Management of Belching, Hiccups, and Aerophagia

Albert J. Bredenoord


Clin Gastroenterol Hepatol. 2013;11(1) 

In This Article


Belching and hiccups occur occasionally and are regarded as normal behavior. However, when belching or hiccups occur in high frequency or become persistent this can become very bothersome and a reason for consultation. In a patient with excessive belching, gastric and supragastric belches are distinguished and this distinction has consequences for therapy. Excessive belching is a behavioral disorder and should be treated as such. Persistent hiccups can be the first presentation of serious disorders and an underlying cause should be searched for. When no underlying cause is found, treatment is symptomatic.

Aerophagia is a disorder in which patients swallow too much air; this air accumulates in the stomach, intestines, and colon, and causes abdominal distention and bloating. Not only children but also adults can suffer from this disorder. Aerophagia can occur in sudden attacks but also more chronically. It is important that explorative laparotomies are avoided in these patients because they do not suffer from an ileus. Now that patients with aerophagia can be identified, the search is for an effective treatment.