Dysphagia

pp 1–9 | Cite as

Speech Therapy as Treatment for Supragastric Belching

  • Liesbeth ten Cate
  • Thomas V. K. Herregods
  • Philippe H. Dejonckere
  • Gerrit J. M. Hemmink
  • André J. P. M. Smout
  • Albert J. Bredenoord
Original Article
  • 107 Downloads

Abstract

The purpose of this study was to describe a newly developed speech therapy program as an innovating therapeutic approach and to assess the results of this intervention in patients with supragastric belching. This is a retrospective analysis of prospectively gathered data from 73 patients with supragastric belching who were treated with speech therapy between 2007 and 2017. Of these, 48 were included for evaluation of therapy. Thirty patients had supragastric belching proven by 24-h impedance measurements. Eighteen patients were diagnosed by an experienced speech language pathologist as having supragastric belching according to precise criteria. Speech therapy consists of explanation, creating awareness of esophageal air influx and exercises to discontinue the supragastric belching mechanism. Therapy effect was measured by comparing visual analogue scale (VAS) scores on belching and related symptoms. The median symptom duration at the start of therapy was 2 years. Supragastric belching symptoms decreased significantly with a total median VAS score of 406 (291–463) prior to treatment and a median VAS score of 125 (17–197) following treatment. Forty patients (83%) had a sufficient to major result with a median therapy duration of 3 months and ten sessions. Speech therapy was an effective treatment in the majority of patients with supragastric belching.

Keywords

Supragastric belching Speech therapy Air inhalation Air injection Glottal closure Abdominal breathing Deglutition Deglutition disorders 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was not required because our manuscript describes a retrospective study wherein the gathered data are part of the regular treatment.

References

  1. 1.
    Scheffer RCH, Akkermans LMA, Bais JE, Roelofs JMM, Smout AJPM, Gooszen HG. Elicitation of transient lower oesophageal sphincter relaxations in response to gastric distension and meal ingestion. Neurogastroenterol Motil. 2002;14:647–55.CrossRefPubMedGoogle Scholar
  2. 2.
    Bredenoord AJ. Management of belching, hiccups, and aerophagia. Clin Gastroenterol Hepatol. 2013;11:6–12.CrossRefPubMedGoogle Scholar
  3. 3.
    Wyman JB, Dent J, Heddle R, Dodds WJ, Toouli J, Downton J. Control of belching by the lower oesophageal sphincter. Gut. 1990;31:639–46.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Bredenoord AJ, Weusten BLAM, Timmer R, Smout AJPM. Psychological factors affect the frequency of belching in patients with aerophagia. Am J Gastroenterol. 2006;101:2777–81.CrossRefPubMedGoogle Scholar
  5. 5.
    Hwang JB, Kim JS, Ahn BH, Jung CH, Lee YH, Kam S. Clonazepam treatment of pathologic childhood aerophagia with psychological stresses. J Korean Med Sci. 2007;22:205–8.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Bredenoord AJ, Weusten BLAM, Sifrim D, Timmer R, Smout AJPM. Aerophagia, gastric, and supragastric belching: a study using intraluminal electrical impedance monitoring. Gut. 2004;53:1561–5.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Kessing BF, Bredenoord AJ, Smout AJPM. Mechanisms of gastric and supragastric belching: a study using concurrent high-resolution manometry and impedance monitoring: gastric belching and supragastric belching. Neurogastroenterol Motil. 2012;24:e573–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Hemmink GJM, Ten Cate L, Bredenoord AJ, Timmer R, Weusten BLAM, Smout AJPM. Speech therapy in patients with excessive supragastric belching: a pilot study. Neurogastroenterol Motil. 2010;22(24–28):e2–3.Google Scholar
  9. 9.
    Koukias N, Woodland P, Yazaki E, Sifrim D. Supragastric belching: prevalence and association with gastroesophageal reflux disease and esophageal hypomotility. J Neurogastroenterol Motil. 2015;21:398–403.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Lang IM, Medda BK, Shaker R. Characterization and mechanisms of the supragastric belch in the cat. Am J Physiol Gastrointest Liver Physiol. 2017;313:G220–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Cigrang JA, Hunter CM, Peterson AL. Behavioral treatment of chronic belching due to aerophagia in a normal adult. Behav Modif. 2006;30:341–51.CrossRefPubMedGoogle Scholar
  12. 12.
    Katzka DA. Simple office-based behavioral approach to patients with chronic belching. Dis Esophagus. 2013;26:570–3.CrossRefPubMedGoogle Scholar
  13. 13.
    Riehl ME, Kinsinger S, Kahrilas PJ, Pandolfino JE, Keefer L. Role of a health psychologist in the management of functional esophageal complaints. Dis Esophagus. 2015;28:428–36.CrossRefPubMedGoogle Scholar
  14. 14.
    Ellegård E, Nilsén CH. Supragastric belching – case report of a severe handicap. Acta Oto-Laryngol Case Rep. 2016;1:1–3.CrossRefGoogle Scholar
  15. 15.
    Kotby MN, Shiromoto O, Hirano M. The accent method of voice therapy: effect of accentuations on F0, SPL, and airflow. J Voice. 1993;7:319–25.CrossRefPubMedGoogle Scholar
  16. 16.
    Boone DR, McFarlane SC, Von Berg SL, Zraick RI. The voice and voice therapy. Boston: Allyn & Bacon; 2009.Google Scholar
  17. 17.
    Martin-Harris B. Coordination of respiration and swallowing. GI Motil Online. 2006.  https://doi.org/10.1038/gimo.10.Google Scholar
  18. 18.
    Chitkara DK, Bredenoord AJ, Talley NJ, Whitehead WE. Aerophagia and rumination: recognition and therapy. Curr Treat Options Gastroenterol. 2006;9:305–13.CrossRefPubMedGoogle Scholar
  19. 19.
    Chitkara DK, Bredenoord AJ, Rucker MJ, Talley NJ. Aerophagia in adults: a comparison with functional dyspepsia. Aliment Pharmacol Ther. 2005;22:855–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Kessing BF, Bredenoord AJ, Smout AJPM. The pathophysiology, diagnosis and treatment of excessive belching symptoms. Am J Gastroenterol. 2014;8:1196–203.CrossRefGoogle Scholar
  21. 21.
    Damsté PH. Methods of restoring the voice after laryngectomy. Laryngoscope. 1975;85:649–55.CrossRefPubMedGoogle Scholar
  22. 22.
    Van Den Berg J, Moolenaar-Bijl AJ, Damste PH. Oesophageal speech. Folia Phoniatr (Basel). 1958;10:65–84.CrossRefGoogle Scholar
  23. 23.
    Edels Y. The voice and pseudo-voice. In: Edels Y, editor. Laryngectomy, diagnosis to rehabilitation. London: Croom Helm; 1983. p. 107–41.Google Scholar
  24. 24.
    Schutte HK, Nieboer GJ. Aerodynamics of esophageal voice production with and without a Groningen voice prosthesis. Folia Phoniatr Logop. 2002;54:8–18.CrossRefPubMedGoogle Scholar
  25. 25.
    Evidente VG. Is it a tic or Tourette’s? Clues for differentiating simple from more complex tic disorders. Postgrad Med. 2000;108(175–6):179–82.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Stem en Spraak (Voice and Speech) Logopedie aan de AmstelAmsterdamThe Netherlands
  2. 2.Department of Gastroenterology and HepatologyAcademic Medical CenterAmsterdamThe Netherlands
  3. 3.KULeuven, Neurosciences & Federal Agency for Occupational RisksBrusselsBelgium
  4. 4.Department of GastroenterologyIsalaZwolleThe Netherlands

Personalised recommendations