Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
J Clin Gastroenterol. 2022 Jan 1;56(1):36-40. doi: 10.1097/MCG.0000000000001631.
Belching is a common condition that frequently overlaps with other functional gastrointestinal disorders. While not associated with any increase in mortality, it is associated with impaired health-related quality of life. Management is challenging, as there are no pharmacologic therapies specifically targeted towards this disorder. This review covers pathogenesis, prevalence, and treatments for this condition, with specific emphasis on the evolving role of behavioral treatments in management.
The diagnosis of gastric and supragastric belching can usually be made clinically, without the need for invasive testing. If necessary, multichannel intraluminal impedance and pH testing can provide a more definitive diagnosis and can also be used to estimate the frequency of gastric and supragastric belching episodes, which each have a distinct appearance on impedance tracing. Belching disorders are commonly associated with gastroesophageal reflux disease and functional disorders of the gastrointestinal tract. Supragastric belching is also associated with behavioral disorders like anxiety and obsessive-compulsive disorder. Speech therapy, cognitive-behavioral therapy, and diaphragmatic breathing are all interventions that have recently shown promise in the management of this challenging disorder.
呃逆是一种常见的病症，常与其他功能性胃肠疾病重叠。虽然与死亡率的增加无关，但它与健康相关的生活质量受损有关。由于没有专门针对这种疾病的药物治疗方法，因此管理具有挑战性。本综述涵盖了这种病症的发病机制、患病率和治疗方法，特别强调了行为治疗在管理中的作用不断发展。
胃和胃上部呃逆的诊断通常可以通过临床进行，而无需进行侵入性检查。如有必要，多通道腔内阻抗和 pH 测试可以提供更明确的诊断，还可以用于估计胃和胃上部呃逆发作的频率，它们在阻抗描记上都有不同的表现。呃逆障碍通常与胃食管反流病和胃肠道功能障碍有关。胃上部呃逆也与焦虑和强迫症等行为障碍有关。言语治疗、认知行为疗法和膈式呼吸等干预措施最近在这种具有挑战性的疾病的管理中显示出了希望。
