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The Physiology of Eructation

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Abstract

Eructation is composed of three independent phases: gas escape, upper barrier elimination, and gas transport phases. The gas escape phase is the gastro-LES inhibitory reflex that causes transient relaxation of the lower esophageal sphincter, which is activated by distension of stretch receptors of the proximal stomach. The upper barrier elimination phase is the transient relaxation of the upper esophageal sphincter along with airway protection. This phase is activated by stimulation of rapidly adapting mechanoreceptors of the esophageal mucosa. The gas transport phase is esophageal reverse peristalsis mediated by elementary reflexes, and it is theorized that this phase is activated by serosal rapidly adapting tension receptors. Alteration of the receptors which activate the upper barrier elimination phase of eructation by gastro-esophageal reflux of acid may in part contribute to the development of supra-esophageal reflux disease.

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References

  1. Lang IM, Medda BK, Shaker R. Digestive and respiratory tract motor responses associated with eructation. Am J Physiol. 2013;304:G1044–53.

    CAS  Google Scholar 

  2. Patrikios J, Martin CJ, Dent J. Relationship of transient lower esophageal sphincter relaxation to postprandial gastroesophageal reflux and belching in dogs. Gastroenterology. 1986;90:545–51.

    CAS  PubMed  Google Scholar 

  3. McNally EF, Kelly JE Jr, Ingelfinger FJ. Mechanism of belching: effects of gastric distension with air. Gastroenterology. 1964;46:254–9.

    CAS  PubMed  Google Scholar 

  4. Strombeck DR, Griffen DW, Harold D. Eructation of gas through the gastroesophageal sphincter before and after limiting distension of the gastric cardias or infusion of beta-adrenergic amine in dogs. Am J Vet Res. 1989;50:751–3.

    CAS  PubMed  Google Scholar 

  5. Franzi SJ, Martin CJ, Cox MR, Dent J. Response of canine lower esophageal sphincter to gastric distension. Am J Physiol. 1990;259:G380–5.

    CAS  PubMed  Google Scholar 

  6. Penagini R, Carmagnola S, Cantu P, Alloca M, Bianchi PA. Mechanoreceptors of the proximal stomach: role in triggering transient lower esophageal sphincter relaxation. Gastroenterology. 2004;126:49–56.

    Article  PubMed  Google Scholar 

  7. Straathof JW, Ringers J, Lamers CB, Masclee AA. Provocation of transient lower esophageal sphincter relaxation by gastric distension with air. Am J. Gastreoenterol. 2001;96:2317–23.

    Article  CAS  Google Scholar 

  8. Wyman JB, Dent J, Heddle R, Dodds WJ, Toouli J, Downton J. Control of belching by the lower esophageal sphincter. Gut. 1990;31:639–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Dougherty RW, Habel RE, Bond HE. Esophageal innervation and the eructation reflex in sleep. Am J Vet Res. 1958;19:115–28.

    CAS  PubMed  Google Scholar 

  10. Kahrilas PJ, Dodds WJ, Dent J, Wyman JB, Hogan WJ, Arndorfer RC. Upper esophageal sphincter function during belching. Gastroenterology. 1986;91:133–40.

    CAS  PubMed  Google Scholar 

  11. Daintree-Johnson H, Laws JW. The cardia in swallowing, eructation, and swallowing. Lancet. 1966;2:1268–73.

    Article  Google Scholar 

  12. Monges H, Salducci J, Naudy B. Dissociation between the electrical activity of the diaphragmatic dome and crura muscular fibers during esophageal distension, vomiting and eructation. J Physiol. 1978;74:541–54.

    CAS  Google Scholar 

  13. Boyle JT, Altschuler SM, Nixon TE, Tuchman DN, Pack AI, Cohen S. Role of diaphragm in the genesis of lower esophageal pressure in the cat. Gastroenterololgy. 1985;88:723–30.

    CAS  Google Scholar 

  14. Mittal RK, Rochester DF, McCallum RW. Electrical and mechanical activity in the human lower esophageal sphincter during diaphragmatic contraction. J Clin Invest. 1988;81:1182–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Lang IM, Medda BK, Shaker R. Mechanisms of UES relaxation initiated by gastric air distension. Am J Physiol. 2014;307:G452–8.

    CAS  Google Scholar 

  16. Babaei A, Bhargava V, Korsapaai H, Zheng WH, Mittal RK. A unique longitudinal muscle contraction pattern associated with transient lower esophageal sphincter relaxation. Gastroenterology. 2008;134:1322–31.

    Article  PubMed  Google Scholar 

  17. Jiang Y, Bhargava V, Mittal RK. Mechanism of stretch-activated excitatory and inhibitory responses in the lower esophageal sphincter. Am J Physiol. 2009;297:G397–405.

    Article  CAS  Google Scholar 

  18. Mittal RK, Karstens A, Leslie E, Babaaei A, Bhargava V. Ambulatory high-resolution manometry, lower esophageal sphincter lift, and transient lower esophageal sphincter relaxation. Neurogastroenterol Motil. 2012;24:40-e2.

    Article  PubMed Central  Google Scholar 

  19. Dogan I, Bhargava V, Liu J, Mittal RK. Axial stretch: a novel mechanism of the lower esophageal sphincter relaxation. Am J Physiol. 2007;292:G329–3344.

    CAS  Google Scholar 

  20. Jiang Y, Bhargava V, Lal HA, Mittal RK. Variability in the muscle composition of rat esophagus and neural pathway of lower esophageal sphincter relaxation. Am J Physiol. 2011;301:G1014–9.

    CAS  Google Scholar 

  21. Staunton E, Smid SD, Dent J, Blackshaw LA. Triggering of transient LES relaxation in ferrets: role of sympathetic pathways and effects of baclofen. Am J Physiol. 2000;279:G157–62.

    CAS  Google Scholar 

  22. Frisby CL, Mattson JP, Jensen JM, Lehmann A, Dent J, Blackshaw LA. Inhibition of transient lower esophageal sphincter relaxation and gastroesophageal reflux by metabotropic glutamate receptor ligands. Gastroenterology. 2005;129:995–1004.

    Article  CAS  PubMed  Google Scholar 

  23. Paterson WG, Rattan S, Goyal RK. Experimental induction of isolated lower esophageal sphincter relaxation in anesthetized opossums. J Clin Invest. 1986;77:1187–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Pandolfino JE, Zhang Q, Ghosh SK, Han A, Boniquit C, Kahrilas PJ. Transient lower esophageal sphincter relaxations and reflux: mechanistic analysis using concurrent fluoroscopy and high-resolution manometry. Gastroenterology. 2006;131:1725–33.

    Article  PubMed  Google Scholar 

  25. Martin CJ, Patrikios J, Dent J. Abolition of gas reflux and transient lower esophageal sphincter relaxation by vagal blockade in the dog. Gastroenterology. 1986;91:890–6.

    CAS  PubMed  Google Scholar 

  26. Reynolds RPE. T Y El-Sharkawy, Diament NE. Lower esophageal sphincter function in the cats: role of central innervation assesses by transient vagal blockade. Am J Physiol. 1984;246:G666–74.

    CAS  PubMed  Google Scholar 

  27. Young RL, Page AJ, Cooper NJ, Frisby CL, Blackshaw LA. Sensory and motor innervation of the crural diaphragm by the vagus nerves. Gastroenterology. 2010;138:1091–101.

    Article  PubMed  Google Scholar 

  28. Liu J, Yamamoto Y, Schirmer BD, Ross RA, Mittal RK. Evidence for a peripheral mechanism of esophagocrural diaphragm inhibitory reflex in cats. Am J Physiol. 2000;278:G281–8.

    CAS  Google Scholar 

  29. Dong H, Jiang Y, Dong J, Mittal RK. Inhibitory motor neurons of the myenteric plexus are mechanosensitive. Am J Physiol. 2015;308:C405–13.

    Article  CAS  Google Scholar 

  30. Sang Q, Goyal RK. Lower esophageal sphincter relaxation and activation of medullary neurons by subdiaphragmatic vagal stimulation in the mouse. Gastroenterology. 2000;119:1600–9.

    Article  CAS  PubMed  Google Scholar 

  31. Niedringhaus M, Jackson PG, Pearson R, Shi M, Dretchen K, Gillis RA, Sahibzada N. Brainstem sites controlling the lower esophageal sphincter and crural diaphragm in the ferret: a neuroanatomical study. Autonom Neurosci: Basic and Clin. 2008;144:50–60.

    Article  Google Scholar 

  32. Collman PI, Trembly L, Diamant NE. The central vagal efferent supply to the esophagus and lower esophageal sphincter. Gastroenterology. 1993;104:1430–8.

    CAS  PubMed  Google Scholar 

  33. Bieger D, Hopkins DA. Viscerotropic representation of the upper alimentary tract in the medulla oblongata in the rate: the nucleus ambiguus. J Comp Neurol. 1987;262:546–62.

    Article  CAS  PubMed  Google Scholar 

  34. Altschuler SM, Bao X, Bieger D, Hopkins DA, Miselis RR. Viscerotropic representation of the upper alimentary tract in the rat: sensory ganglia and nuclei of the solitary and spinal trigeminal tracts. J Comp Neurol. 1989;283:248–68.

    Article  CAS  PubMed  Google Scholar 

  35. Niedringhaus M, Jackson PG, Evans SRT, Verbalis JG, Gillis RA. Dorsal motor nucleus of the vagus: a site for evoking simultaneous changes in crural diaphragm, lower esophageal sphincter pressure and fundus tone. Am J Physiol. 2008;294:R121–31.

    CAS  Google Scholar 

  36. Rossiter CD, Norman WP, Jain M, Hornby PM, Benjamin S, Gillis RA. Control of the lower esophageal sphincter pressure from two sites in dorsal motor nucleus of the vagus. Am J Physiol. 1990;259:G899–906.

    CAS  PubMed  Google Scholar 

  37. Kalia M, Mesulum M-M. Brain stem projections of sensory and motor components of the vagus comoplex in the cat: I. The cervical vagus and nodose ganglion. J Comp Neurol. 1980;193:435–65.

    Article  CAS  PubMed  Google Scholar 

  38. Lehmann A, Antonsson M, Bremmer-Danilesen M, Flardh M, Hansson-Branden L, Karrberg L. Activation of GABAb receptor inhibits transient lower esophageal sphincter relaxations in dogs. Gastroenterology. 1999;117:1147–54.

    Article  CAS  PubMed  Google Scholar 

  39. Blackshaw LA, Smid SD, O’Donnell TA, Dent J. GABA(B) receptor-mediated effects on vagal pathways to the lower esophageal sphincter and heart. Br J Pharmacol. 2000;130:279–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Blackshaw LA, Staunton E, Lehmann A, Dent J. Inhibition of transient LES relaxations and reflux in ferrets by GABA receptor agonist. Am J Physiol. 1999;277:G867–74.

    CAS  PubMed  Google Scholar 

  41. Lidums I, Lehmann A, Checklin H, Dent J, Holloway RH. Control of transient lower esophageal sphincter relaxations and reflux by the GABA(B) agonist baclofen in normal subjects. Gastroenterology. 2000;118:7–13.

    Article  CAS  PubMed  Google Scholar 

  42. Smid SD, Young RL, Cooper NJ, Blackshaw LA. GABABR expressed on vagal afferent neurons inhibit gastric mechanosensitivity in ferret proximal stomach. Am J Physiol. 2001;281:G1494–501.

    CAS  Google Scholar 

  43. Liu J, Pehlivanov N, Mittal RK. Baclofen blocks LES relaxation and crural diaphragm inhibition by esophageal and gastric distension in cats. Am J Physiol. 2002;283:G1276–81.

    CAS  Google Scholar 

  44. Jensen J, Lehmann A, Uverbant A, Carlsson A, Jerndal G, Nilsson K, Frisby C, Blackshaw LA, Mattson JP. Transient lower esophageal sphincter relaxations in dogs are inhibited by metabotropic glutamate receptor 5 antagonist. Eur J Pharmacol. 2005;519:154–7.

    Article  CAS  PubMed  Google Scholar 

  45. Brooks PA, Glaum SR, Miller RJ, Spyer KM. The actions of baclofen on neurons and synaptic transmission in the nucleus tractus solitarii of the rat in vitro. J Physiol. 1992;457:115–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Margeta-Mitrovic M, Mitrovic I, Riley RC, Jan LY, Basbaum AI. Immunohistochemical localization of GABA(B) receptors in the rat central nervous system. J Comp Neurol. 1999;405:299–321.

    Article  CAS  PubMed  Google Scholar 

  47. Smid SD, Blackshaw LA. Vagal neurotransmission to the ferret lower esophageal sphincter: inhibition via GABA(B) receptors. Br J Pharmacol. 2000;131:624–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Page AJ, Blackshaw LA. GABA(9B) receptors inhibit mechanosensitivity of primary afferent endings. J Neurosci. 1999;19:8597–602.

    CAS  PubMed  Google Scholar 

  49. Partosoedarso ER, Young RL, Blackshaw LA. GABA(B) receptors on vagal afferent pathways: peripheral and central inhibition. Am J Physiol. 2001;280:G658–68.

    CAS  Google Scholar 

  50. Lehmann A, Blackshaw LA, Branen L, Carlsson A, Jensen J, Nygen E, Smid SD. Cannabinoid receptor agonism inhibits lower esophageal sphincter relaxation and reflux in dogs. Gastroenterology. 2002;123:1129–34.

    Article  CAS  PubMed  Google Scholar 

  51. Lehmann A, Branden L. Effects of antagonism of NMDA receptors on transient lower esophageal sphincter relaxation in the dog. Eur J Pharmacol. 2001;431:253–8.

    Article  CAS  PubMed  Google Scholar 

  52. Lang IM, Medda BK, Jadcherla S, Shaker R. The role of the superior laryngeal nerve in esophageal reflexes. Am J Physiol. 2012;302:G1445–57.

    CAS  Google Scholar 

  53. Pandolfino JE, Ghosh SK, Zhang Q, Han A, Kahrilas PJ. Upper esophageal function during transient lower oesophageal sphincter relaxation (tLOSR); it is mainly about microburps. Neurogastroenterol Motil. 2007;19:202–10.

    Article  Google Scholar 

  54. Babaei A, Bhargava V, Mittal MK. Upper esophageal sphincter during transient lower esophageal sphincter relaxation: effects of reflux content and posture. Am J Physiol. 2010;298:G601–7.

    CAS  Google Scholar 

  55. Shaker R, Ren J, Kern M, Dodds WJ, Hogan WJ, Li Q. Mechanisms of airway protection and upper esophageal sphincter opening during belching. Am J Physiol. 1992;262:G621–8.

    CAS  PubMed  Google Scholar 

  56. Szczesniak MM, Williams RBH, Brake HM, Maclean JC, Cole IE, Cook IJ. Upregulation of the esophago-UES relaxation response: a possible pathophysiological mechanisms in suspected reflux laryngitis. Neurogastroenterol Motil. 2010;22(381–386):e89.

    Google Scholar 

  57. Lang IM, Medda BK, Shaker R. Mechanisms of reflexes induced by esophageal distension. Am J Physiol. 2001;281:G1246–63.

    CAS  Google Scholar 

  58. Lang IM. Upper esophageal sphincter. In: Goyal RK, Shaker R, editors. Goyal and Shaker’s GI online. New York: Nature Publishing Group; 2006. doi:10.1038/gimo12.

    Google Scholar 

  59. Mu L, Sanders I. Neuromuscular organization of the human upper esophageal sphincter. Ann Otol Rhinol Laryngol. 2001;107:370–7.

    Article  Google Scholar 

  60. Szczesniak MM, Williams RB, Cook IJ. Mechanisms of esophago-pharyngeal acid regurgitation in human subjects. PLoS ONE. 2011;6:e22630.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Harding R, Titchen DA. Chemosensitive vagal endings in the esophagus of the cat. J Physiol. 1975;247:52P–3P.

    CAS  PubMed  Google Scholar 

  62. Clerc N, Mei N. Vagal mechanoreceptors located in the lower oesophageal sphincter of the cat. J Physiol. 1983;336:487–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Zagorodnyuk VP, Brookes SJH. Transduction sites of vagal mechanoreceptors in the guinea pig esophagus. J Neurosci. 2000;20:6249–55.

    CAS  PubMed  Google Scholar 

  64. Page AJ, Blackshaw LA. An in vitro study of the properties of vagal afferent fibers innervating the ferret oesophagus and stomach. J Physiol. 1998;512:907–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Hwang K, Grossman MI, Ivy AC. Nervous control of the cervical portion of the esophagus. Am J Physiol. 1948;154:343–57.

    CAS  PubMed  Google Scholar 

  66. Brok HAJ, Copper MP, Stroeve RJ, Ongerboer BW, Venker-van Haagen AJ, Schouwenburg PF. Evidence for recurrent laryngeal nerve contribution in motor innervation of the human cricopharyngeal muscle. Laryngoscope. 1999;109:705–8.

    Article  CAS  PubMed  Google Scholar 

  67. Lang IM, Medda BK, Shaker R. Differential activation of medullary vagal nuclei caused by stimulation of different esophageal mechanoreceptors. Brain Res. 2011;1368:119–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Kalia M, Mesulum M-M. Brain stem projections of sensory and motor components of the vagus complex in the cat: II. Laryngeal, trachea-bronchial, pulmonary, cardiac, and gastrointestinal branches. J Comp Neurol. 1980;193:467–508.

    Article  CAS  PubMed  Google Scholar 

  69. Holstege G, Graveland G, Bijker-Biemond C, Scuddeboom I. Location of motoneurons innervating soft palate, pharynx, and upper esophagus. Anatomical evidence for a possible swallowing center in the pontine reticular fomation. Brain Behav Evol. 1983;23:47–62.

    Article  CAS  PubMed  Google Scholar 

  70. Van Loveren H, Saunders MC, Casini P, Keller JT. Localization of motoneurons of the stylopharyngeus muscle in the cat. Neurosci Lett. 1985;58:251–5.

    Article  PubMed  Google Scholar 

  71. Yoshida T, Miyazaki T, Hirano M, Shin T, Totoki T, Kanaseki T. An investigation of the location of the motoneurons innervating the pharyngeal constrictors and the cervical esophagus muscles of cats using horderadish peroxidase method. J Otorhinolaryngol Soc Jpn. 1981;84:758–61.

    CAS  Google Scholar 

  72. Pasaro R, Lobera B, Gonzolez-Baron S, Delgado-Garcia JM. Cytoarchitectonic organization of laryngeal motoneurons within the nucleus ambiguous of the cat. Exp Neurol. 1983;82:623–34.

    Article  CAS  PubMed  Google Scholar 

  73. Borison HL. Area postrema: chemoreceptor circumventricular organ of the medulla oblongata. Prog Neurobiol. 1989;32:351–90.

    Article  CAS  PubMed  Google Scholar 

  74. Blondeau K, Boecxstaens V, Rommel N, Farre R, Depeyer S, Holvoet L, Boeckxstaens G, Tack JF. Baclofen improves symptoms and reduces postprandial flow events in patients with rumination and supragastric belching. Clin Gastroenterol Hepatol. 2012;10:379–84.

    Article  CAS  PubMed  Google Scholar 

  75. Cossentino MJ, Mann K, Armbruster SP, Lake JM, Maydonovitch C, Wong RK. Randomized clinical trial: the effects of baclofen in patients with gastro-esophageal reflux- a randomized perspective. Aliment Pharmacol Ther. 2012;35:1036–44.

    CAS  PubMed  Google Scholar 

  76. Carr DH, Scott PC, Titchen DA. Manometric and electromyographic observations of the esophagus of sheep in eructation, regurgitation and swallowing. J Exp Physiol. 1983;68:661–74.

    Article  CAS  Google Scholar 

  77. Laskiewitcz A. Vomiting and eructation with regard to the upper respiratory organs. Acta Oto-Laryngol. 1956;3:27–34.

    Article  Google Scholar 

  78. Heywood LH, Wood AKW. Thoracic oesophageal motor activity during eructation in sheep. J Exp Phsyiol. 1985;70:603–13.

    Article  CAS  Google Scholar 

  79. Stevens CE, Sellers AF. Pressure events in bovine esophagus and reticulum associated with eructation, deglutition and regurgitation. Am J Physiol. 1960;199:598–602.

    Google Scholar 

  80. Winship DH, Zboralske F, Weber WN, Soergel KH. Esophagus in rumination. Am J Physiol. 1964;207:1189–94.

    CAS  PubMed  Google Scholar 

  81. Duncan DL. The effects of vagotomy and splanchnectomy on gastric motility is sheep. J Physiol. 1953;119:156–69.

    Article  Google Scholar 

  82. Clerc N. Afferent innervation of the lower esophageal sphincter of the cat. J ANS. 1984;10:213–6.

    CAS  Google Scholar 

  83. Clerc N, Mei N. Thoracic esophageal mechanoreceptors connected with fibers following sympathetic pathways. Brain Res Bull. 1983;10:1–7.

    Article  CAS  PubMed  Google Scholar 

  84. Nichols TR, Cope TC, Abelow TA. Rapid spinal mechanisms of motor coordination. Exerc Sport Sci Rev. 1999;27:255–84.

    Article  CAS  PubMed  Google Scholar 

  85. Heywood LY, Wood AK. Retrograde oesophageal contractions in the dog. Quart J Exp Physiol. 1988;73:87–94.

    Article  CAS  Google Scholar 

  86. Szczesniak MM, Fuentealba SE, Burnett A, Cook IJ. Differential relaxation and contractile responses of the human upper esophageal sphincter mediated by interplay of mucosal and deep mechanoreceptor activation. Am J Physiol. 2008;294:G982–8.

    CAS  Google Scholar 

  87. Kessing BF, Bredenoord AJ, Smout AJPM. Mechanism of gastric and supragastric belching: a study using concurrent high-resolution manometry and impedance monitoring. Neurogastroenterol Motil. 2012;24:e573–9.

    Article  CAS  PubMed  Google Scholar 

  88. Hemmink GJM, Bredenoord AJ, Weusten BLAM, Timmer R, Smout AJPM. Supragastric belching in patients with reflex symptoms. Am J Gastroenterol. 2009;104:1992–7.

    Article  PubMed  Google Scholar 

  89. Kessing BF, Govaert F, Masclee ADAM, Conchillo JM. Impedance measurements and high-resolution manometry help to better define rumination episodes. Scan J Gastroentrol. 2011;46:1310–5.

    Article  Google Scholar 

  90. Bredenoord AJ, Weusten BLAM, Sifrim D, Timmer R, Smout AJPM. Aerophagia, gastric, and supragastric belching: a study using intraluminal electrical impedance monitoring. Gut. 2004;53:1561–5165.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Bredenoord AJ, Weusten BLAM, Timmer R, Smout AJPM. Air swallowing, belching, and reflux in patients with gastroesophageal reflux disease. Gastroenterology. 2006;101:1721–6.

    Google Scholar 

  92. Doty RW, Bosma JF. An electromyographic analysis of reflex deglutition. J Neurophysiol. 1956;19:44–60.

    CAS  PubMed  Google Scholar 

  93. Lang IM, Dana N, Medda BK, Shaker R. Mechanism of airway protection during retching, vomiting, and swallowing. Am J Physiol. 2002;283:G529–36.

    CAS  Google Scholar 

  94. Hardemark Cedborg AI, Sundman E, Boden K, Hedstrom HW, Kuylenstierna R, Ekberg O, Erikson KI. Co-ordination of spontaneous swallowing with respiratory airflow and diaphragmatic and abdominal muscle activity in healthy adult humans. Exp Physiol. 2009;94:459–68.

    Article  PubMed  Google Scholar 

  95. Uysal H, Kizilay F, Unal A, Gungor HA, Ertekin C. The interaction between breathing and swallowing in healthy individuals. J Electromyogr Kinesiol. 2013;23:659–63.

    Article  PubMed  Google Scholar 

  96. Fernandez S, Aspirot A, Kerzner B, Froedlandaer J, Di Lorenzo C. Do some adolescents with rumination syndrome have “supragastric vomiting”? J Pediat Gastroenterol Hepatol Nutrition. 2010;50:103–5.

    Article  Google Scholar 

  97. Titchen DA. Diaphragmatic and oesophageal activity in regurgitation in sheep: an electromyographic study. J Physiol. 1979;292:381–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Hopman WP, van Kouwen MC, Smout AJ. Does (supra)gastric belching trigger recurrent hiccups? W J Gastroenterol. 2010;16:1795–9.

    Article  Google Scholar 

  99. Shaker R, Babaei A, Naini S. Prevention of esophagopharyngeal reflux by augmenting the upper esophageal sphincter pressure barrier. Laryngoscope. 2014;2014(124):2268–74.

    Article  Google Scholar 

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Acknowledgments

This project was supported by NIH P01DK068051; Mechanisms of Upper Gut and Airway Interaction; Project 3: The Physiology of the Pharyngo-Esophageal Junction

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  1. Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA

    Ivan M. Lang

  2. Dysphagia Institute Animal Research Laboratory, MACC Fund Research Center, Medical College of Wisconsin, 8701 Watertown Plank Road, 4066, Milwaukee, WI, 53226, USA

    Ivan M. Lang

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Lang, I.M. The Physiology of Eructation. Dysphagia 31, 121–133 (2016). https://doi.org/10.1007/s00455-015-9674-6

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