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Updated: Oct 31, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Belching in children: Prevalence and association with gastroesophageal reflux disease
Daisuke Masui1,2, Kornilia Nikaki1, Akinari Sawada1,3
1Barts and The London School of Medicine and Dentistry, Upper GI Physiology Unit Royal London Hospital, Wingate Institute of Neurogastroenterology, Blizard Institute, Queen Mary University of London, London, UK.
Insights
Gastric belching is linked to increased acid exposure time in children with reflux disease. Supra-gastric belching is uncommon in pediatric patients, suggesting it is not a primary factor in pediatric reflux.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Reflux Disease Research
Background:
- Excessive belching is common in adults with gastro-oesophageal reflux disease (GORD) and dyspepsia.
- Gastric belching (GB) is a physiological gastric venting mechanism.
- Supra-gastric belching (SGB) is recognized as a distinct behavioral disorder.
Background:
Excessive belching is frequently reported in adult patients with gastro-oesophageal reflux disease (GORD) and dyspepsia. Although postprandial gastric belching (GB) is considered a physiological mechanism for gastric venting, supra-gastric belching (SGB) is considered a distinct behavioural disorder. We aimed to define the prevalence of different types of belching and its association with reflux disease in paediatric patients.
Methods:
We retrospectively analysed reflux monitoring studies from 287 patients (median age: 7.0 years; interquartile range 3.0-11.3 years) with a suspicion of GORD. Based on oesophageal acid exposure time (AET) patients were divided in 3 groups: (a) physiological AET, (b) borderline AET and (c) pathological AET. MII-pH studies were manually edited and reflux disease parameters were measured together with quantification of GB and SGB.
Key Results:
Two hundred one children (70.0%) had physiological AET (median: 0.8; interquartile range 0.3-1.6), 52 (18.1%) had borderline AET (median: 4.2; interquartile range 3.4-5.3) and 34 (11.9%) had pathologic AET (median: 10.7; interquartile range 9.1-14.2). Gastric belching was observed in all studies. Gastric belching related reflux was more frequently observed in patients with borderline and pathological AET (p < 0.001). This was more common in older children. SGB were observed in only 7 (2.4%) children (age range: 8-17years) in our population and all patients had Physiological AET. Only 3 (1%) patients had pathological number of SGB (>13/24 h).
Conclusions And Inferences:
Gastric belching related reflux is observed in children with increased AET. SGB is very rare in the paediatric population.
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