Keeratichananont Suriya, Patcharatrakul Tanisa, Gonlachanvit Sutep
NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
J Neurogastroenterol Motil. 2023 Jul 30;29(3):343-351. doi: 10.5056/jnm22198.
BACKGROUND/AIMS: A high prevalence of GERD has been reported in patients with supragastric belching. We aim to evaluate reflux characteristics and explore the temporal relationship between supragastric belches (SGBs) and reflux episodes in GERD patients with excessive belching.
Twenty-four hour esophageal pH-impedance monitoring was analyzed. Reflux episodes were classified into: refluxes preceded by SGBs, followed by SGBs, and lone refluxes. Reflux characteristics were compared between patients with pH-positive (pH+) and pH-negative(pH-).
Forty-six patients (34 Female, age 47 ± 13 years) were included. Fifteen patients (32.6%) had pH+. Almost half (48.1 ± 21.0%) of refluxes were preceded by SGBs. The number of SGBs significantly correlated with the number of reflux episodes preceded by SGBs ( = 0.43, < 0.05) and % time pH < 4 at the distal esophagus ( = 0.41, < 0.05). Patients with pH+ had significantly more SGBs and reflux episodes preceded by SGBs/day than pH- patients ( < 0.05). The difference in the number of refluxes between pH+ and pH- patients was caused by reflux episodes preceded by SGBs, but not lone refluxes and refluxes followed by SGBs. The proportion of SGBs followed by reflux/total SGBs was similar between patients with pH+ and pH- ( > 0.05). Reflux episodes preceded by SGBs and followed by SGBs extended more proximal and had longer bolus and acid contact time than lone refluxes ( < 0.05).
In patients with GERD and SGB, the number of SGBs positively correlates with the number of reflux episodes preceded by SGBs. Identifying and managing SGB may be beneficial and more likely to improve GERD.
背景/目的：有报道称，在嗳气患者中胃食管反流病（GERD）的患病率较高。我们旨在评估反流特征，并探讨在嗳气过多的GERD患者中，胃上嗳气（SGB）与反流发作之间的时间关系。
对24小时食管pH阻抗监测进行分析。反流发作分为：SGB之前的反流、SGB之后的反流和单独的反流。比较pH阳性（pH+）和pH阴性（pH-）患者的反流特征。
纳入46例患者（34例女性，年龄47±13岁）。15例患者（32.6%）为pH+。几乎一半（48.1±21.0%）的反流发生在SGB之前。SGB的次数与SGB之前的反流发作次数（r=0.43，P<0.05）以及远端食管pH<4的时间百分比（r=0.41，P<0.05）显著相关。pH+患者每天的SGB次数和SGB之前的反流发作次数显著多于pH-患者（P<0.05）。pH+和pH-患者反流次数的差异由SGB之前的反流发作引起，而非单独的反流和SGB之后的反流。pH+和pH-患者中SGB之后出现反流的比例/总SGB的比例相似（P>0.05）。SGB之前和之后的反流发作比单独的反流更靠近近端，推注和酸接触时间更长（P<0.05）。
在GERD和SGB患者中，SGB的次数与SGB之前的反流发作次数呈正相关。识别和处理SGB可能有益，更有可能改善GERD。
