J Korean Neuropsychiatr Assoc.  2014 Sep;53(5):327-331. 10.4306/jknpa.2014.53.5.327.

A Psychiatric Approach to a Patient with Excessive Belching

• Kim HY
• Bang BW
• Kim CE

• KMID: 2016569
• DOI: http://doi.org/10.4306/jknpa.2014.53.5.327

Abstract

Belching is the audible escape of air from the esophagus into the pharynx. It is considered a disorder when the symptom is very frequent and causes significant distress to the patients. Excessive belching can be divided according to excessive supragastric and gastric belching. Gastric belching is usually physiological. In contrast, supragastric belching can be considered learned behavior. In addition, many psychiatric conditions, including anxiety, have been described in patients with supragastric belching and some patients have reported that their symptoms increased during stressful events. We report on a case of supragastric belching in a depressive patient and discuss its management through psychiatric approaches.

Keyword

Belching; Supragastric belching; Major depressive disorder; Cognitive therapy

MeSH Terms

Anxiety
Cognitive Therapy
Depressive Disorder, Major
Eructation*
Esophagus
Humans
Life Change Events
Pharynx
United Nations

Reference

1. Disney B, Trudgill N. Managing a patient with excessive belching. Frontline Gastroenterol. 2014; 5:79–83.

2. Bredenoord AJ, Weusten BL, Sifrim D, Timmer R, Smout AJ. Aerophagia, gastric, and supragastric belching: a study using intraluminal electrical impedance monitoring. Gut. 2004; 53:1561–1565.

3. Bredenoord AJ, Weusten BL, Timmer R, Smout AJ. Psychological factors affect the frequency of belching in patients with aerophagia. Am J Gastroenterol. 2006; 101:2777–2781.

4. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology. 2006; 130:1466–1479.

5. Chitkara DK, Bredenoord AJ, Rucker MJ, Talley NJ. Aerophagia in adults: a comparison with functional dyspepsia. Aliment Pharmacol Ther. 2005; 22:855–858.

6. Zella SJ, Geenens DL, Horst JN. Repetitive eructation as a manifestation of obsessive-compulsive disorder. Psychosomatics. 1998; 39:299–301.

7. Hemmink GJ, Ten Cate L, Bredenoord AJ, Timmer R, Weusten BL, Smout AJ. Speech therapy in patients with excessive supragastric belching--a pilot study. Neurogastroenterol Motil. 2010; 22:24–28. e2–e3.

8. Bredenoord AJ, Weusten BL, Timmer R, Smout AJ. Air swallowing, belching, and reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol. 2006; 101:1721–1726.

9. Bredenoord AJ, Smout AJ. Impaired health-related quality of life in patients with excessive supragastric belching. Eur J Gastroenterol Hepatol. 2010; 22:1420–1423.

10. Karamanolis G, Triantafyllou K, Tsiamoulos Z, Polymeros D, Kalli T, Misailidis N, et al. Effect of sleep on excessive belching: a 24-hour impedance-pH study. J Clin Gastroenterol. 2010; 44:332–334.

11. Rommel N, Tack J, Arts J, Caenepeel P, Bisschops R, Sifrim D. Rumination or belching-regurgitation? Differential diagnosis using oesophageal impedance-manometry. Neurogastroenterol Motil. 2010; 22:e97–e104.

12. Kessing BF, Bredenoord AJ, Smout AJ. Mechanisms of gastric and supragastric belching: a study using concurrent high-resolution manometry and impedance monitoring. Neurogastroenterol Motil. 2012; 24:e573–e579.

13. Bredenoord AJ, Smout AJ. Physiologic and pathologic belching. Clin Gastroenterol Hepatol. 2007; 5:772–775.

14. Katzka DA. Simple office-based behavioral approach to patients with chronic belching. Dis Esophagus. 2013; 26:570–573.

15. Chitkara DK, Bredenoord AJ, Talley NJ, Whitehead WE. Aerophagia and rumination: recognition and therapy. Curr Treat Options Gastroenterol. 2006; 9:305–313.

16. Bredenoord AJ. Management of belching, hiccups, and aerophagia. Clin Gastroenterol Hepatol. 2013; 11:6–12.

17. Spiegel SB. Uses of hypnosis in the treatment of uncontrollable belching: a case report. Am J Clin Hypn. 1996; 38:263–270.