Belching is also known as hiccups, and belching with heartburn may be caused by improper diet, reflux esophagitis, gastritis and gastric ulcer. 1. Improper diet: The symptoms of belching with heartburn may be caused by long-term bad dietary habits, such as eating spicy and stimulating or easy to produce gas food. 2. Reflux esophagitis: inflammatory lesions of the esophagus caused by the reflux of gastric and duodenal contents into the esophagus. This causes belching with heartburn and post-sternal discomfort. In severe cases, it may cause difficulty in swallowing and affect sleep. 3. Gastritis: Gastritis can also cause belching with heartburn, which is one of the common digestive system diseases. Clinical manifestations include epigastric pain, bloating, belching, heartburn, loss of appetite, acid reflux, nausea, and so on. 4. Gastric ulcer: belching with heartburn may be caused by gastric ulcer, gastric ulcer is usually associated with dietary factors, drug stimulation and Helicobacter pylori infection, etc. Symptoms include burning sensation in the stomach, epigastric pain, acid reflux, belching, lack of appetite and so on. Patients with belching with heartburn symptoms may also be pyloric spasm, gastrointestinal neurosis, etc., should go to the hospital in a timely manner, under the guidance of the doctor to clarify the cause of the disease and then treatment.