PURPOSE OF REVIEW: Supragastric belching (SGB), rumination syndrome (RS), and abdominophrenic dyssynergia are often misunderstood and underdiagnosed syndromes. Better understanding of these conditions is needed to increase recognition and guide treatment. RECENT FINDINGS: Diagnosis is typically made by history and physical examination though supplementary evaluations can be considered in difficult to diagnose cases. These diseases are unique in that their optimal therapies are behavioral and focused entirely on the basic physiology of breathing techniques. Once one of these syndromes is recognized, the change in life for these patients can be formidable. As a result, recognition and proper treatment of these syndromes is essential for the gastroenterologist.