Belching symptoms in gastroesophageal reflux disease, and prevalence and clinical characteristics of belching in Japanese adults

Background Belching is the act of expelling gas from the stomach or esophagus noisily through the oral cavity. Although it is a physiological phenomenon, belching may also be a symptom of upper gastrointestinal diseases such as gastroesophageal reflux disease (GERD). A detailed epidemiology of belching has not yet been reported. Aim The aim of this study was to examine the prevalence and clinical characteristics of belching in Japanese adults. Methods We analyzed 1,998 subjects using data from a previous study of the association between GERD, psychological stress, and sleep disturbances in Japanese adults. Belching was evaluated according to the score to question 11 (‘Do you burp a lot?’) on the frequency scale for the symptoms of GERD (FSSG): 0 (never), 1 (occasionally), 2 (sometimes), 3 (often), and 4 (always). We also collected the clinical parameters, endoscopic findings, and data according to the Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression scale (HADS). Results Subjects with GERD, especially non-erosive reflux disease, complained of belching more frequently. When we defined belching as an FSSG Q11 score ≥ 2 (sometimes or more frequent), 347 (17.4%) Japanese adults had belching. Subjects with belching were predominantly men and had more common functional dyspepsia. In addition, scores of HADS and AIS in subjects with belching were significantly higher compared to subjects without belching. Male sex, presence of functional dyspepsia, anxiety/depression, and sleep disturbances were significantly associated with a higher odds ratio for belching. Conclusion The epidemiology of belching in Japanese adults was clarified.