Speech therapy can reduce the number of reflux episodes: A proof of concept study

The majority of belches originates from the stomach. However, in some patients
the eructated air does not originate from the stomach but is sucked or injected
in the esophagus from the pharynx and expelled immediately afterwards in oral
direction again. This behavior is called supragastric belching because the air
does not originate from the stomach and does not reach the stomach either1.
Recently, Hemmink et al demonstrated that supragastric belches can precede
gastroesophageal reflux episodes and these authors suggested that supragastric
belches could elicit reflux episodes2.
Patients with severe and excessive belching as a main symptom are characterized
by an increased frequency of supragastric belches. A recent study performed in
our center demonstrated that supragastric belches are also associated with
troublesome belching in GERD patients. Speech therapy can decrease severity of
belching symptoms in patients with excessive supragastric belching. In GERD
patients with a demonstrated increased frequency of supragastric belches, there
is currently no evidence based treatment available. Speech therapy can
potentially be helpful and is therefore the only therapeutic option available
in this subgroup of GERD patients.
We hypothesize that speech therapy reduces troublesome belching symptoms in
GERD patients by reducing the number of supragastric belches. Furthermore, we
hypothesize that a reduction in supragastric belches also reduces the number of
reflux episodes.

The aim of this study is to assess the number of supragastric belches and
reflux episodes before and after speech therapy in GERD patients with
troublesome belching symptoms due to an increased number of supragastric
belches.

A prospective study using impedance measurements.

Patient will undergo an ambulatory imepdance measurement. This is free of risk.