The inability to belch syndrome: A study using concurrent high‐resolution manometry and impedance monitoring

• DOI: 10.1111/nmo.14250
• Publication Date: 2021-08-26T10:18:36Z
• Authors: Renske A.B. Oude ...; Jurjaan A. Snelleman; Jac M. Oors; Boudewijn F. Kessing; Derrek A. Heuveling; Jeroen M. Schuite...; Liesbeth ten Cate; Andreas J.P.M. Smout; Albert J. Bredenoord
• Keywords: High resolution manometry; Esophageal pH monitoring

Although inability to belch has previously been linked dysfunction of the upper esophageal sphincter (UES), its underlying pathogenesis remains unclear. Our aim was study mechanisms and effect UES botulinum toxin (botox) injections in these patients.We prospectively enrolled consecutive patients with symptoms belch. Patients underwent stationary high-resolution impedance manometry (HRIM) provocation ambulatory 24-h pH-impedance monitoring before 3 months after botox injection.Eight (four males, age 18-37 years) were included. Complete normal relaxation occurred response deglutition all patients. A median number 33(15-64) gastroesophageal gas reflux episodes observed. Despite subsequent increase pressure (from -4.0 [-7.7-4.2] 8 [3.3-16.1] mmHg; p < 0.012), none events resulted relaxation. Periods continuous high levels, indicating air entrapment (median presence time 10.5% [0-43]), observed during monitoring. reduced basal 95.7[41.2-154.0] 29.2 [16.7-45.6] 0.02) restored belching capacity As a result, decreased from (0-43.4) 0.7% (0.1-18.6; improved (VAS 6.0 [1.0-7.9] 1.0 [0.0-2.5]; 0.012).The results this underpin existence syndrome characterized by an support hypothesis that ineffective relaxation, entrapment, may lead symptoms.