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Management of supragastric belching
Monica Velosa1, Ilia Sergeev1, Daniel Sifrim1
1Wingate Institute of Neurogastroenterology, Bart and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Neurogastroenterology and Motility
|January 5, 2022
Summary
Increased supraesophageal belching (SGB) is linked to refractory reflux symptoms. Behavioral therapies, including cognitive behavioral therapy (CBT) and speech therapy, show promise for managing SGB, outperforming usual care.
Area of Science:
- Gastroenterology
- Neurogastroenterology
- Esophageal Motility Disorders
Background:
- Supraesophageal belching (SGB) is increasingly recognized in patients with refractory gastroesophageal reflux disease (GERD) symptoms and reflux hypersensitivity.
- Impedance-pH monitoring is crucial for detecting increased SGB and understanding symptom pathophysiology.
Purpose of the Study:
- To critically review current treatment modalities for pathological SGB.
- To evaluate the efficacy of behavioral therapies compared to other interventions for SGB.
Main Methods:
- Analysis of impedance-pHmetry data for SGB detection.
- Review of existing literature on SGB treatments.
- Presentation of findings from a controlled clinical trial comparing behavioral therapy to follow-up.
Main Results:
- Behavioral therapy, including cognitive behavioral therapy (CBT) and speech therapy, is identified as the most effective treatment for increased SGB.
- Pharmacological treatments are less effective and associated with mild side effects.
- A controlled clinical trial demonstrated the superiority of behavioral therapy over standard follow-up for SGB patients.
Conclusions:
- Accurate detection of SGB via impedance-pHmetry aids in personalized treatment strategies.
- Behavioral therapies offer a superior and effective approach for managing pathological SGB compared to pharmacological options.
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