Esophageal Motility in Troublesome Belching

Silva, Ana Cristina Viana da; Aprile, Lilian Rose Otoboni; Dantas, Roberto Oliveira

doi:10.1590/s0004-28032013000200017

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…However this study was performed with standard (not high resolution) manometry and therefore may have underdiagnosed hypomotility. 8 Our current study cannot distinguish cause and effect with this relationship. It is possible that hypomotility could lead to symptoms that lead to SGB.…”

Section: Discussionmentioning

confidence: 68%

Supragastric Belching: Prevalence and Association With Gastroesophageal Reflux Disease and Esophageal Hypomotility

Koukias

Woodland

Yazaki

et al. 2015

J Neurogastroenterol Motil

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Background/AimsSupragastric belching (SGB) is a phenomenon during which air is sucked into the esophagus and then rapidly expelled through the mouth. Patients often complain of severely impaired quality of life. Our objective was to establish the prevalence of excessive SGB within a high-volume gastrointestinal physiology unit, and evaluate its association with symptoms, esophageal motility and gastresophageal reflux disease. MethodsWe established normal values for SGB by analyzing 24-hour pH-impedance in 40 healthy asymptomatic volunteers. We searched 2950 consecutive patient reports from our upper GI Physiology Unit (from 2010-2013) for SGB. Symptoms were recorded by a standardized questionnaire evaluating for reflux, dysphagia, and dyspepsia symptoms. We reviewed the predominant symptoms, 24-hour pH-impedance and high-resolution esophageal manometry results. ResultsExcessive SGB was defined as ＞ 13 per 24 hours. We identified 100 patients with excessive SGB. Ninety-five percent of these patients suffered from typical reflux symptoms, 86% reported excessive belching, and 65% reported dysphagia. Forty-one percent of patients with excessive SGB had pathological acid reflux. Compared to the patients with normal acid exposure these patients trended towards a higher number of SGB episodes. Forty-four percent of patients had esophageal hypomotility. Patients with hypomotility had a significantly higher frequency of SGB compared to those with normal motility (118.3 ± 106.1 vs 80.6 ± 75.7, P = 0.020). ConclusionsIncreased belching is rarely a symptom in isolation. Pathological acid exposure and hypomotility are associated with more SGB frequency. Whether SGB is a disordered response to other esophageal symptoms or their cause is unclear.

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Section: Discussionmentioning

confidence: 68%

Supragastric Belching: Prevalence and Association With Gastroesophageal Reflux Disease and Esophageal Hypomotility

Koukias

Woodland

Yazaki

et al. 2015

J Neurogastroenterol Motil

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“…Alterations in esophageal transit may be the consequence of inappropriate behavior of the patients and should be changed with treatment. The described transit alteration does not cause dysphagia (20) .…”

Section: Discussionmentioning

confidence: 68%

“…It was described that after the swallow of a liquid bolus, the bolus head has a slower advance through the superior and middle esophagus and a shorter bolus presence time at the distal esophagus without alterations of esophageal contractions (20) . Alterations in esophageal transit may be the consequence of inappropriate behavior of the patients and should be changed with treatment.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Gum Chewing on Air Swallowing, Saliva Swallowing and Belching

Silva

Aprile

Dantas

2015

Arq. Gastroenterol.

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-Background -Eructation is a physiologic event which allows gastric venting of swallowed air and most of the time is not perceived as a symptom. This is called gastric belching. Supragastric belching occurs when swallowed air does not reach the stomach and returns by mouth a short time after swallowing. This situation may cause discomfort, life limitations and problems in daily life. Objective -Our objective in this investigation was to evaluate if gum chewing increases the frequency of gastric and/or supragastric belches. Methods -Esophageal transit of liquid and gas was evaluated by impedance measurement in 16 patients with complaint of troublesome belching and in 15 controls. The Rome III criteria were used in the diagnosis of troublesome belching. The esophageal transit of liquid and gas was measured at 5 cm, 10 cm, 15 cm and 20 cm from the lower esophageal sphincter. The subjects were evaluated for 1 hour which was divided into three 20-minute periods: (1) while sitting for a 20-minute base period; (2) after the ingestion of yogurt (200 mL, 190 kcal), in which the subjects were evaluated while chewing or not chewing gum; (3) final 20-minute period in which the subjects then inverted the task of chewing or not chewing gum. In gastric belch, the air flowed from the stomach through the esophagus in oral direction and in supragastric belch the air entered the esophagus rapidly from proximal and was expulsed almost immediately in oral direction. Air swallows were characterized by an increase of at least 50% of basal impedance and saliva swallow by a decrease of at least 50% of basal impedance, that progress from proximal to distal esophagus. Results -In base period, air swallowing was more frequent in patients than in controls and saliva swallowing was more frequent in controls than in patients. There was no difference between the medians of controls and patients in the number of gastric belches and supragastric belches. In six patients, supragastric belches were seen at least once during the 20-minute base period. None of the controls had supragastric belches. In the control group, the ingestion of yogurt caused no significant alteration in the number of air swallows, saliva swallows, gastric belches and supragastric belches. In the patient group, there was an increase in the number of air swallows. If the subjects were chewing gum during this 20-minute period, there was an increase in the number of saliva swallows in both groups, without alterations of the number of air swallow, gastric belches and supragastric belches. There was no alteration in the number of the saliva swallows, air swallows, gastric belches and supragastric belches in both groups for subjects who did not chew gum in the 20-40 minute period after yogurt ingestion. When the subjects were chewing the gum, there was an increase in saliva swallows in the control and patients groups and in air swallows in the patients group. Conclusion -Gum chewing causes an increase in saliva swallowing in both patients with excessive belching and in co...

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“…Motility: Silva et al [6] studied esophageal motility in 16 patients with troublesome belching and 15 controls [6], on the hypothesis that symptomatic patients demonstrate aberrant patterns of esophageal contractions and bolus transit. The study disproved the former premise (there was no difference in esophageal contractions between patients and controls) but did identify abnormal bolus transit in patients compared to controls, whereby the ingested bolus travelled slower through the proximal and middle esophageal body, then crossed the distal esophageal body faster [5].…”

Section: Aetiology Of Supragastric Belchingmentioning

confidence: 99%

Use of Esophageal Impedance beyond Diagnosis of GERD

Vardar¹

2017

GHOA

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Combined multichannel intraesophageal impedance-pH (MII-pH) monitoring is currently the the gold standard method to diagnosis of gastroesophageal reflux disease (GERD). A standard MII-pH catheter has six pairs of impedance electrodes. Multiple impedance-measuring within the esophagus allows determination of direction of bolus movement within the esophagus. So that MII is used as a good esophageal functional test in the diagnosis of swallow, belching, aerophagia and regurgitation. Baseline impedance value has been considered is a marker of transepithelial resistance measured in vitro, which is indicating esophageal epithelial integrity. It has been shown that distal baseline impedance values are correlated with esophageal acid exposure in GERD patients. In addition, baseline impedance values has been studied in the patients with disorders rather than GERD such as eosinophilic esophagitis, esophageal motor disorders and effect of radiofrequency ablation treatment in Barrett's esophagus. In this article, MII-pH is reviewed its clinical applications beyond the diagnosis of GERD.

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Esophageal Motility in Troublesome Belching

Cited by 4 publications

References 16 publications

Supragastric Belching: Prevalence and Association With Gastroesophageal Reflux Disease and Esophageal Hypomotility

Supragastric Belching: Prevalence and Association With Gastroesophageal Reflux Disease and Esophageal Hypomotility

Effect of Gum Chewing on Air Swallowing, Saliva Swallowing and Belching

Use of Esophageal Impedance beyond Diagnosis of GERD

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