Aerophagia

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Aerophagia (or aerophagy) is a condition of excessive air swallowing, which goes to the stomach instead of the lungs. Aerophagia may also refer to an unusual condition where the primary symptom is excessive flatus (farting), belching (burping) is not present, and the actual mechanism by which air enters the gut is obscure or unknown. [1] Aerophagia in psychiatry is sometimes attributed to nervousness or anxiety. [2]

Contents

Symptoms and signs

Causes

Aerophagia is associated with excessively chewing gum, smoking, drinking carbonated drinks, eating too quickly, as well as anxiety, high continuous positive airway pressure and wearing loose dentures. Aerophagia is also carried out deliberately as a voluntary action to increase the length and volume of a belch, as any air successfully swallowed serves to increase the partial pressure in the stomach and expand a burp. [13] [14] In people with cervical spinal blockages, inhaling can cause some air to enter the esophagus and stomach involuntarily. [15]

Diagnosis

Aerophagia is diagnosed in 8.8% of cognitively delayed patients [16] where the coordination between swallowing and respiration is impaired and not well-defined. [17]

Aerophagia is a dangerous potential side effect of non-invasive ventilation (NIV), commonly used in treatments of respiratory problems and cardiovascular critical care or in surgery when a general anaesthetic is required. In the case of aerophagia during NIV, it is normally diagnosed by experienced medical specialists who check on patients intermittently during NIV use for any emergent problems. The diagnosis is based on the sound heard by listening through a stethoscope placed outside the abdominal cavity. Using this approach, the problem is sometimes detected later than when it develops, possibly also later than necessary. Belated detection or response to aerophagia may lead to gastric distension, which in turn could elevate the diaphragm or cause aspiration of the stomach contents into the lungs [18] or pneumatic rupture of the esophagus due to extreme gastric insufflation. [19]

See also

Related Research Articles

Heartburn, also known as pyrosis, cardialgia or acid indigestion, is a burning sensation in the central chest or upper central abdomen. Heartburn is usually due to regurgitation of gastric acid into the esophagus. It is the major symptom of gastroesophageal reflux disease (GERD).

<span class="mw-page-title-main">Gastroesophageal reflux disease</span> Medical condition

Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications. Symptoms include dental corrosion, dysphagia, heartburn, odynophagia, regurgitation, non-cardiac chest pain, extraesophageal symptoms such as chronic cough, hoarseness, reflux-induced laryngitis, or asthma. In the long term, and when not treated, complications such as esophagitis, esophageal stricture, and Barrett's esophagus may arise.

<span class="mw-page-title-main">Barrett's esophagus</span> Medical condition

Barrett's esophagus is a condition in which there is an abnormal (metaplastic) change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cells that are normally present only in the small intestine and large intestine. This change is considered to be a premalignant condition because it is associated with a high incidence of further transition to esophageal adenocarcinoma, an often-deadly cancer.

<span class="mw-page-title-main">Hiatal hernia</span> Type of hernia

A hiatal hernia or hiatus hernia is a type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn. Other symptoms may include trouble swallowing and chest pains. Complications may include iron deficiency anemia, volvulus, or bowel obstruction.

<span class="mw-page-title-main">Nissen fundoplication</span> Surgical procedure to treat gastric reflux and hiatal hernia

A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal, Belsey, Dor, Lind, and Toupet fundoplications are alternative procedures with somewhat different indications and outcomes.

<span class="mw-page-title-main">Esomeprazole</span> Medication that suppresses stomach acidity

Esomeprazole, sold under the brand name Nexium among others, is a medication which reduces stomach acid. It is used to treat gastroesophageal reflux disease, peptic ulcer disease, and Zollinger–Ellison syndrome. Effectiveness is similar to other proton pump inhibitors (PPIs). It is taken by mouth or injection into a vein.

Burping is the release of gas from the upper digestive tract of animals through the mouth. It is usually audible.

<span class="mw-page-title-main">Achlorhydria</span> Medical condition

Achlorhydria and hypochlorhydria refer to states where the production of hydrochloric acid in gastric secretions of the stomach and other digestive organs is absent or low, respectively. It is associated with various other medical problems.

Indigestion, also known as dyspepsia or upset stomach, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. People may also experience feeling full earlier than expected when eating. Indigestion is relatively common, affecting 20% of people at some point during their life, and is frequently caused by gastroesophageal reflux disease (GERD) or gastritis.

Abdominal bloating is a short-term disease that affects the gastrointestinal tract. Bloating is generally characterized by an excess buildup of gas, air or fluids in the stomach. A person may have feelings of tightness, pressure or fullness in the stomach; it may or may not be accompanied by a visibly distended abdomen. Bloating can affect anyone of any age range and is usually self-diagnosed, in most cases does not require serious medical attention or treatment. Although this term is usually used interchangeably with abdominal distension, these symptoms probably have different pathophysiological processes, which are not fully understood.

<span class="mw-page-title-main">Abdominal distension</span> Physical symptom

Abdominal distension occurs when substances, such as air (gas) or fluid, accumulate in the abdomen causing its expansion. It is typically a symptom of an underlying disease or dysfunction in the body, rather than an illness in its own right. People with this condition often describe it as "feeling bloated". Affected people often experience a sensation of fullness, abdominal pressure, and sometimes nausea, pain, or cramping. In the most extreme cases, upward pressure on the diaphragm and lungs can also cause shortness of breath. Through a variety of causes, bloating is most commonly due to buildup of gas in the stomach, small intestine, or colon. The pressure sensation is often relieved, or at least lessened, by belching or flatulence. Medications that settle gas in the stomach and intestines are also commonly used to treat the discomfort and lessen the abdominal distension.

Esophageal dysphagia is a form of dysphagia where the underlying cause arises from the body of the esophagus, lower esophageal sphincter, or cardia of the stomach, usually due to mechanical causes or motility problems.

Stretta is a minimally invasive endoscopic procedure for the treatment of gastroesophageal reflux disease (GERD) that delivers radiofrequency energy in the form of electromagnetic waves through electrodes at the end of a catheter to the lower esophageal sphincter (LES) and the gastric cardia – the region of the stomach just below the LES. The energy heats the tissue, ultimately causing it to swell and stiffen; the way this works was not understood as of 2015, but it was thought that perhaps the heat causes local inflammation, collagen deposition and muscular thickening of the LES and that it may disrupt the nerves there.

<span class="mw-page-title-main">Esophageal stricture</span> Medical condition

A benign esophageal stricture, or peptic stricture, is a narrowing or tightening of the esophagus that causes swallowing difficulties.

Biliary reflux, bile reflux (gastritis), duodenogastroesophageal reflux (DGER) or duodenogastric reflux is a condition that occurs when bile and/or other contents like bicarbonate, and pancreatic enzymes flow upward (refluxes) from the duodenum into the stomach and esophagus.

<span class="mw-page-title-main">Laryngopharyngeal reflux</span> Medical condition

Laryngopharyngeal reflux (LPR) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. LPR causes respiratory symptoms such as cough and wheezing and is often associated with head and neck complaints such as dysphonia, globus pharyngis, and dysphagia. LPR may play a role in other diseases, such as sinusitis, otitis media, and rhinitis, and can be a comorbidity of asthma. While LPR is commonly used interchangeably with gastroesophageal reflux disease (GERD), it presents with a different pathophysiology.

A hiccup is an involuntary contraction of the diaphragm or a disability that may repeat several times per minute. The hiccup is an involuntary action involving a reflex arc. Once triggered, the reflex causes a strong contraction of the diaphragm followed about a quarter of a second later by closure of the vocal cords, which results in the "hic" sound.

Roemheld syndrome (RS), or gastrocardiac syndrome, or gastric cardiac syndrome or Roemheld–Techlenburg–Ceconi syndrome or gastric-cardia, was a medical syndrome first coined by Ludwig von Roemheld (1871–1938) describing a cluster of cardiovascular symptoms stimulated by gastrointestinal changes. Although it is currently considered an obsolete medical diagnosis, recent studies have described similar clinical presentations and highlighted potential underlying mechanisms.

<span class="mw-page-title-main">Esophageal pH monitoring</span>

Esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment. It can also be used in diagnosing laryngopharyngeal reflux.

<span class="mw-page-title-main">Lymphocytic esophagitis</span> Medical condition

Lymphocytic esophagitis is a rare and poorly understood medical disorder involving inflammation in the esophagus. The disease is named from the primary inflammatory process, wherein lymphocytes are seen within the esophageal mucosa. Symptoms of the condition include difficulty swallowing, heartburn and food bolus obstruction. The condition was first described in 2006 by Rubio and colleagues. Initial reports questioned whether this was a true medical disorder, or whether the inflammation was secondary to another condition, such as gastroesophageal reflux disease.

References

  1. ↑ Levitt MD, Furne J, Aeolus MR, Suarez FL (1998). "Evaluation of an extremely flatulent patient: case report and proposed diagnostic and therapeutic approach". Am J Gastroenterol. 93 (11): 2276–81. doi:10.1111/j.1572-0241.1998.00635.x. PMID   9820415. S2CID   20991299.
  2. ↑ "Aerophagia - Define Aerophagia at Dictionary.com". dictionary.com. Archived from the original on 7 July 2017. Retrieved 26 April 2018.
  3. ↑ Chitkara DK (2005). "Aerophagia in adults: a comparison with functional dyspepsia". Alimentary Pharmacology and Therapeutics. 22 (9): 855–858. doi: 10.1111/j.1365-2036.2005.02651.x . PMID   16225495.
  4. ↑ Callahan, Christy. "Chest Pressure and Swallowing Air While Eating". livestrong.com. Archived from the original on 1 December 2017. Retrieved 26 April 2018.
  5. ↑ "Hyperventilation Syndrome". Archived from the original on 2016-03-04. Retrieved 2015-12-14.
  6. ↑ "heartburn" at Dorland's Medical Dictionary
  7. ↑ "Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults". The National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on 2015-07-25. Retrieved 2015-07-24.
  8. ↑ Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014). "Studies of the symptom abdominal pain--a systematic review and meta-analysis". Family Practice. 31 (5): 517–29. doi: 10.1093/fampra/cmu036 . PMID   24987023.
  9. ↑ Wilkes, Garry (2 August 2007). "Hiccups". eMedicine. Medscape. Retrieved 22 April 2009.
  10. ↑ Oxford University Press. "satiety, n." OED Online. Retrieved 14 March 2017.
  11. ↑ "Pediatric Vomiting". The Lecturio Medical Concept Library. Retrieved 27 July 2021.
  12. ↑ Shepherd, Kelly; Hillman, David; Eastwood, Peter (15 January 2013). "Symptoms of Aerophagia Are Common in Patients on Continuous Positive Airway Pressure Therapy and Are Related to the Presence of Nighttime Gastroesophageal Reflux". Journal of Clinical Sleep Medicine. 9 (1): 13–17. doi:10.5664/jcsm.2328. PMC   3525982 . PMID   23319899.
  13. ↑ "Belching: Is it Normal?". International Foundation for Gastrointestinal Disorders . Retrieved 31 October 2018.
  14. ↑ Luo, Elaine K. "What are the best ways to make yourself burp?". Medical News Today . Medical News Today . Retrieved 31 October 2018.
  15. ↑ Krasiuk MM, Kratinov VP (July 1993). "The characteristics of aerophagy and its treatment". Likars'ka Sprava . 7 (7): 114–6. PMID   8209520.
  16. ↑ Loening-Baucke V (2000). "Aerophagia as cause of gaseous abdominal distention in a toddler". J. Pediatr. Gastroenterol. Nutr. 31 (2): 204–7. doi: 10.1097/00005176-200008000-00026 . PMID   10941981.
  17. ↑ Perlman AL, Ettema SL, Barkmeier J (2000). "Respiratory and acoustic signals associated with bolus passage during swallowing". Dysphagia. 15 (2): 89–94. doi:10.1007/s004550010006. PMID   10758191. S2CID   9995350.
  18. ↑ RUBEN H, KNUDSEN EJ, CARUGATI G (1961). "Gastric inflation in relation to airway pressure". Acta Anaesthesiol Scand. 5 (3): 107–14. doi:10.1111/j.1399-6576.1961.tb00089.x. PMID   14494855. S2CID   8648152.
  19. ↑ Meyerovitch J, Ben Ami T, Rozenman J, Barzilay Z (1988). "Pneumatic rupture of the esophagus caused by carbonated drinks". Pediatr Radiol. 18 (6): 468–70. doi:10.1007/BF00974081. PMID   3186323. S2CID   359997.


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