PMID- 14572558
OWN - NLM
STAT- MEDLINE
DCOM- 20031126
LR  - 20041117
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 98
IP  - 10
DP  - 2003 Oct
TI  - Belching: dyspepsia or gastroesophageal reflux disease?
PG  - 2139-45
AB  - OBJECTIVES: Eructation (belching) is a common symptom seen in clinical practice. 
      Because either belching or heartburn may result from transient lower esophageal 
      sphincter relaxations, it has been proposed that belching may be a manifestation 
      of gastroesophageal reflux disease (GERD). In this retrospective study we 
      evaluated the prevalence of belching in dyspepsia and GERD and the relation of 
      belching to acid reflux events documented by pH monitoring. METHODS: We examined 
      the prevalence, frequency, and severity of belching and other GERD symptoms by 
      use of standardized questionnaires in 180 GERD patients (group A) and 78 
      dyspeptic controls (group B) referred for evaluation at our institution. GERD was 
      defined as either endoscopic esophagitis (or Barrett's esophagus) or positive 
      DeMeester score (>14.2) on pH monitoring or both. Dyspeptic patients had normal 
      endoscopy and pH studies. We also analyzed the relationship of belching to acid 
      reflux events during the 24-h period of pH studies. RESULTS: Of 180 GERD 
      patients, 132 (70%) reported belching during pH monitoring, versus 63 of 78 
      dyspeptic patients (80%) (p = ns). Similarly, 163 of 180 GERD patients (90%) 
      reported heartburn versus 64 of 78 of dyspeptic patients (82%) (p = ns). Review 
      of symptom questionnaires revealed no significant difference in belching severity 
      between groups. However, heartburn and acid regurgitation were significantly more 
      severe among GERD patients. There was a significantly higher correlation of both 
      heartburn and belching with acid events in patients with GERD compared with 
      patients with dyspepsia. In addition, although both belching and heartburn were 
      significantly improved in patients with GERD, belching scores remained unchanged 
      after proton pump inhibitor (PPI) therapy in patients with dyspepsia. 
      CONCLUSIONS: Belching is as common and as severe in patients with dyspepsia as it 
      is in patients with GERD. Belching and heartburn in GERD patients are more likely 
      correlated with episodes of pathological acid reflux. Because belching cannot be 
      clinically used as a discriminatory symptom, ambulatory pH monitoring should be 
      considered to elucidate the relationship of belching to acid reflux in patients 
      with dyspepsia or GERD.
FAU - Lin, Mona
AU  - Lin M
AD  - Gastroenterology Section, Veterans Affairs Medical Center Palo Alto, and Division 
      of Gastroenterology and Hepatology, Stanford University, Stanford, California 
      94304, USA.
FAU - Triadafilopoulos, George
AU  - Triadafilopoulos G
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
SB  - IM
MH  - Case-Control Studies
MH  - Diagnosis, Differential
MH  - Dyspepsia/complications/*diagnosis/therapy
MH  - Eructation/diagnosis/*etiology
MH  - Esophagoscopy/methods
MH  - Female
MH  - Gastroesophageal Reflux/complications/*diagnosis/therapy
MH  - Gastroscopy/methods
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Monitoring, Ambulatory
MH  - Prevalence
MH  - Probability
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
EDAT- 2003/10/24 05:00
MHDA- 2003/12/03 05:00
CRDT- 2003/10/24 05:00
PHST- 2003/10/24 05:00 [pubmed]
PHST- 2003/12/03 05:00 [medline]
PHST- 2003/10/24 05:00 [entrez]
AID - S0002927003005380 [pii]
AID - 10.1111/j.1572-0241.2003.07627.x [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2003 Oct;98(10):2139-45. doi: 
      10.1111/j.1572-0241.2003.07627.x.