching who did belly breathing daily for four weeks saw a significant improvement, compared with just 19 per cent in a control group.

To do belly breathing, sit or lie down and then place one hand on your chest and one hand on your abdomen. Inhale through your nose for about four seconds, feeling your abdomen expand. Hold your breath for two seconds. Then exhale slowly through your mouth for about six seconds and repeat for five to 15 minutes.

When it comes to flatulence, let me stress that this is nothing to be embarrassed about and, in fact, it would be unhealthy not to pass wind. It’s a sign your gut bacteria are doing their job — i.e. breaking down foods that can’t be digested elsewhere. A by-product of this process is gas, which then has to get out somewhere.

One concern people have is the odour. I’ve seen clients whose gas is of a room-clearing intensity. It doesn’t have to be that way as 99 per cent of the gas our gut bugs produce — hydrogen, carbon dioxide and methane — is odourless. The whiff comes from sulphur-containing compounds, in particular hydrogen sulphide gas.

And how much of that you emit is dictated by your diet. Sulphur sources include meat, chicken, eggs, some additives in beer and wine, and protein supplements (see recipe below).

Another type of sulphur comes from veg such as broccoli, kale, Brussels sprouts, garlic, onion and leeks. However, studies show that veg has less smell potential than other sulphur sources.

So if you are concerned about the odour of your wind, try cutting back on meat, beer and wine for two weeks — but not your veg. In fact, there’s a case to up your veg as your bacteria prefer to consume fibre: the more of this they get, the less they will ferment the potentially smellier protein in your diet. For some people it’s not the smell but the frequency that bothers them. Excess flatulence can result from your gut bacteria being over-fed. This can happen if, for example, you are suffering from traveller’s tummy.

In this case, food comes through your intestine more quickly than usual, which means that by the time it gets to your gut microbes (which mostly live in the final 1.5m of your 9m-long gut), it isn’t as well digested as it should be. This gives the bacteria more to snack on, hence more gas.

This can also happen if you have a food intolerance, for instance to lactose (the sugar in milk).

Because you lack the enzyme that breaks down lactose, the gut microbes are hit with large amounts of it, leading to a feeding frenzy — and a lot of gas.

Upping your fibre intake too quickly can have a similar effect, providing your gut microbes with plenty to eat.

The fibre-induced gas should normally be pushed into the bloodstream and dispersed that way. But if you aren’t used to eating a lot of fibre, this mechanism won’t work well (your gut needs time to build up its efficiency) and the gas is expelled as flatulence.

Don’t let this put you off a high-fibre diet because it has many health gains — just slow down the rate at which you add it. Think of it as a marathon, not a sprint: your gut is in training.

Furthermore, eating more fibre can curb flatulence long term as it helps reduce the risk of constipation (if food lingers in the colon it ferments more than normal, causing excess flatulence). Excess flatulence and bloating are also symptoms of small intestinal bacterial overgrowth (SIBO), where bacteria that normally live lower down the gut creep higher up, meaning they can feast on food before it’s broken down.

SIBO is more common in people with diabetes because they are at higher risk of gut movement impairment due to damaged nerves in the gut.

In clinic, we typically diagnose SIBO with a breath test that detects excess hydrogen production, along with a symptom diary kept by the patient.

And finally, some people struggle with not being able to control their wind when this is socially appropriate, so-called flatulence incontinence.

One possible remedy for this is pelvic floor exercises, which can give you a bit more control over the anal sphincter (the muscle that controls the release of wind).

This involves first tightening your back passage as if stopping gas coming out. Then extend that contraction forwards as if you are trying to stop the flow of urine. Your pelvic floor muscles are now contracted. Now squeeze and hold this muscle for ten seconds, before letting go and repeating (or hold for three seconds if ten is too tough at first, and work your way up).

Repeat five times and then try ten quick snaps, tightening your muscle back and forth quickly (this exercises another type of pelvic floor muscle). Ideally, do this once a day.

As with diaphragmatic breathing for burping, pelvic floor exercises are a simple measure with a large gain.