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1.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526530

RESUMEN

A 15-year-old man presented with an acute history of facial swelling following a bout of forceful eructation after eating. Subcutaneous emphysema was noted on examination of his left face and neck. He was initially managed with intravenous antibiotics for suspected facial infection. A chest radiograph performed on day 3 of admission identified subcutaneous emphysema of the upper thorax and neck. CT with oral contrast confirmed extensive subcutaneous emphysema of neck, thorax and upper abdomen, with associated pneumomediastinum. The site of air leak was not identified. He subsequently underwent upper gastrointestinal endoscopy and this was normal. Despite the delay in diagnosis, he remained haemodynamically stable, and repeated radiography showed improvement reflecting the benign course of this condition as described in existing literature. There are no previous published reports of spontaneous pneumomediastinum following eructation; therefore, high clinical suspicion should be maintained in this presentation.


Asunto(s)
Enfisema Mediastínico/diagnóstico por imagen , Enfisema Subcutáneo/diagnóstico por imagen , Adolescente , Diagnóstico Tardío , Edema , Eructación/complicaciones , Cara , Humanos , Masculino , Enfisema Mediastínico/etiología , Radiografía Torácica , Enfisema Subcutáneo/etiología , Tomografía Computarizada por Rayos X
2.
BMC Gastroenterol ; 19(1): 34, 2019 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-30782128

RESUMEN

BACKGROUND: This study was conducted to analyze the association between digestive symptoms and sleep disturbance, and to determine if any digestive symptoms are related to sleep disturbance. METHODS: This was a cross-sectional study of 5792 subjects surveyed in a community-based cohort. Subjects provided information regarding the quality of sleep as assessed by the Pittsburgh Sleep Quality Index (PSQI), as well as digestive symptoms as assessed by the Gastrointestinal Symptom Rating Scale (GSRS). Logistic regressions were used to examine factors associated with sleep quality. RESULTS: The mean PSQI global score of the no sleep disturbances group (n = 4948) was 3.92 (SD = 2.14), while that of the sleep disturbance group (n = 844) was 11.18 (SD = 2.17). The association between digestive symptoms and sleep disturbance was evaluated by logistic regression after adjusting for cofounding factors. The results revealed that sleep disturbances were associated with digestive symptoms (aOR = 1.29, 95% CI = 1.22-1.36), especially abdominal pains (aOR = 1.63, 95% CI = 1.19-2.25), acid regurgitation (aOR = 1.48, 95% CI = 1.17-1.86), abdominal distension (aOR = 1.80, 95% CI = 1.42-2.28), and eructation (aOR = 1.59, 95% CI = 1.24-2.03). CONCLUSIONS: Digestive symptoms and sleep disturbances seem to be associated. These results will help medical professionals to effectively diagnose and manage patients with sleep disturbance. Furthermore, subsequent studies using comprehensive longitudinal data should be conducted to confirm the results of the present study.


Asunto(s)
Enfermedades del Sistema Digestivo/complicaciones , Trastornos del Sueño-Vigilia/complicaciones , Dolor Abdominal/complicaciones , Anciano , Estreñimiento/complicaciones , Estudios Transversales , Dispepsia/complicaciones , Eructación/complicaciones , Femenino , Reflujo Gastroesofágico/complicaciones , Humanos , Masculino , Persona de Mediana Edad
3.
J Gastrointest Surg ; 22(11): 1852-1860, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30030717

RESUMEN

BACKGROUND: Laparoscopic 270 degree posterior, or Toupet (LTF), and 180 degree anterior partial fundoplication (LAF) ensure equal reflux control and reduce the risk of gas-related symptoms compared to 360 degree (Nissen) fundoplication. It is unclear which type of partial fundoplication is superior in preventing gas-related side-effects. The aim of this study was to determine differences in effect of LTF and LAF on reflux characteristics and belching patterns. METHODS: Upper gastrointestinal endoscopy, esophageal manometry, and 24-h combined pH-impedance monitoring were performed before and 6 months after fundoplication (n = 10, LTF vs. n = 10, LAF). Observed changes after surgery (∆) were compared between the two procedures. RESULTS: Symptomatic reflux control as well as the reduction in the mean number of acid (∆ - 58.5 vs. - 66.5; P = 0.912), liquid (∆ - 17.0 vs. - 43.5; P = 0.247), and mixed liquid gas reflux episodes (∆ - 38.0 vs. - 40.0; P = 0.579) were comparable following LTF and LAF. There were no differences in the mean number of weakly acidic reflux episodes after LTF and LAF (1.0 (0.8-4) vs. 1.0 (0-3), P = 0.436). The reduction in proximal (P = 1.000), mid-esophageal (P = 0.063), and distal reflux episodes (P = 0.315) was comparable. Both procedures equally reduced the number of gastric belches (P = 0.278) and supragastric belches (P = 0.123), with no significant reduction in the number of air swallows after either procedure (P = 0.278). CONCLUSION: LTF and LAF provide similar reflux control, with a comparable effect on acidic, liquid, and gas reflux. Both procedures equally reduced the number of belches and supragastric belches. This study provides the physiological evidence for the published randomized trials reporting similar symptomatic outcome after both types of partial fundoplication.


Asunto(s)
Eructación/complicaciones , Fundoplicación/métodos , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/cirugía , Laparoscopía/métodos , Adulto , Endoscopía Gastrointestinal , Monitorización del pH Esofágico , Esofagitis Péptica , Femenino , Reflujo Gastroesofágico/diagnóstico por imagen , Reflujo Gastroesofágico/fisiopatología , Pirosis , Humanos , Masculino , Manometría , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
4.
Am J Gastroenterol ; 113(4): 539-547, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29460918

RESUMEN

OBJECTIVES: Excessive supragastric belching (SGB) manifests as troublesome belching, and can be associated with reflux and significant impact on quality of life (QOL). In some GERD patients, SGB-associated reflux contributes to up to 1/3 of the total esophageal acid exposure. We hypothesized that a cognitive-behavioral intervention (CBT) might reduce SGB, improve QOL, and reduce acid gastroesophageal reflux (GOR). We aimed to assess the effectiveness of CBT in patients with pathological SGB. METHODS: Patients with SGB were recruited at the Royal London Hospital. Patients attended CBT sessions focused on recognition of warning signals and preventative exercises. Objective outcomes were the number of SGBs, esophageal acid exposure time (AET), and proportion of AET related to SGBs. Subjective evaluation was by patient-reported questionnaires. RESULTS: Of 51 patients who started treatment, 39 completed the protocol, of whom 31 had a follow-up MII-pH study. The mean number of SGBs decreased significantly after CBT (before: 116 (47-323) vs. after 45 (22-139), P<0.0003). Sixteen of 31 patients were shown to have a reduction in SGB by >50%. In patients with increased AET at baseline, AET after CBT was decreased: 9.0-6.1% (P=0.005). Mean visual analog scale severity scores decreased after CBT (before: 260 (210-320) mm vs. after: 140 (80-210) mm, P<0.0001). CONCLUSIONS: Cognitive behavioral therapy reduced the number of SGB and improved social and daily activities. Careful analysis of MII-pH allows identification of a subgroup of GERD patients with acid reflux predominantly driven by SGB. In these patients, CBT can reduce esophageal acid exposure.


Asunto(s)
Terapia Cognitivo-Conductual , Eructación/complicaciones , Eructación/terapia , Reflujo Gastroesofágico/etiología , Adulto , Anciano , Monitorización del pH Esofágico , Terapia por Ejercicio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Calidad de Vida , Índice de Severidad de la Enfermedad , Adulto Joven
5.
Korean J Gastroenterol ; 70(6): 273-277, 2017 12 25.
Artículo en Coreano | MEDLINE | ID: mdl-29277088

RESUMEN

Supragastric belching is the most important factor in the etiology of excessive belching complaints. Supragastric belching is a belching disorder with a behavioral origin. The standard diagnosis is made by monitoring the esophageal impedance. Supragastric belching has been shown to be associated with globus, as well as reflux symptoms in proton pump inhibitor non-responders in gastroesophageal reflux disease; however, the pathophysiology of supragastric belching in patients with gastroesophageal reflux disease or functional dyspepsia has not been clarified. Patient education with behavioral therapy is the treatment of choice in isolated supragastric belching. On the other hand, the best management of supragastric belching associated with globus, gastroesophageal reflux disease, and dyspepsia remains to be studied.


Asunto(s)
Eructación/diagnóstico , Animales , Conducta , Impedancia Eléctrica , Eructación/complicaciones , Eructación/patología , Eructación/terapia , Esófago/fisiología , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/diagnóstico , Humanos , Rumiación Digestiva
6.
Anesth Prog ; 64(4): 244-247, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29200370

RESUMEN

Excessive supragastric belching is rarely described in the anesthesia literature. Anesthesia planning of a 26-year-old patient with excessive supragastric belching, history of superior mesenteric artery syndrome (SMAS), and dental anxiety requires preoperative assessment. This case report outlines the anesthetic considerations and the management to facilitate comprehensive dentistry. Key anesthetic considerations include anxiolysis, aspiration risk reduction, total intravenous anesthesia (TIVA), and postoperative nausea and vomiting (PONV) prophylaxis.


Asunto(s)
Anestesia Dental/métodos , Atención Odontológica/métodos , Eructación/complicaciones , Adulto , Ansiedad al Tratamiento Odontológico/psicología , Femenino , Humanos , Síndrome de la Arteria Mesentérica Superior/complicaciones
9.
Int J Eat Disord ; 45(2): 298-301, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21374693

RESUMEN

This report offers the first detailed description of repetitive eructation (belching) in a patient with bulimia nervosa. The case was a man in his 30's with bulimia nervosa characterized by daily bingeing and purging behavior. Detailed assessment revealed repetitive eructation which was construed as a learned behavior precipitated and maintained by aerophagia (air swallowing) secondary to regular binge-eating. Eructation was associated with a strong sense of "relief" that shared a common phenomenology with other purging behaviors. Repetitive eructation was addressed as part of outpatient treatment using a cognitive-therapy approach. Eructation became less frequent during outpatient treatment but the patient disengaged after six sessions. We define a new term "eructophilia" where repetitive eructation takes on an ego-syntonic, self-contained, and autonomous quality which serves as a reinforcing stimulus in itself. Issues of phenomenology and motivating factors are further discussed.


Asunto(s)
Bulimia Nerviosa/terapia , Terapia Cognitivo-Conductual , Eructación/terapia , Adulto , Bulimia Nerviosa/complicaciones , Bulimia Nerviosa/psicología , Eructación/complicaciones , Eructación/psicología , Humanos , Masculino , Resultado del Tratamiento
10.
J Pediatr Gastroenterol Nutr ; 54(4): 516-20, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21921809

RESUMEN

OBJECTIVE: Aerophagia is a functional gastrointestinal disorder characterised by repetitive air swallowing, abdominal distension, belching, and flatulence. In severe cases, it can lead to pneumoperitonium, volvulus of the colon, and intestinal perforation. Little is known about the epidemiology and clinical profile of affected children. The main objective of the present study was to assess the epidemiology of aerophagia in 10- to 16-year-olds in Sri Lanka. METHODS: A school-based cross-sectional survey was conducted in 8 randomly selected schools in 4 randomly selected provinces in Sri Lanka. Data were collected using a pretested, self-administered questionnaire, which was distributed in an examination setting and collected on the same day. Trained research assistants were present during completion of the questionnaire, for any required clarification. Aerophagia was diagnosed using the Rome III criteria. RESULTS: In the present study, aerophagia was seen in 163 (7.5%) of the 2163 children evaluated. The prevalence was higher in older children (10.5% in 15-year-olds) and no sex difference was observed (boys 8.2% vs girls 6.8%, P>0.05). Intestinal-related (abdominal pain, nausea, and anorexia) and extraintestinal symptoms (headache, limb pain, sleeping difficulty, photophobia, and lightheadedness) were more prevalent among affected children (P<0.05). A higher percentage of affected children were found to be exposed to stressful events when compared with controls (P<0.05). CONCLUSIONS: The present study highlights the high prevalence of aerophagia among Sri Lankan children and adolescents. This condition is more common in those exposed to emotional stress. Intestinal-related symptoms and extraintestinal somatic symptoms are frequently seen in affected children.


Asunto(s)
Dolor Abdominal/epidemiología , Aerofagia/diagnóstico , Aerofagia/epidemiología , Eructación/epidemiología , Flatulencia/epidemiología , Estrés Psicológico/epidemiología , Dolor Abdominal/complicaciones , Dolor Abdominal/fisiopatología , Adolescente , Aerofagia/complicaciones , Aerofagia/fisiopatología , Pueblo Asiatico , Niño , Estudios Transversales , Eructación/complicaciones , Eructación/fisiopatología , Femenino , Flatulencia/complicaciones , Flatulencia/fisiopatología , Humanos , Acontecimientos que Cambian la Vida , Masculino , Prevalencia , Distribución Aleatoria , Factores de Riesgo , Sri Lanka/epidemiología , Estrés Psicológico/complicaciones , Estrés Psicológico/fisiopatología , Encuestas y Cuestionarios
11.
Rev Esp Enferm Dig ; 103(3): 129-32, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21434715

RESUMEN

BACKGROUND: Pregnancy is associated with an increased incidence of heartburn. However, there is no information for other symptoms related to gastro-esophageal reflux (GOR). AIM: to assess the prevalence of atypical symptoms of GOR during pregnancy, and to examine its association with typical GOR symptoms. METHODS: we report data for 263 women with a pregnancy of less than 12 weeks. They were interviewed at the end of each trimester of pregnancy and at 1-year post-partum, using the Gastro Esophageal Reflux Questionnaire (GERQ). In the first interview, information about symptoms in the year before pregnancy was also collected with GERQ. RESULTS: women suffered atypical GOR symptoms during pregnancy more frequently than in the year before: non-cardiac chest pain (NCCP) (9.1 vs. 1.9%), dysphagia (12.6 vs. 2.3%), globus (33.1 vs. 4.6%), cough (26.6 vs. 6.8%), belching (66.2 vs. 19.4%) and hiccups (19.0 vs. 8.4%). Atypical GOR symptoms in pregnancy showed an association with suffering the same symptom before pregnancy and NCCP, globus, belching and hiccups with suffering typical GOR symptoms in the first trimester. CONCLUSIONS: Atypical GOR symptoms are highly prevalent in pregnancy, and are associated with atypical symptoms before pregnancy and with typical symptoms of GOR in the first trimester.


Asunto(s)
Reflujo Gastroesofágico/epidemiología , Complicaciones del Embarazo/epidemiología , Adolescente , Adulto , Recolección de Datos , Eructación/complicaciones , Femenino , Reflujo Gastroesofágico/diagnóstico , Reflujo Gastroesofágico/fisiopatología , Humanos , Modelos Logísticos , Persona de Mediana Edad , Embarazo , Complicaciones del Embarazo/diagnóstico , Trimestres del Embarazo , Factores Socioeconómicos , España/epidemiología , Teléfono , Adulto Joven
13.
World J Gastroenterol ; 16(14): 1795-9, 2010 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-20380015

RESUMEN

Twenty-four hours multichannel intraesophageal impedance and pH monitoring in a patient who suffered from recurrent hiccups for more than a year revealed frequent supragastric belching and pathological oesophageal acid exposure. Furthermore, a temporal relationship between the start of a hiccup episode and gastric belching was observed. The data support the hypothesis that there is an association between supragastric belching, persistent recurrent hiccups and gastro-oesophageal reflux disease, and that gastric belching may evoke hiccup attacks.


Asunto(s)
Eructación/complicaciones , Hipo/etiología , Anciano , Impedancia Eléctrica , Eructación/diagnóstico , Monitorización del pH Esofágico , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/diagnóstico , Humanos , Masculino , Manometría , Recurrencia
15.
Pacing Clin Electrophysiol ; 28(5): 458-60, 2005 May.
Artículo en Inglés | MEDLINE | ID: mdl-15869682

RESUMEN

We describe a case of situational syncope induced by belching. The patient showed severe syncope with a high-degree atrioventricular block just after belching, but has not experienced syncope or dizziness over a 3-month follow-up after permanent pacemaker implantation.


Asunto(s)
Eructación/complicaciones , Síncope/etiología , Humanos , Masculino , Persona de Mediana Edad , Marcapaso Artificial , Síncope/terapia
16.
Mov Disord ; 19(7): 856-9, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15254955

RESUMEN

We report on an uncommon manifestation of molecularly proven neuroacanthocytosis in a 32-year-old man in whom dyspnea with desaturation while awake accompanied by continuous involuntary belching were the major consequences of the disease.


Asunto(s)
Corea/complicaciones , Corea/diagnóstico , Eructación/complicaciones , Adulto , Corea/genética , Cromosomas Humanos Par 9/genética , Diafragma/fisiopatología , Dilatación Patológica/fisiopatología , Electromiografía , Electrooculografía , Eructación/fisiopatología , Tracto Gastrointestinal/fisiopatología , Humanos , Masculino , Músculo Esquelético/fisiopatología , Mutación Puntual/genética , Polisomnografía , Proteínas/genética , Proteínas de Transporte Vesicular
18.
Heart ; 81(3): 313-5, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10026360

RESUMEN

Three cases with supraventricular tachyarrhythmias related to oesophageal transit are reported. A 61 year old man had episodes of atrial tachycardia on each swallow of food but not liquid; this has been reported only rarely. A 55 year old man had atrial fibrillation initiated by drinking ice cold beverages; this has not been described previously although atrial tachycardia triggered by drinking ice cold beverages has been described once. A 68 year old man had supraventricular tachycardia initiated by belching; this has not been described previously. These cases illustrate the diversity of atrial tachyarrhythmias that can be precipitated by oesophageal stimulation and suggest that what is regarded as a very rare phenomenon may be found more commonly when sought.


Asunto(s)
Deglución , Eructación/complicaciones , Taquicardia Supraventricular/etiología , Anciano , Electrocardiografía , Eructación/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Taquicardia Supraventricular/fisiopatología
19.
Gut ; 44(1): 47-54, 1999 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-9862825

RESUMEN

BACKGROUND: Belching has been proposed as a major mechanism underlying acid gastro-oesophageal reflux in normal subjects. However, the presence of oesophageal gas has not been measured directly but only inferred from manometry. AIMS: To investigate, using intraluminal electrical impedance, the patterns of gas and liquid reflux during transient lower oesophageal sphincter (LOS) relaxations, the main mechanism of acid reflux in normal subjects. METHODS: Impedance changes associated with the passage of gas were studied in vitro, and in vivo in cats. Oesophageal manometry, pH, and intraluminal electrical impedance measurements were performed in 11 normal subjects after a meal. RESULTS: Gas reflux caused a sudden increase in impedance that propagated rapidly to the proximal oesophagus whereas liquid reflux induced a retrogressively propagated fall in impedance. Impedance showed gas or liquid reflux during most (102/141) transient LOS relaxations. When acid reflux occurred, impedance showed evidence of intraoesophageal retrograde flow of liquid in the majority (78%) of events. Evidence of gas retroflow was found in almost half (47%) of acid reflux episodes. When present together, however, liquid preceded gas on 44% of occasions. Overall, gas reflux occurred as the initial event in only 25% of acid reflux episodes. CONCLUSIONS: These findings suggest that in upright normal subjects, although belching can precipitate acid reflux, most acid reflux occurs as a primary event.


Asunto(s)
Eructación/complicaciones , Gases/metabolismo , Reflujo Gastroesofágico/etiología , Adolescente , Adulto , Animales , Gatos , Impedancia Eléctrica , Esófago/fisiopatología , Femenino , Alimentos , Reflujo Gastroesofágico/metabolismo , Reflujo Gastroesofágico/fisiopatología , Humanos , Concentración de Iones de Hidrógeno , Masculino , Manometría , Relajación Muscular/fisiología , Reproducibilidad de los Resultados , Soluciones
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