Symptoms and treatment of neurotic aerophagia. Aerophagia, what is this disease? Aerophagia symptoms treatment with folk remedies

05.09.2023

Why can there be an eructation of air in a child? There are several causes of aerophagia in children:

In infants, burping or regurgitation occurs due to improper attachment to the breast, incomplete latch on of the nipple, or due to milk or formula coming in too fast or too slow.
In younger and older children, aerophagia can occur due to neurological and psychogenic causes, as well as due to diseases of internal systems and organs.
Neurological aerophagia is observed due to poor chewing, talking while eating.
Also, the cause of neurological aerophagia can be increased salivation. This occurs due to the frequent use of chewing gum or lollipops.
Psychogenic aerophagia in a child develops as a result of stressful situations, fright or after hysteria. The child swallows air not only during meals.
Diseases of the respiratory tract, gastrointestinal tract, mouth and teeth, as well as the cardiovascular system can also provoke frequent belching of air in a child.
Aerophagia can be caused by congenital damage to internal organs or systems, and in particular to the digestive tract.

Symptoms

Parents can recognize the pathology in a child on their own according to certain signs.

There is an eructation. It can be loud, odorless. Bouts of belching disturb the child throughout the day. During sleep, aerophagia usually does not occur.
The child has bloating, there is a feeling of heaviness after eating.
Sometimes there is hiccups.
There may be shortness of breath, difficulty breathing, and there is also a risk of developing tachycardia.
In infants, signs of aerophagia are regurgitation, colic, and bloating. During and after feeding, the baby experiences discomfort due to excess air in the digestive tract, which manifests itself in the form of strong crying. But usually aerophagia in infants disappears after 4 months of life.

Diagnosis of aerophagia in a child

A pediatrician can diagnose the disease with an external examination of the child. The doctor takes an anamnesis, takes into account the complaints of a small patient and his mother. The doctor lightly taps the abdomen to detect a loud sound. With the help of X-ray examination, you can detect the amount of gases in the digestive organs, as well as follow the external changes in the internal organs.

The doctor may ask the child to provoke a burp. To do this, you need to stretch your head forward, press your chin to your chest and simulate the process of swallowing. To identify the cause of the development of aerophagia, the child is sent for additional examination methods. It can be an ECG, an ultrasound of the abdominal cavity.

Sometimes a psychiatric consultation is required if there is a possibility of a psychogenic cause of aerophagia.

Complications

What is the danger of the disease for the child?

In most cases, aerophagia is treatable and causes no complications.
If treatment is not started on time, there may be disturbances in the digestive system due to changes in the structure of internal organs.
There is a possibility of developing a hernia of the esophagus, as the pressure on the diaphragm of the stomach increases.
In infants, aerophagia usually resolves on its own without the use of special treatment, unless it is caused by congenital pathologies.
Aerophagia is dangerous for a nursing baby in that he can choke if he lies on his back during an attack of regurgitation. Therefore, it is recommended to put the baby on its side.

Treatment

What can you do

Parents cannot treat their own aerophagia in a child. Consultation of specialists is necessary for the appointment of the correct treatment.

If the doctor prescribes medication, parents must strictly observe the dosage of medications.
Eating should take place in small portions.
The child should chew solid food thoroughly, as well as drink the required amount of liquid.
Foods that increase gas formation in the stomach should be excluded from the children's diet.
If regurgitation occurs frequently in infants, it is necessary to ensure that feeding is correct. During feeding, the baby should be in a semi-vertical position. The breast or nipple of the bottle must be fully grasped.
After feeding the baby, you can not shake, do gymnastic exercises with him, play or change clothes.

What does a doctor do

To cure aerophagia in a child, the doctor needs to find out the cause of its occurrence:

In infants, aerophagia is not a pathology if the baby continues to gain weight and develop.
It is necessary to treat neurotic aerophagia with the help of physiotherapy, taking sedative drugs.
The doctor may prescribe breathing exercises, massage, and taking a warm bath.
If aerophagia is caused by diseases of the internal organs, appropriate treatment with special medications is prescribed.

Prevention

To prevent belching of air in a child, parents should help him with this:

The child must adhere to the rules of nutrition.
Chewing gum and hard candies should be kept to a minimum.
If psychological disorders occur, the child should be taken to a psychiatrist to start timely treatment. Parents should protect the child from stressful situations.
An infant must be properly attached to the breast or bottle, and not fed while crying. After feeding, the baby should be kept upright for some time. Usually there is an eructation of air.

Article content:

Aerophagia is a violation of the work of the stomach, in which air is swallowed. In a healthy state, when a person is not swallowing, their esophageal valve is closed. When eating, the sphincter opens and, together with food, air always enters in a certain amount. Normally, the stomach is filled with 200 ml of air, which is required for absorption by the intestines. Gas is an integral part of the stomach and colon. The air that enters the gastrointestinal area includes the bulk of all gas. The remaining gases are created by intestinal microorganisms. Aerophagia is accompanied by an increase in air in the stomach, since air enters the stomach regardless of food intake. Today, in medicine, aerophagia is also defined by such a term as pneumatosis of the stomach.

Etiology of stomach disease

The causes of the disease are:

unbalanced diet, non-compliance with the rules of nutrition: haste, conversations;
breathing problems;
diseases of the gastrointestinal tract;
cardiac pathologies;
inappropriate dentures;
severe stress, nervous disorders.

Clinical picture

The main symptoms of the disease:

strong air belching due to stress, nervous disorders;
involuntary belching, not associated with meals;
heaviness in the stomach, distension, which is due to distension of the stomach, the symptoms decrease after belching;
feeling of lack of air, severe shortness of breath, soreness in the heart after eating. Symptoms subside after belching. Heart pains imply differential diagnosis;
hiccups
flatulence.

Symptoms of aerophagia should be differentiated from malignant tumors of the gastrointestinal tract, stomach ulcers, pyloric stenosis, intestinal dyskinesia and biliary tract.

Aerophagia is accompanied by stretching of the lower valve of the esophagus, contributes to the weakening of its tone and the occurrence of a hernia. Also, the pathology differs from Alvarez syndrome, in which there is an increase in the abdomen. This is typical for female patients who are very nervous and prone to tantrums. This disease does not cause such a strong increase in the abdomen.

Complications of stomach disease:

if left untreated, stretching of the muscle that separates the esophagus from the stomach can occur;
hiatal hernia.

Pneumatosis of the stomach involves identifying the causes of the development of pathology. Establishing the functional state of the central nervous system and gastrointestinal tract not only simplifies the recognition of aerophagia, but also determines its cause, after which appropriate treatment is prescribed.

Classification

Neurological aerophagia is a conditioned reflex swallowing of air. Organic pathology can cause anomalies in the digestive system. Functional pathology of the stomach occurs due to the characteristics of the structure of an incompletely formed digestive system.

Treatment of the disease

Pneumatosis also includes restorative treatment, hypnosis therapy, psychotherapy, therapeutic exercises. It is not necessary to flush the stomach, as the resulting vomiting can aggravate the inferiority of the diaphragm, which can lead to a hernia.

Treatment of the disease is as follows:

observance of hygienic norms of consumption of food. You need to eat slowly, slowly, drink the required amount of liquid;
you need to eat often small amounts of food;
soda and food that leads to severe flatulence should be excluded from the diet;
air must be removed from the digestive sphere. To do this, a massage of the abdomen is done, you should lie in a horizontal position on the left side, your head should be lowered, take warm sitz baths;
saliva must be spit out;
you should do breathing exercises regularly;
patients with severe neurosis should take antidepressants.

Treatment of stomach disease in children

Disease of the stomach in children is manifested by regurgitation. This phenomenon is due to the flow of a small amount of milk from the stomach back to the esophagus and into the oral cavity. This pathology is observed in all infants. This process leads to discomfort. It must be borne in mind that aerophagia in children can indicate various pathologies, in this regard, it is worth consulting with a pediatrician.

Usually, over time, aerophagia in children disappears. To minimize unpleasant symptoms, all the causes that cause the disease should be excluded. Particular attention should be paid to feeding, it is not necessary to allow the baby to quickly absorb milk, this can cause overfeeding. It is necessary to ensure that the nipple is comfortable for the baby to grasp in order to minimize the absorption of air during feeding.

In the process of artificial feeding, it is necessary to ensure that there is no air in the bottle. It should be at a separate angle of inclination when feeding. The child should be in a semi-vertical position. No need to feed the baby when he cries. After eating, the baby is held upright to completely burp the air from the stomach. Do not exercise or change your child's clothes after meals. Lay him in a horizontal position on his back before feeding and stroke his tummy, ensure free access of air, make sure that nothing blocks his nose.

If the above recommendations do not help eliminate the symptoms of aerophagia, then a dietary treatment is required, which is prescribed by a pediatrician, medication may be prescribed to improve intestinal motility. Dietary treatment includes special mixtures with high levels of casein, thickeners.

Prevention of aerophagia

Preventive measures for stomach disease should be aimed at a balanced diet and compliance with all rules during meals.

Do not ignore the symptoms of stomach disease, hoping that they will go away on their own. If there are characteristic signs of the presence of air, you should consult your doctor.

Description:

Aerophagia (aerophagia; Greek aēr air + phagein eat, absorb) - swallowing excess air and then burping it out.
It is necessary to distinguish from aerophagy the physiological swallowing of a certain amount of air (this regulates intragastric pressure), which is not accompanied by belching, as well as belching due to the rapid filling of the stomach with gas when drinking carbonated water, beer or after taking baking soda.

Symptoms:

The diagnosis of aerophagia is established on the basis of anamnesis and objective examination data. Often a typical belching occurs during a medical examination, and the doctor can see the preparation for swallowing air: the patient pulls his head forward, presses his chin to his chest and makes empty swallowing movements. Percussion is determined by the extended space of Traube. An X-ray examination reveals a high standing of the upper dome of the diaphragm due to the large air bladder of the stomach and abundant accumulation of gases in the intestines; quite often find the functional cascade of a stomach.
With neurotic aerophagia, swallowing of air often occurs outside the process of eating. Patients complain of frequent empty and loud, sometimes "multi-story" eructations without smell, which in patients with hysteria in some cases is accompanied by a loud scream. observed both after eating and at any other time, sometimes it is almost constant and disappears only during sleep. With severe A., patients are disturbed by sensations of heaviness, fullness in the pancreas, and often swelling of the entire abdomen. In some cases, there is: sometimes (more often in people suffering from coronary heart disease). Less often at And. the difficulty of breath which was designated earlier as asthma dyspepticum is observed.
Aerophagia in children is observed most often in infancy when sucking on an empty nipple or low-milk breast, and severe aerophagia can sometimes cause severe malnutrition, accompanied by persistent regurgitation and progressive weight loss. Signs of aerophagia in infants are crying during meals, rapid bloating, and refusal to eat. When changing position, and sometimes on its own, the child has an eructation of air, after which he calms down and begins to suck again. The diagnosis can be confirmed radiographically. In some children, swallowing air is a habit that can be weaned off by strictly regulating food intake, and sometimes even using tube feeding. In most cases, aerophagia is associated with underdevelopment of the apparatus of nervous regulation of the digestive organs and disappears with age.

Causes of occurrence:

Aerophagia is observed in violation of the rules of eating (fast food, talking while eating), due to a disease of the respiratory tract (difficulty in nasal breathing) or the digestive system (especially diseases of the teeth, oral cavity), but as a stable pathological phenomenon of aerophagia that requires special attention, more often of all is a pathological conditioned reflex - a manifestation.

Treatment:

For treatment appoint:

Treatment is directed at the underlying disease; with neurotic aerophagia, the patient needs advice and medical assistance from a psychotherapist (sometimes a psychiatrist). In addition, the patient is advised to spit rather than swallow saliva, eat slowly, and not talk while eating. Assign a diet with the exception of drinks containing carbon dioxide. Systematic breathing exercises, physical education are advisable.

There are a number of phenomena in the functioning of our body that we consider completely normal and do not pay any special attention to them. However, in some cases, they may be symptoms of various pathological conditions and require adequate correction under the supervision of a physician. Such is the case with burping, which all of us experience from time to time. But how do you know that such a phenomenon requires treatment? Let's talk about such an ailment as aerophagia, discuss its symptoms and find out how it is treated with medicines and folk remedies.

How does aerophagia manifest itself, what are its symptoms?

The term aerophagia should mean the same belching that becomes a functional indigestion. In this case, a person swallows an excess amount of air, and then burps it.

You can talk about pathology if the patient is worried about a loud, odorless eructation that occurs after a meal, and at other times. In certain cases, such a symptom appears almost constantly, disappearing only for a period of night rest. Sometimes patients also complain of hiccups.

With aerophagia, many patients note the appearance of a feeling of heaviness, as well as bursting in the area under the pit of the stomach, and they may also be disturbed by bloating of the entire abdomen.

In certain cases, for example, with hysteria, belching is accompanied by a sudden loud cry.

Sometimes aerophagia is also manifested by gastrocardiac syndrome. So in a number of patients, extrasystole may appear (as extraordinary heart contractions are called). Others are concerned about angina pectoris (pain in the region of the heart). Most often, gastrocardiac syndrome develops in patients with coronary heart disease.

Among other things, aerophagia can make itself felt by some breathing difficulties.

Is aerophagia corrected with medication? How exactly?

In general, doctors treat aerophagia, focusing on the causes of its development. The patient is strongly advised to change the rules of eating, refuse certain foods, do breathing exercises, etc.

If aerophagia is of neurological origin, the patient may be prescribed sedative medications, as well as tranquilizers. The selection of the right drug and the optimal dosage can only be carried out by a specialist psychiatrist.

Quite often, aerophagia therapy is carried out with the help of a medication such as chlorpromazine. This medication has antipsychotic and sedative properties. It is usually advised to take it in the form of dragees or tablets of 0.025-0.6 g per day. The dosage is selected individually, as well as the duration of therapy. It should be borne in mind that such a medicine has a number of contraindications, including impaired activity of the kidneys and liver, problems in the functioning of the hematopoietic organs, as well as systemic progressive ailments of the brain or spinal cord. Chlorpromazine is not used in the treatment of pregnant women and nursing mothers, it is not prescribed for brain injuries and gastrointestinal ulcers.

In some cases, aerophagia therapy may involve taking compounds such as Espumizan, Bebicalm, Cuplaton and Bobotic.

How is aerophagia eliminated by traditional medicine?

Aerophagia folk remedies are treated well. However, it is better to discuss the advisability of using certain formulations with your doctor in advance.

So a good effect is the use of a collection prepared from four parts of three-leaf watch leaves, three parts of yarrow inflorescences, peppermint leaves and dill seeds, as well as six parts of perforated St. John's wort herb. A couple of tablespoons of this composition should be brewed with two liters of boiled water only. Infuse the future medicine for two hours, then strain and consume one or two tablespoons about thirty minutes before the meal.

If aerophagia is of a nervous nature, combine two parts of hop cones, the same number of lemon balm leaves, three parts of St. John's wort (leaves and flowers) and the same amount. Also add two and a half parts of valerian root to the collection. Brew a couple of tablespoons of the resulting composition with half a liter of only boiled water. Infuse this composition for two hours, then strain. Consume a quarter cup about half an hour before a meal.

Combine half a glass of cranberry juice with exactly the same amount of aloe juice. Add to this composition a tablespoon of liquid honey and one glass of warm, pre-boiled water. Store the medicine in the refrigerator and take it three times a day for a tablespoon. The duration of therapy should be one week. Such treatment can be repeated in another month.

Traditional medicine experts say that taking goat's milk about half a liter a day immediately after a meal gives an excellent effect in the treatment of belching. Divide the recommended amount by three times.

You can also combine one hundred milliliters of potato and carrot juice and consume the resulting composition in half a glass three times a day shortly before a meal.

With nervous aerophagy, warm baths, for example, with pine needles, will also benefit. You can cook them yourself by brewing pine or spruce needles with boiling water and insisting for some time.

When aerophagia appears, it is worth seeking help from a doctor, because this phenomenon can be a symptom of many fairly serious conditions.

About what aerophagia is, its treatment with pharmaceutical preparations and using folk recipes, I told you, Ekaterina, www.site

P.S. The text uses some forms characteristic of oral speech.

Aerophagia - the ingestion of air and its discharge, physiological components in the process of physiological digestion. Belching is the process by which swallowed air from the stomach exits through the oropharynx. Aerophagia is a term borrowed from Greek: aer means "air" and phaegen means "swallowing". From a clinical point of view, aerophagia and too frequent belching are considered pathological if they significantly affect the well-being of a person. There is some discrepancy in the literature regarding the clinical "working" definition of aerophagia. So, some authors consider this term in conjunction with symptoms caused by the presence of excess gas in the stomach and intestines, as a secondary phenomenon, the result of swallowing air. According to the Rome III recommendations, both aerophagia and too frequent belching of any kind are defined by excessively profuse retrograde movement of air with a clear difference, which consists in the fact that during aerophagia it is possible to objectively fix the swallowing of air, which is not simply the case with belching. These disorders are usually diagnosed clinically and treated with outreach and behavioral psychotherapy.

Regurgitation is the regurgitation of undigested food into the oropharynx, which occurs without any effort. Regurgitation is a normal part of the digestive process in animals with multiple stomachs. They call it chewing gum, but chewing gum is unusual for a person. Regurgitation as a normal phenomenon is observed in children, as well as in adults with developmental delay. In addition, it has now been shown that regurgitation can also occur in healthy adults. Both aerophagia and regurgitation are diagnosed clinically and treated conservatively.

Epidemiology of aerophagia

The frequency and prevalence of aerophagia, a disorder associated with belching and regurgitation, is not clearly defined. It is believed that such manifestations are observed relatively rarely, but this is explained by the fact that many patients do not go to doctors, and when they do, in most cases their symptoms are interpreted incorrectly and other diagnoses are made, other diseases of the gastrointestinal tract are called.

Causes of aerophagia

Belching or regurgitation of air is an audible retrograde discharge of air from the esophagus into the oropharynx. Normally, physiological belching prevents the accumulation of excess air in the proximal GI tract, which may be accompanied by bloating and excessive gas. Physiological eructations are usually repeated 25-30 times a day. The use of multichannel impedance monitoring made it possible to distinguish two different types of belching: gastric and supragastric.

Gastric belching is what we usually think of as a normal physiological expulsion of air, while the stomach is relieved of excess gas. The air inside the stomach collects due to the peristalsis of the esophagus during eating and drinking, especially when drinking carbonated drinks. The resulting proximal gastric distention triggers a vagal reflex that leads to TRNPS and gas expulsion in a mechanism similar to that seen in GERD. This reflex leads to a rapid distension of the lower esophagus, causing reflex relaxation in the PS, thereby allowing air to move into the oropharynx.

In contrast, supragastric belching occurs when air enters the oropharynx and esophagus but does not enter the stomach, but is instead quickly expelled in a retrograde direction. It is believed that such formation of belching cannot be attributed to physiological reflexes, rather, this mechanism refers to learning behavior, when air is supplied through diaphragm contraction, which can reduce intraesophageal pressure. The involvement of diaphragmatic contractions is not well understood, but it may be associated with visceral irritation, as in GERD. It should be noted that belching is more common in patients with psychiatric comorbidity, and it has been proven that if the person's attention is diverted, the frequency of belching can be reduced; both of these facts support the hypothesis that belching is mainly a behavioral disorder.

The pathophysiology of aerophagia appears to be excessive voluntary swallowing of air. Bloating and distension of the abdomen are symptoms of other gastrointestinal disorders, such as irritable bowel syndrome (IBS), but patients with true aerophagia do overswallow air, and this can be proven using impedancemetry.

The physiological mechanisms underlying regurgitation are not entirely clear. However, new technologies, such as high-resolution manometry and intraluminal impedancemetry, have shed light on this problem. During regurgitation, intragastric pressure rises and at the same time pressure rises in the segment 2-3 cm above the gastroesophageal junction. This promotes the retrograde movement of food into the lower esophagus. This phenomenon was designated by a new term - "the phenomenon of the common cavity". At the same time, liquid or solid contents move up the esophagus in a retrograde direction, which is accompanied by relaxation of the BPS, and as a result, the food bolus reaches the oral cavity. This is followed by normal antegrade peristalsis, in which the food is swallowed again. It is believed that the initial increase in intragastric pressure is provided by an arbitrary contraction of the muscles of the abdominal wall. This is partly the basis of the treatment approaches described below.

Symptoms and signs of aerophagia

Patients talk about recurring unpleasant episodes of retrograde air discharge, usually without nausea and vomiting. Belching is also associated with other conditions, such as GERD and functional dyspepsia (FD), so the combination of belching with symptoms of other illnesses should raise the question of alternative diagnoses. In a typical case, the doctor from the very beginning and the first contact with the patient notes incessant eructations, sometimes more than twenty per minute.

In addition to belching, patients with aerophagia usually complain of bloating and abdominal discomfort. Along with this, they are more prone to excessive discharge of gases and constipation. Of course, it is these manifestations that can dominate, and then belching becomes the second most important complaint.

Diagnosis of aerophagia

For the clinic, only supragastric belching is almost always relevant. Diagnosis is determined by a carefully collected history and observation of the patient. Physical examination usually reveals no abnormalities other than frequent diaphragmatic contractions. With characteristic symptoms, no additional examination methods are required. When the symptom complex is atypical, they resort to esophageal manometry and impedance-pH-metry, that is, methods that will help identify another pathology. In patients with excessive supragastric belching, impedancemetry reveals a rapid increase in impedance from the proximal to the distal esophagus (reflecting air intake), followed by a retrograde decrease in impedance.

Abdominal x-rays in patients with aerophagia show intestinal gas without fluid levels.

As with pathological regurgitation, anamnestic data are usually sufficient to diagnose regurgitation, and there is no need for additional diagnostic studies. Regurgitation can be difficult to distinguish from other functional disorders (GERD, gastric paresis, etc.). Regurgitation, which causes regurgitation, typically occurs during or immediately after eating. Such a retrograde movement of the food mass is not accompanied by any kind of effort. It is not preceded by increased convulsive belching, as happens with vomiting, and nausea is not characteristic. These signs distinguish regurgitation from manifestations of paresis of the stomach. Regurgitated food is usually distinguishable in appearance and does not have an unpleasant taste. Regurgitation stops as soon as the substrate becomes acidic. This is what distinguishes regurgitation from GERD. However, regurgitation may be accompanied by heartburn. The origin of heartburn is secondary, it turns out to be a consequence of the corrosive effect of gastric contents on the esophagus. In patients, especially in adolescents, there is often a decrease in body weight. It can be very difficult to distinguish regurgitation from bulimia and anorexic behavior, so people with risk factors for developing certain eating disorders should be taken very seriously, especially young women. During the physical examination, voluntary contractions of the abdominal muscles are sometimes noticed. When the diagnosis is unclear, esophageal manometry with intraluminal impedance measurements is done to help distinguish regurgitation from other conditions. Regurgitation is characterized by an increase in pressure within the stomach, followed by a retrograde esophageal flow, which is determined using impedancemetry. Much less frequently performed and much less available is intraluminal manometry. The technique is quite applicable for the diagnosis of regurgitation syndrome. During the procedure, a classic R-wave is recorded, which indicates regurgitation. The R-wave actually reflects the Valsalva test: intra-abdominal pressure increases, as does intrathoracic pressure, and esophageal pH decreases.

Differential diagnosis of aerophagia, excessive belching and regurgitation

Treatment of aerophagia

The main key to success in the treatment of patients with pathological belching and aerophagia is accurate diagnosis and a clear understanding of what disease underlies the observed symptoms. For individuals who burp too frequently, treatment is aimed at reducing the voluntary but usually unintentional diaphragmatic contractions that initiate air into the esophagus. Psychotherapeutic influence on behavioral responses can be useful. Patients are taught to recognize and reduce their diaphragmatic contractions through biofeedback training. Sometimes the patient should be consulted by a speech therapist, especially if the specialist has experience in teaching esophageal vocalization, a therapeutic technique used by patients who have undergone laryngectomy. It is also advisable to consider trial therapy aimed at suppressing acid-forming function. This technique is simultaneously aimed at eliminating latent GERD. Unfortunately, it has not been specifically tested.

In patients with aerophagia, the effect can only be expected from an integrated approach, although none of the measures that make up it has not been subjected to in-depth study. Dietary changes in the form of less carbonated drinks and the recommendation to eat slowly, avoiding talking while eating, will reduce the amount of air entering the stomach. It may be useful to use drugs that reduce the surface tension of the gas bubbles. One of them is simethicone. If the above measures are not effective enough or the clinical picture is too pronounced, it is recommended to consult the patient with a speech therapist or orient him to a course of behavioral psychotherapy.

Recommendations for the treatment of regurgitation syndrome are based primarily on case series reports and expert opinion. A key aspect in therapy is understanding the underlying mechanisms behind the process. Regurgitation begins with voluntary, albeit unintentional, contractions of the abdominal wall muscles, so a behavioral response to suppress such contractions can be effective. An example and the best way to achieve a given goal is diaphragmatic breathing, in which attention is focused on relaxing the diaphragm and abdominal muscles. A psychologist who corrects behavior is called upon to teach such breathing to the patient.

Opinions about PPIs that suppress acid secretion in this context are controversial. Typically, regurgitation stops as soon as the ingested food tastes sour, so PPI exposure can actually prolong the period when regurgitation is possible.

It has been suggested that an increase in the tone of the LES by surgical or pharmacological methods is the key to success in eliminating regurgitation. Currently, there is a limited number of publications supporting surgical fundoplication, however, given the risks inherent in any surgical intervention, it is not recommended to perform it. Baclofen, which can reduce the incidence of TRNPS, has been tested in small groups of patients with regurgitation. It has been shown to reduce the frequency of regurgitation episodes determined by impedance measurement.

Key aspects of patient management

Belching, aerophagia, and regurgitation are among the relatively rare conditions. The key to an accurate diagnosis of these symptoms is a thorough history and physical examination. The need for specialized research is rare.
After excluding other diseases of the gastrointestinal tract in the treatment of aerophagia, belching and regurgitation, emphasis should be placed on explaining to the patient the essence of the underlying mechanisms of this pathology, giving recommendations in accordance with the principles of behavioral psychotherapy.
Pathological belching is usually supragastric rather than gastric. This is important from the point of view that therapy is aimed at changing behavioral responses, mainly to counter the "sucking" of air, and not to reduce the amount of air inside the stomach.