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Speech Therapy as Treatment for Supragastric Belching

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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.

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References

  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.

    Article  PubMed  CAS  Google Scholar 

  2. Bredenoord AJ. Management of belching, hiccups, and aerophagia. Clin Gastroenterol Hepatol. 2013;11:6–12.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  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.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  12. Katzka DA. Simple office-based behavioral approach to patients with chronic belching. Dis Esophagus. 2013;26:570–3.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  14. Ellegård E, Nilsén CH. Supragastric belching – case report of a severe handicap. Acta Oto-Laryngol Case Rep. 2016;1:1–3.

    Article  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  16. Boone DR, McFarlane SC, Von Berg SL, Zraick RI. The voice and voice therapy. Boston: Allyn & Bacon; 2009.

    Google Scholar 

  17. Martin-Harris B. Coordination of respiration and swallowing. GI Motil Online. 2006. https://doi.org/10.1038/gimo.10.

    Article  Google Scholar 

  18. Chitkara DK, Bredenoord AJ, Talley NJ, Whitehead WE. Aerophagia and rumination: recognition and therapy. Curr Treat Options Gastroenterol. 2006;9:305–13.

    Article  PubMed  Google Scholar 

  19. Chitkara DK, Bredenoord AJ, Rucker MJ, Talley NJ. Aerophagia in adults: a comparison with functional dyspepsia. Aliment Pharmacol Ther. 2005;22:855–8.

    Article  PubMed  CAS  Google Scholar 

  20. Kessing BF, Bredenoord AJ, Smout AJPM. The pathophysiology, diagnosis and treatment of excessive belching symptoms. Am J Gastroenterol. 2014;8:1196–203.

    Article  Google Scholar 

  21. Damsté PH. Methods of restoring the voice after laryngectomy. Laryngoscope. 1975;85:649–55.

    Article  PubMed  Google Scholar 

  22. Van Den Berg J, Moolenaar-Bijl AJ, Damste PH. Oesophageal speech. Folia Phoniatr (Basel). 1958;10:65–84.

    Article  Google Scholar 

  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. Schutte HK, Nieboer GJ. Aerodynamics of esophageal voice production with and without a Groningen voice prosthesis. Folia Phoniatr Logop. 2002;54:8–18.

    Article  PubMed  CAS  Google Scholar 

  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 

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Authors and Affiliations

  1. Stem en Spraak (Voice and Speech), Logopedie aan de Amstel, Herengracht 500, 1017 CB, Amsterdam, The Netherlands

    Liesbeth ten Cate

  2. Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Thomas V. K. Herregods, André J. P. M. Smout & Albert J. Bredenoord

  3. KULeuven, Neurosciences & Federal Agency for Occupational Risks, Brussels, Belgium

    Philippe H. Dejonckere

  4. Department of Gastroenterology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands

    Gerrit J. M. Hemmink

Authors
  1. Liesbeth ten Cate
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  2. Thomas V. K. Herregods
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  3. Philippe H. Dejonckere
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  4. Gerrit J. M. Hemmink
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  5. André J. P. M. Smout
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  6. Albert J. Bredenoord
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Correspondence to Liesbeth ten Cate.

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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.

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ten Cate, L., Herregods, T.V.K., Dejonckere, P.H. et al. Speech Therapy as Treatment for Supragastric Belching. Dysphagia 33, 707–715 (2018). https://doi.org/10.1007/s00455-018-9890-y

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  • DOI: https://doi.org/10.1007/s00455-018-9890-y

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