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Query: UMLS:C0154059 (Esophagus)
 2,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnosis of gastroesophageal reflux is sometimes challenging, especially when symptoms are unresponsive to high-dose acid suppression. With the advent of new technology it is possible to detect and quantify nonacid or weakly acidic reflux. Multichannel intraluminal impedance (MII), introduced over 10 years ago, is gaining popularity as a reflux detection tool. The ability to detect nonacid or weakly acidic reflux events, aerophagia, and to discern true reflux events from swallows could make it more a powerful tool than pH detection alone. This is a review of the role of MII as it pertains to the diagnosis of GERD and related disorders. Studies done on normal subjects and in GERD reveal that nonacid or weakly acidic reflux occurs frequently. Several studies have been published that document types and frequency or reflux episodes comparing pH to MII. pH electrodes fail to detect the majority of nonacid or weakly acidic reflux events. MII has revealed nonacid reflux to be less common in untreated GERD subjects than in normal subjects. GERD subjects have greater degrees of liquid-type reflux events compared to normal subjects who have more gas-type reflux events. In treated GERD subjects and normal subjects, proton pump inhibitors do not seem to decrease the amount of reflux but render the reflux nonacid or weakly acidic in nature. Recently work evaluating atypical symptoms of GERD with MII has been published.
Dis Esophagus 2007
PMID:Utilising multichannel intraluminal impedance for diagnosing GERD: a review. 1743 89

Belching is physiological venting of excessive gastric air. Excessive and bothersome belching is a common symptom, which is often seen in patients with functional dyspepsia and gastroesophageal reflux disease. Other symptoms are usually predominant. However, a small group of patients complain of isolated excessive belching, with a frequency of several belches per minute. In these patients, the eructated air does not originate from the stomach but is sucked or injected in the esophagus from the pharynx and expelled immediately afterward in oral direction. This behavior is called supragastric belching because the air does not originate from the stomach and does not reach the stomach either. Excessive belching can be treated by speech therapy or behavior therapy. The term aerophagia should be reserved for those patients where there is evidence that they swallow air too frequently and in too large quantities. These patients have excessive amounts of intestinal gas visualized on a plain abdominal radiogram and their primary symptoms are bloating and abdominal distension and they belch only to a lesser degree. Aerophagia and excessive supragastric belching are thus two distinct disorders.
Dis Esophagus 2010 May
PMID:Excessive belching and aerophagia: two different disorders. 2009 92

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.
Dis Esophagus 2013 Aug
PMID:Simple office-based behavioral approach to patients with chronic belching. 2319 81