Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Dis Esophagus. 2013 Aug;26(6):570-3. doi: 10.1111/dote.12006. Epub 2012 Nov 30.
Chronic belching can be a difficult and socially disabling symptom often attributed to reflux with poor response to therapy. In patients where aerophagia is identified as a clear cause, treatment with baclofen may not be tolerated, and biofeedback therapy is time-intensive and may still not be effective. In this pilot study, an office-based easy-to-perform method based on sustained glottal opening was used in five patients with chronic belching, in whom reflux and other causes had been excluded. Treatment consisted of having the patient breathe slowly and diaphragmatically with his or her mouth open during supine, then sitting periods to prevent belching. When this was successful, patients were then counseled on continuing this breathing with mouth slightly ajar as an outpatient using this persistently. Wide mouth opening was used for rescue therapy of belching attacks. All five patients responded to the office-based therapy with complete cessation of belching during the visit. At 1-month follow up, four patients remained asymptomatic. One patient was asymptomatic but for two breakthrough attacks easily managed with the protocol. A simple office-based procedure based on complete glottal opening can be curative for a subset of patients with chronic eructation secondary to repetitive air swallowing.
慢性呃逆是一种难以治疗且会导致社交障碍的症状，常归因于反流，但对治疗反应不佳。对于明确由吞气症引起的患者，巴氯芬治疗可能无法耐受，而生物反馈疗法耗时且可能仍然无效。在这项初步研究中，我们在五名慢性呃逆患者中使用了一种基于持续声门开放的易于在办公室进行的简单方法，这些患者已排除反流和其他病因。治疗包括让患者在仰卧和坐姿期间缓慢呼吸并张开嘴进行膈式呼吸，以防止呃逆。如果成功，我们会建议患者在继续门诊治疗时保持口腔微张，持续使用这种方法。张大嘴巴用于呃逆发作的急救治疗。所有五名患者均对该办公室治疗有反应，在就诊期间完全停止呃逆。在 1 个月的随访中，四名患者无症状。一名患者无症状，但有两次突破发作，通过该方案可轻松管理。对于因反复吞气引起的慢性呃逆的亚组患者，基于完全声门开放的简单办公室程序可能是一种有效的治疗方法。
