Aerophagia refers to excess air in the gastrointestinal tract. Usually, some air always enters the digestive tract when speaking, eating or drinking, but in aerophagia, the amount of swallowed air is so great that it causes bloating, abdominal pain and excessive belching.
What is aerophagia?
Aerophagy refers to excess air in the gastrointestinal tract. The amount of air swallowed is so great that it causes bloating, abdominal pain, and excessive belching. While there are usually few problems with swallowing air, aerophagy can cause painful and chronic discomfort in the gastrointestinal tract. The majority of swallowed air that has entered the stomach is expelled during burping. However, if small amounts of oxygen pass from the stomach into the small intestine, this often results in bloating, painful stomach cramps, and flatulence. In children in particular, extreme amounts of swallowed air can cause the stomach to expand extremely and lead to complications such as gastric volvulus, intestinal obstruction or breathing difficulties. In 2009, a study on aerophagy was published for the first time, using radiographs to document that a group of patients had excessive bloating and symptoms related to excessive air swallowing.
Causes
The initial causes of aerophagia are eating or drinking too quickly, which leads to excessive air swallowing. Excess air also enters the stomach via carbonated drinks or chewing gum. A stuffy nose or other breathing problems such as excessive mouth breathing, can also be a cause of aerophagia. An anxious, nervous or tense state can also lead to uncontrolled air intake. In this respect, psychosomatic illnesses can also lead to swallowing of air due to additional nervousness or tension. In about nine percent of mentally handicapped people, aerophagia is an expression of disturbed coordination between swallowing and breathing. Talking too fast equally causes aerophagia and is usually an unconscious problem. Aerophagy can also be an expression of allergies, especially lactose intolerance. Last but not least, medical devices or ill-fitting dentures can also cause aerophagia.
Symptoms, complaints, and signs
Aerophagia is associated with some unpleasant complaints and symptoms. However, these discomforts are not particularly dangerous and usually do not negatively affect the health of the affected person. Only in severe cases, a tear in the esophagus can occur if the air pressure rises too much. The affected person primarily suffers from a strong belching and also from flatulence and bloating. In some cases, flatulence also leads to pain in the abdomen and stomach. There is a feeling of fullness, which is usually very strong after the ingestion of food. The stomach itself presses on the lungs, making it difficult for the sufferer to breathe. This also reduces the patient’s ability to cope with stress and leads to permanent fatigue and exhaustion. Furthermore, aerophagia can also lead to nausea or vomiting, although these syndromes do not occur particularly frequently. A feeling of tightness also occurs in the stomach in some cases. Furthermore, aerophagy can also lead to heartburn. Due to the permanent belching and due to the flatulence, some patients also suffer from depression or psychological discomfort.
Diagnosis and course
A diagnosis of aerophagia usually refers to persistent symptoms within a year with at least three months of continuous straining with significant air swallowing, an increase in gas formation within the digestive tract, bloating, and repetitive belching. Other symptoms of aerophagia include bloating, gas, and reflux. If aerophagia is a dangerous side effect of other uses, the trapped air can be heard by listening with a stethoscope outside the abdominal cavity. This buildup can cause distension of the stomach and cause the stomach to press on the lungs, obstructing breathing. Due to the buildup of air pressure, aerophagia can cause the esophagus to rupture in severe cases.
Complications
Several complications can occur as a result of aerophagia.At the beginning of the disease, flatulence and abdominal pain often occur in addition to the typical swallowing difficulties. In general, air swallowing leads to strongly pronounced discomfort, which increases as the disease progresses. The increase in gas formation within the gastrointestinal tract also leads to an increased feeling of fullness, which increases the pressure on the lungs. This can cause breathing problems and an increase in aerophagia symptoms; in extreme cases, the buildup of air pressure can cause the esophagus to rupture. In young children, aerophagia carries the risk of life-threatening intestinal obstruction. In addition, in the elderly, ill, and pain patients, air swallowing can lead to respiratory depression or promote an existing condition. Complications are unlikely with treatment of air swallowing because therapy focuses primarily on swallow training. Problems can occur when aerophagia is a symptom of lung disease. Then, rarely, the actual underlying condition may be carried over, causing permanent damage. If a stress disorder is present as the cause, it must be treated concomitantly with aerophagy treatment.
When should you see a doctor?
It is not always necessary to go to the doctor in case of malaise or atypical symptoms. Sometimes, however, mild discomfort, especially if it occurs temporarily repeatedly or over a long period of time, should be clarified by a doctor. And this is exactly the case for complaints that could indicate aerophagia. If nausea that is considered normal, sometimes stronger and sometimes weaker, persists over a longer period of time, at least a discussion with an extensive medical history is necessary so that other underlying diseases can be identified and treated at an early stage. Anyone who suffers from massive air swallowing, increasing gas formation in the digestive tract as well as flatulence and constantly recurring belching for at least three months should not think twice, but should immediately make an appointment for an examination with their family doctor or a gastrointestinal specialist. The feeling of fullness, often described as trivial, as well as severe flatulence and temporary or constant reflux must also be treated by a specialist. If the breathing in the lower part of the lungs, that is, near the stomach, is hampered by a feeling of tightness, a doctor should be consulted as soon as possible.
Treatment and therapy
Treatment of aerophagia mainly refers to a change of causative habits to slow chewing and swallowing, eating with the mouth closed, and avoiding carbonated drinks and coffee. At the same time, training is needed to calm breathing, especially to avoid nervous tension. Some patients need to learn through logopedic exercises to discontinue excessive inhalation before speaking. Treatment of subconscious aerophagia specifically includes elements such as general calming, slowing, and conscious nasal breathing, for example, using the Buteyko breathing technique or yoga. In cases where otherwise necessary treatment has caused medical devices to cause aerophagia, a change in therapy should be considered. A comprehensive allergy test can diagnose allergies and indicate appropriate action. In terms of drug treatment, Thorazine has been shown to be helpful in some cases; drugs such as dimethicone and simethicone prevent gas formation in the intestines and may relieve symptoms. Regulating herbal teas with fennel, chamomile or thyme can also be used. For mentally disabled people with acute aerophagia, insertion of a feeding tube and administration of sedatives may be helpful.
Outlook and prognosis
Aerophagia causes the patient to experience various gastrointestinal discomforts. This discomfort has a very negative effect on the patient’s daily life and quality of life. As a rule, flatulence and abdominal pain occur. Furthermore, those affected suffer from unpleasant belching and not infrequently from bad breath. These complaints may also cause irritability or psychological discomfort. In addition, there is a feeling of fullness, which can lead to a loss of appetite and thus to underweight. Especially after the intake of food, these complaints occur.In the worst case, aerophagia can lead to a rupture of the esophagus, which can be life-threatening for the affected person. As a rule, aerophagia can be treated relatively well and easily. In most cases, no surgical intervention is necessary to alleviate the symptoms. The affected person can use various therapies and techniques to permanently avoid swallowing air. There is always a positive course of the disease. Further complications do not occur in most cases.
Prevention
To prevent aerophagy, avoidance of mouth breathing, even during night sleep, is generally advised. Reducing consumption of milk and milk products and carbohydrate-rich foods and eating in a quiet atmosphere will reduce much of the risk of excessive air intake. A calm manner of speaking and controlled breathing when articulating also counteract aerophagia.
Here’s what you can do yourself
The disease can be prevented or even completely avoided by taking various measures. When eating, food should not be taken too hastily and quickly. Slow chewing and swallowing, as well as eating with the mouth closed, can help. This allows the stomach to work more quickly. Avoiding certain foods that release gas in the stomach, such as legumes, peppers or yeast products, can also improve symptoms. In addition, large amounts of carbonated drinks and coffee should be avoided, as these lead to an increased release of carbon dioxide in the stomach. Smoking and gum chewing should also be avoided if possible. Since stress is also a very strong risk factor in air swallowing, stress-reducing measures such as a balanced diet, sufficient physical exercise or relaxation exercises such as yoga are recommended. A change in breathing technique can also lead to an improvement in symptoms. Through logopedic exercises, it is possible for some patients to learn to discontinue excessive inhalation before speaking. If aerophagia occurs during drug treatment, it may be appropriate to change the drug used.
