Abstract
BackgroundSupragastric belching (SGB) may play a role in the pathophysiology of proton pump inhibitors (PPIs)-refractoriness in gastroesophageal reflux disease (GERD). SGB may be present in up to 40% of reflux symptoms in PPI-refractory GERD. Most reports on SGB have come from Western countries, and little is known about the prevalence and relevance of SGB in Asian refractory GERD patients. This study aimed at comparing the role of SGB in GERD patients in Japan and the UK.MethodsWe re-analyzed impedance-pH monitoring tracings from patients who were referred to tertiary centers in Japan and the UK due to PPI-refractory reflux symptoms. The prevalence of excessive SGB and the impact of SGB on reflux symptoms were compared between the two countries.ResultsImpedance-pH tracings from124 Japanese and 83 British patients were re-analyzed. Japanese patients were significantly younger and had smaller body mass index than the British (P < 0.001). Japanese patients had significantly lower prevalence of excessive SGB (18.5%) than the UK (36.1%) irrespective of reflux phenotype (P = 0.006). Logistic regression analysis showed that the geographical/cultural difference was the only factor associated with the different prevalence of SGB (odds ratio; 2.91, 95% CI 1.09–7.73, P = 0.032). SGB were related to typical reflux symptoms very rarely in Japan [0% (0–4.9)] compared to the UK [35% (0–54.1)] (P = 0.071).ConclusionsThe prevalence of SGB and their impact on reflux symptoms is significantly lower in Japan compared to the UK. The difference is not related to reflux parameters but might come from ethnic/cultural factors to be further characterized.
Highlights
Belching is defined as ‘‘audible escape of air from the esophagus or the stomach into the pharynx’’ [1]
Japanese patients had significantly lower prevalence of excessive Supragastric belching (SGB) (18.5%) than the UK (36.1%) irrespective of reflux phenotype (P = 0.006)
The prevalence of SGB and their impact on reflux symptoms is significantly lower in Japan compared to the UK
Summary
Belching is defined as ‘‘audible escape of air from the esophagus or the stomach into the pharynx’’ [1]. Several studies reported the prevalence of increased belching in the general population ranging from 9.3 to 28.8%, and is much higher among patients having reflux symptoms [4,5,6,7,8]. These studies included both types of belching, the prevalence of SGB might differ regionally as it is the case with gastroesophageal reflux disease (GERD) [9]. The prevalence of excessive SGB and the impact of SGB on reflux symptoms were compared between the two countries
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