Belching and the development of Boerhaave’s syndrome

Eructophilia in bulimia nervosa: A clinical feature

“…In some cases, eructation can cause severe pain and has been associated with intestinal perforation, tachyarrhythmias, and Boerhaave's syndrome. [8][9][10] Furthermore, repetitive eructation and aerophagia have also been associated with a variety of psychiatric conditions such as mood disorders, anxiety disorders, obsessive-compulsive disorder, somatoform disorders and conversion disorders where it is thought that unconscious swallowing of repeated boluses of air can lead to repetitive eructation. 14,15 Some people may consciously swallow large boluses of air (air gulping) as a form of self-stimulation or self-injurious behavior which is sometimes seen in the learning disabled population.…”

“…Although seemingly benign in origin, eructophilia may have serious clinical implications due to the potential for life-threatening consequences in chronic cases of repetitive eructation [8][9][10] and its resistance to treatment. Behavioral modification, psychotherapy, hypnosis, antidepressants and benzodiazepines have all been successfully used in the treatment of repetitive eructation 14,25,26 but their effectiveness in treating repetitive eructation in bulimia nervosa and other eating disorders is not known.…”

“…7 However, little is known about the occurrence of eructation (belching) in bulimia nervosa despite reports of life-threatening complications in chronic cases. [8][9][10] This report offers the first description of repetitive eructation in a patient with bulimia nervosa and discusses the phenomenology and motivating factors behind it. Furthermore, we define a new term, namely ''eructophilia,'' where eructation takes on an ego-syntonic, self-contained, and autonomous quality which serves as a reinforcing stimulus in itself.…”

Spontaneous Pneumomediastinum: An Uncommon Complication from an Augmented Physiological Belching (Imitating a TV Show Game)

“…16 Differentiation between spontaneous pneumomediastinum and Boerhaave's syndrome may not be easy if Boerhaave's syndrome presents without a history of vomiting. 18 Boerhaave's syndrome has been reported to be misdiagnosed as spontaneous pneumomediastinum. 19 Treatment of Boerhaave's syndrome should be surgical repair and drainage followed by intensive supportive care.…”

Evaluation and Management of Patients with Chest Syndromes

“…Indeed, Boerhaave's syndrome has been reported after a variety of events, some less dramatic than others. Belching [94], simply swallowing a sandwich [95], violent cough [96], defecation, childbirth, weight lifting, asthma attacks, seizures, and blunt abdominal trauma [97,98] have all been reported as precipitant events for Boerhaave's syndrome. It has been reported to complicate the vomiting associated with acute MI [99].…”