Simple office-based behavioral approach to patients with chronic belching

Area of Science:

• Gastroenterology
• Otolaryngology
• Behavioral Therapy

Background:

• Chronic belching is a socially disabling symptom often resistant to standard treatments like reflux medication.
• Aerophagia (air swallowing) is a common cause of chronic belching, but treatments like baclofen or biofeedback have limitations.
• Existing therapies for aerophagia-induced belching are often poorly tolerated, time-consuming, or ineffective.

Purpose of the Study:

• To evaluate an easy-to-perform, office-based method for treating chronic belching secondary to aerophagia.
• To assess the efficacy of a sustained glottal opening technique in managing chronic belching.

Main Methods:

• A pilot study involving five patients with chronic belching, excluding reflux and other causes.
• Treatment involved office-based instruction in slow, diaphragmatic breathing with an open mouth (glottal opening) to prevent belching.
• Patients continued the technique as outpatients, using wide mouth opening for belching attacks.

Main Results:

• All five patients achieved complete cessation of belching during the office visit using the glottal opening technique.
• At one-month follow-up, four patients remained completely asymptomatic.
• One patient experienced two breakthrough belching attacks, which were easily managed with the protocol.

Conclusions:

• A simple, office-based procedure utilizing sustained glottal opening can be curative for specific patients with chronic belching.
• This technique offers a promising, non-invasive treatment option for chronic eructation caused by repetitive air swallowing.
• The method is easy to perform and demonstrates high efficacy in a pilot group.