Search
belching (eructation)
Etiology:
1) aerophagia (swallowing air)
2) generally does NOT occur from excess gas production in the stomach
Pathology:
1) most swallowed air generally passes only part way down the esophagus, then is regurgitated (belching)
2) because belching may provide temporary relief, a viscious cycle of aerophagia & belching may occur
3) inability to belch may occur after surgical repair of a hiatal hernia
Special laboratory:
- impedance pH monitoring can help to differentiate between gastric & supragastric belching.
- upper GI endoscopy with small bowel biopsy
- confirm celiac disease
- worsening symptoms
Radiology:
- abdominal imaging as indicated
Management:
- supragastric belching
- brain-gut behavioral therapies, either separately or in combination
- cognitive behavioral therapy
- diaphragmatic breathing
- speech therapy
- central neuromodulators
- gastric belching
- low FODMAP diet with GI dietician oversight
Related
aerophagia
bloat
General
sign/symptom
References
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 234
- American Gastroenterological Association
Clinical practice update focuses on belching, bloating, distension.
https://gastroenterology.acponline.org/archives/2023/07/28/1.htm
- Moshiree B, Drossman D, Shaukat A.
AGA Clinical Practice Update on Evaluation and Management of Belching,
Abdominal Bloating, and Distension: Expert Review.
Gastroenterology. 2023. July 13
PMID: 37452811 Free article Review.
https://www.gastrojournal.org/article/S0016-5085(23)00823-5/fulltext