M1143 Quality of Life in Patients With Excessive Supragastric Belching

Abstract

Excessive supragastric belching, sometimes called aerophagia, is a rare behavioural disorder in which patients belch frequently, up to twenty times a minute. This is perceived by the patients as disturbing and interferes with social functioning and is likely to affect quality of life. Psychiatric disorders such as anxiety and depression are suggested to play a role. Methods: 21 patients (11 males, age 49 (28-78)) whose presenting symptom was excessive belching underwent impedance monitoring to confirm the diagnosis of supragastric belching. They were asked to fill in questionnaires regarding the presence and severity of their symptoms, quality of life (SF-36), reflux and dyspepsia related quality of life (QoLRaD) and the hospital anxiety and depression scale (HADS). Results: Impedance monitoring showed supragastric belching in all patients, concurrent with audible belches. On a scale 0-4 patients scored the frequency of the following symptoms: epigastric discomfort (4 iqr 3-4), heartburn (1 iqr 0-1), retrosternal pain (0 iqr 0-2), early satiety (0 iqr 0-2), bloating (0 iqr 0-3), nausea (0 iqr 0-2), belching (4 iqr 4-4) and vomiting (0 iqr 0-0). On a scale 0-5 patients scored the severity of the following symptoms: epigastric discomfort (3 iqr 2-4), heartburn (0 iqr 0-1), retrosternal pain (0 iqr 0-3), early satiety (0 iqr 0-3), bloating (0 iqr 0-3), nausea (0 iqr 0-2), belching (4 iqr 3-4) and vomiting (0 iqr 0-0). Compared to normative values, patients showed a decreased quality of life for the domains social functioning (64.3 ± 17.8), mental health (67.4 ± 16.5), vitality (47.6 ± 20.3), bodily pain (58.9 ± 21.7) and general health (44.8 ± 19.8) but not for physical functioning (75.5 ± 21.5) and physical (63.1 ± 40.0) and emotional role (81.0 ± 35.9). The QoLRaD scores were not decreased for any factor (emotional distress (4.7 iqr 4.2-6.2), sleep disturbance (5.0 iqr 3.8-6.3), food and drink problems (4.8 iqr 3.2-6.4), physical and social function (5.0 iqr 4.3-5.9), vitality (5.0 iqr 3.8-6.0)). The median HADS for anxiety (3 iqr 2-4) and/or depression (2 iqr 1-4) were not elevated and only 1 patient showed a score higher than 8 for anxiety (9) and another one for depression (10). Conclusions: In patients with excessive supragastric belching, quality of life is significantly decreased, in particular due to impairment of social function and vitality. Patients with excessive belching present a distinct symptom pattern which does not resemble reflux disease or functional dyspepsia, furthermore reflux symptoms and dyspepsia do not play a role in the observed reduction of quality of life. Depression and anxiety disorders are absent.