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Belching
Last reviewed: 04.07.2025
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Belching is a sudden release of gases from the stomach or esophagus through the mouth, accompanied by a characteristic sound. Belching is part of a range of phenomena united by the general term "pneumatosis of the stomach".
Regurgitation is a belching accompanied by the release of food or gastric juice into the throat or oral cavity and not accompanied by nausea or other autonomic disorders, and there is no contraction of the diaphragm.
[ Causes of belching
If belching is persistent enough and is associated with the patient's habitual swallowing of air, which, when released, to a certain extent alleviates the patient's condition, then in these cases we are talking about aerophagia (nervous belching). With aerophagia, the process of swallowing air is accelerated, unpleasant sensations appear, which are reduced by belching. Belching can become an obsessive phenomenon, accompanied by significant sound manifestations, which, naturally, causes stress in patients.
Within the framework of the specified disorders, it is necessary to single out the gastrocardial syndrome of Remheld (the so-called gastrointestinal neurosis), which is manifested by aerophagia, unpleasant sensations and pain in the abdominal region in combination with cardialgic manifestations. All the specified disorders arise against the background of a number of vegetative disorders - hyperventilation, tachycardia, extrasystole, hypotension and disorders of the affective sphere of the depressive circle.
Clinical analysis of the above phenomena should include a thorough somatic examination of the patients, since the exclusion of organic disease is especially necessary here for the reason that the phenomenology of the disorders in question often suggests to the physician, even to the gastroenterologist, the idea of the possibility of psychogenic disorders.
Belching is often associated with certain features of the eating behavior of patients: fast eating with insufficient chewing of food, swallowing large pieces, smoking during meals, drinking drinks with a large amount of gases dissolved in them. In some patients, the presence of chronic pharyngitis is accompanied by frequent swallowing of air; frequent swallowing movements are also possible when smoking, with hypersalivation.
The pathogenesis of the above disorders is mainly associated with the penetration of air into the gastrointestinal tract. As is known, each swallowing movement is accompanied by the introduction of air into the stomach. Over a short period of time, it is possible to swallow a large amount of air, which is quite easily determined by percussion over the left part of the diaphragm. In emotional and vegetative disorders, especially when there is hyperventilation syndrome in the structure, swallowing movements become more frequent and the process of swallowing air is sharply accelerated. This mechanism is apparently the leading one in pathogenesis, although a violation of the process of gastric digestion with a large amount of released gases is also taken into account. Similar mechanisms play a role in a sharp increase in abdominal volume within the framework of hysterical disorders, causing the well-known phenomenon of "imaginary pregnancy" - Alvarez syndrome.
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