Belching and Reflux: The Relationship and the Underlying Mechanism

Area of Science:

• Gastroenterology
• Digestive Physiology

Background:

• Belching can occur independently or alongside reflux symptoms.
• The relationship and mechanisms between belching and reflux require further investigation.

Purpose of the Study:

• To explore the relationship between belching and reflux.
• To elucidate the underlying physiological mechanisms linking belching and reflux events.

Main Methods:

• Retrospective enrollment of patients with isolated or concurrent belching and reflux symptoms.
• High-resolution esophageal impedance manometry (HRIM) and 24-hour pH impedance monitoring.
• Prospective recruitment of subjects with belching disorder for postprandial HRIM monitoring.

Main Results:

• Preceding-reflux belching was more common in patients with objective gastroesophageal reflux disease (GERD).
• Belching may trigger reflux events, increasing the overall reflux burden.
• Higher intragastric pressure and pressure gradients were observed in preceding-reflux belching compared to independent belching.

Conclusions:

• Belching can initiate reflux by increasing intragastric pressure and altering pressure gradients across the esophagogastric junction.
• Targeting belching frequency may represent a potential therapeutic approach for managing refractory GERD.