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Speech therapy beneficial to patients with supragastric belching

10 Oct 2018

Speech therapy may effectively reduce excessive supragastric belching, according to a study. This treatment is aimed at increasing awareness of air inhalation and injection manoeuvres, as well as performing exercises to enhance abdominal, quiet and fluent breathing (without sudden stops).

A total of 73 patients with supragastric belching underwent speech therapy, among whom 48 were included in the analysis. Therapy comprised five components: explanation of the supragastric belching mechanism, promotion of awareness of oesophageal air influx, exercises to improve breathing, enhancement of lingual–laryngeal–cricopharyngeal complex functioning and implementation into daily life.

Supragastric belching was proven by 24-hour impedance measurements in 30 patients and diagnosed by an experienced speech language pathologist in 18 patients. The median symptom duration at the start of therapy was 2 years.

Speech therapy yielded significant reductions in the symptoms of supragastric belching, with efficacy evaluated using visual analogue scale (VAS) scores. Total median VAS score was 406 (291–463) prior to treatment vs 125 (17–197) following treatment.

Sufficient-to-major improvements were achieved in 40 patients (83 percent) over a median therapy duration of 3 months and 10 sessions.

The present data demonstrate the clinical importance of speech therapy in patients with excessive supragastric belching, researchers said. Among the main focuses of therapy are the frequent strained mouth and/or glottal closures.

While the method by which the patient relaxes the upper oesophageal sphincter (UES) at the moment of air influx is not clearly understood, researchers postulated that higher pharyngeal pressure, in case of air injection, could open the oesophageal sphincter. Additionally, the tight and abrupt laryngeal and vocal folds closure plays a role in the initiation of the supragastric air influx.

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