Department of Gastroenterology, Sint Antonius Hospital, Nieuwegein, The Netherlands.
Neurogastroenterol Motil. 2010 Jan;22(1):24-8, e2-3. doi: 10.1111/j.1365-2982.2009.01371.x. Epub 2009 Jul 27.
In patients whose main symptom is excessive belching, supragastric belching appears to be the predominant mechanism. This belch pattern is characterized by a rapid influx of air into the oesophagus, immediately followed by rapid air expulsion. The rate at which supragastric belching occurs is influenced by attention and distraction, suggesting a behavioural disorder and speech therapy may be of benefit to these patients. In 17 consecutive patients with excessive belching, concurrent impedance monitoring and high-resolution manometry were performed to ascertain the mechanism of belching. Patients with supragastric belches were referred to a speech therapist, who was familiar with the concept of supragastric belching. Before and after treatment by the speech therapist, patients filled out a VAS scale regarding the severity of their symptoms. In all patients, supragastric belches were identified with impedance monitoring. Eleven patients were referred to a speech therapist, six patients were not able or willing to undergo repetitive treatments. Eleven patients completed treatment by the speech therapist consisting of 10 (8-10) sessions. Overall, the VAS scales showed a significant improvement of the severity of symptoms (P < 0.05). Six of the 11 patients reported a large decrease (>30%) in their symptoms and four patients reported a modest decrease (<30%). In one patient, the VAS scores indicated an increase in symptoms. Speech therapy performed by a well-informed speech pathologist leads to a significant symptom reduction in patients with excessive supragastric belching. This is the first study indicating benefit of a treatment for excessive belching.
在以过度嗳气为主要症状的患者中，胃上嗳气似乎是主要机制。这种嗳气模式的特点是空气迅速涌入食管，随后迅速排出。胃上嗳气的发生速度受注意力和分心的影响，这表明存在行为障碍，言语治疗可能对这些患者有益。在 17 例连续的过度嗳气患者中，同时进行阻抗监测和高分辨率测压，以确定嗳气的机制。有胃上嗳气的患者被转介给熟悉胃上嗳气概念的言语治疗师。在接受言语治疗师治疗前后，患者使用 VAS 量表评估其症状严重程度。在所有患者中，阻抗监测均能识别胃上嗳气。11 例患者被转介给言语治疗师，6 例患者无法或不愿接受重复治疗。11 例患者完成了言语治疗师的 10 次（8-10 次）治疗。总体而言，VAS 量表显示症状严重程度显著改善（P<0.05）。11 例患者中有 6 例报告症状明显减轻（>30%），4 例报告症状适度减轻（<30%）。在 1 例患者中，VAS 评分表明症状加重。由知识渊博的言语病理学家进行的言语治疗可显著减轻过度胃上嗳气患者的症状。这是第一项表明过度嗳气治疗有益的研究。
