Help from habit reversal for supragastric belching

Area of Science:

• Gastroenterology
• Esophageal Disorders
• Behavioral Medicine

Background:

• Supragastric belching is a distinct upper aerodigestive disorder characterized by the expulsion of air from the esophagus, not the stomach.
• It frequently co-occurs with other gastrointestinal symptoms, with 95% of patients experiencing reflux and 65% reporting dysphagia.
• Unlike gastric belching, supragastric belching involves the voluntary, though often unconscious, act of swallowing air into the esophagus.

Purpose of the Study:

• To differentiate supragastric belching from gastric belching.
• To highlight the common comorbidities of reflux and dysphagia in patients with supragastric belching.
• To outline the therapeutic approach for managing supragastric belching.

Main Methods:

• Utilizing 24-hour intra-esophageal impedance monitoring for diagnosis.
• Clinical assessment of associated symptoms like reflux and dysphagia.
• Behavioral therapy incorporating patient education, diaphragmatic breathing, and habit reversal.

Main Results:

• Supragastric belching can be accurately detected using impedance monitoring.
• High prevalence of reflux (95%) and dysphagia (65%) in patients diagnosed with supragastric belching.
• Therapeutic interventions including education on the belching mechanism and diaphragmatic breathing show promise.

Conclusions:

• Supragastric belching is a distinct entity diagnosed via impedance monitoring, often linked with reflux and dysphagia.
• Effective management relies on behavioral interventions, emphasizing patient understanding of the mechanism and corrective breathing techniques.
• Habit reversal training is a key component in managing the preemptive symptoms of supragastric belching.