Management of Belching, Hiccups, and Aerophagia

Abstract and Introduction

Abstract

Although belching and hiccups are regarded as normal behaviors, they can occur at high frequency or become persistent, becoming bothersome and requiring medical care. Patients with excessive belching frequently have supragastric belches. Excessive belching should be treated as a behavioral disorder. Persistent hiccups, however, can be the first presentation of a serious disorder that requires extensive diagnostic testing. When no cause is found, only the symptoms can be treated. Aerophagia is an episodic or chronic disorder in which patients (children and adults) swallow large quantities of air, which accumulate in the gastrointestinal tract to cause abdominal distention and bloating. These patients should not undergo explorative laparotomy because they do not have ileus. New treatment approaches are needed for patients with aerophagia.

Introduction

Belching and hiccups occur occasionally in everyone and most often are not related to a disease or pathologic condition. Only rarely a physician is consulted for these complaints. Only when belching and hiccups become very frequent and bothersome is it considered pathologic. Aerophagia and excessive belching are 2 different conditions that often are mistaken for each other. Aerophagia is a disorder in which the voluminous intake of air results in abdominal distention and bloating, in contrast to excessive belching disorder in which belching is the predominant symptom.

In this review the available knowledge on the management of belching, hiccups, and aerophagia is discussed.