Gas swallow during meals in patients with excessive belching

Abstract

Background

Swallowed gas is an important source of abdominal gas, and aerophagia is often believed as a putative cause of gas-related abdominal symptoms. However, altered gas-swallow during meals has not been demonstrated. Our aim was to characterize the number of gas swallows during meals in patients complaining of excessive belching and gaseousness and a control group without abdominal symptoms during a 24-h period.

Methods

A 24-h pH-impedance monitoring was performed in 10 patients with excessive belching, and 11 patients without digestive symptoms or reflux in the pH-impedance study. During the study, patients followed their daily routine and customary meals, without any specific limitation. In each patient the number and content of swallows and belches were analyzed.

Key Results

Total meal periods were similar in controls (75±26 min) and patients (79±21 min; P=.339), but the number of gaseous swallows was greater in patients (114±13 swallows) than controls (71±8 swallows; P=.007), due to a greater frequency of gaseous swallows during meals (15±2 swallows/10 min vs 10±1 swallows/10 min, respectively; P=.008). During the 24-h study period, 66±13 belches were recorded in patients, but only 13±3 belches in controls (P<.001), mainly gastric belches (80±4% and 92±2% of belches, patients, and controls, respectively) which showed a good correlation with the number of gaseous swallows performed during meals (r=.756; P=.011).

Conclusion and Inferences

Gas is frequently swallowed during meals. Patients complaining of excessive belching have a different swallow pattern during meals, with an increased ingestion of gas that correlates with increased gastric belching events.

• During meals, air is ingested in most swallows, either alone or mixed with liquid contents.
• Patients complaining of excessive belching have a different swallow pattern during meals than non-symptomatic controls, with an increased rate of swallows despite a similar time expended for meals.
• Increased ingestion of gas during meals, correlates with an increased number of gastric belching events along the day.

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