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Journal of Veterinary Internal Medicine 2024Aerophagia (ingestion of air), is a functional aerodigestive disorder in people. Criteria for diagnosis of aerophagia in dogs are >1/3 of bolus volume containing air or...
BACKGROUND
Aerophagia (ingestion of air), is a functional aerodigestive disorder in people. Criteria for diagnosis of aerophagia in dogs are >1/3 of bolus volume containing air or ingested air resulting in gastric distention (>1/3 of end gastric volume). Aerophagia is highlighted during eating and drinking. Videofluoroscopic swallow studies (VFSS) document aerophagia in dogs, but the incidence, clinical signs (CS), and associated disorders are unknown.
OBJECTIVES
Identify the incidence of aerophagia, compare CS between dogs with and without aerophagia, and identify associated and predisposing disorders using VFSS.
ANIMALS
A total of 120 client-owned dogs.
METHODS
Sequential VFSS and associated medical records from dogs presenting to veterinary teaching hospitals at Auburn University and the University of Missouri were retrospectively reviewed. Statistical comparisons were made using Mann-Whitney and chi-squared tests, odds ratios (OR), and multiple logistic regression (P < .05).
RESULTS
The incidence (95% confidence interval [CI]) of aerophagia was 40% (31.7-48.9). Dogs with mixed CS (gastrointestinal [GI] and respiratory; P < .001, 58.3%) were more likely to have aerophagia than dogs with exclusively respiratory CS (25%). Aerophagia was significantly more common in brachycephalic dogs (P = .01; 45.8% vs 13.8%), dogs with nonbrachycephalic upper airway obstruction (P < .001; 33.3% vs 4.1%), pathologic penetration and aspiration (P-A) scores (P = .04; 41.6% vs 23.6%), and gagging (P < .001; 25% vs 11.7%). Mixed CS (P = .01), brachycephaly (P < .001), and upper airway obstruction (P < .001) were independent predictors of aerophagia.
CONCLUSIONS AND CLINICAL IMPORTANCE
Aerophagia was common, particularly in dogs with mixed CS. Brachycephalic dogs and dogs with upper airway obstruction are predisposed. Aspiration risk was high, emphasizing overlapping upper aerodigestive pathways.
Topics: Animals; Dogs; Dog Diseases; Female; Male; Retrospective Studies; Fluoroscopy; Incidence; Aerophagy; Video Recording; Deglutition
PubMed: 38561963
DOI: 10.1111/jvim.17054 -
PloS One 2022Aerophagia is a common functional gastrointestinal disorder among children. The disease leads to symptoms related to air in the intestine leading to burping, abdominal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Aerophagia is a common functional gastrointestinal disorder among children. The disease leads to symptoms related to air in the intestine leading to burping, abdominal distension, and excessive flatus. We aimed to perform a systematic review and a meta-analysis to assess the epidemiology of aerophagia in children.
METHODS
We conducted a thorough electronic databases (MEDLINE, EMBASE, PsycINFO and Web of Science) search for all epidemiological surveys conducted in children on aerophagia. All selected studies were assessed for their scientific quality and the extracted data were pooled to create a pooled prevalence of aerophagia.
RESULTS
The initial search identified 76 titles. After screening and in depth reviewing, 19 studies representing data from 21 countries with 40129 children and adolescents were included in the meta-analysis. All studies have used standard Rome definitions to diagnose aerophagia. The pooled prevalence of aerophagia was 3.66% (95% Confidence interval 2.44-5.12). There was significant heterogeneity between studies [I2 98.06% with 95% Confidence interval 97.70-98.37). There was no gender difference in prevalence of aerophagia in children. The pooled prevalence of aerophagia was highest in Asia (5.13%) compared to other geographical regions.
CONCLUSION
In this systematic review and meta-analysis, we found aerophagia has a significant prevalence across the world.
Topics: Adolescent; Aerophagy; Child; Eructation; Gastrointestinal Diseases; Humans; Prevalence; Surveys and Questionnaires
PubMed: 35905055
DOI: 10.1371/journal.pone.0271494 -
European Review For Medical and... Sep 2021Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity....
OBJECTIVE
Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity. Since the end of 2019 the world has been facing COVID-19 pandemic. The associated control measures have affected the psychological health of people. The aim of the present study is to evaluate the impact of the COVID-19 pandemic on the prevalence of functional gastrointestinal disorders among Italian children and adolescents.
PATIENTS AND METHODS
The study sample is composed of 407 patients (187 males, 220 females), aged from 10 to 17 years. The mean age is 14.27 ± 2.24 years. The study was conducted through the Italian version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version. The prevalence of each disorder has been calculated as the ratio of affected subjects for each disease and the total number of effective cases for that specific disease.
RESULTS
The study demonstrates that the prevalence of Functional Gastrointestinal Disorder in Italian children, during the COVD-19 pandemic, is higher, compared with the one reported in the previous studies. The most frequent disorders are Abdominal Migraine and Irritable Bowel Syndrome.
CONCLUSIONS
Our study is the first one which provides data of the prevalence of Functional gastrointestinal disorders in sample of Italian adolescents, during the COVID-19 pandemic. The study underlines the need to focus on stress management, in order to reduce the effects of the lockdown on the psychological wellness of the youngest.
Topics: Abdominal Pain; Adolescent; Aerophagy; COVID-19; Child; Constipation; Dyspepsia; Fecal Incontinence; Female; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Italy; Male; Migraine Disorders; Prevalence; Quarantine; Rumination Syndrome; Social Isolation; Stress, Psychological; Surveys and Questionnaires; Vomiting
PubMed: 34604975
DOI: 10.26355/eurrev_202109_26802 -
Zhongguo Dang Dai Er Ke Za Zhi =... Sep 2020To study the clinical features of aerophagia in children.
OBJECTIVE
To study the clinical features of aerophagia in children.
MEYJODS
A retrospective analysis was performed on the medical data of 46 children with aerophagia who were diagnosed and treated in Children's Hospital Affiliated to Nanjing Medical University from October 2011 to September 2019.
RESULTS
Among these 46 children, 15 (33%) had Tourette syndrome. Abdominal distension was the most common symptom and was observed in 45 children (98%). The 24-hour esophageal multichannel intraluminal impedance monitoring showed a mean number of 341 times of air swallowing and a mean number of 212 times of gas reflux, and 95% of gas refluxes occurred in the upright body position. Compared with those without Tourette syndrome, the children with Tourette syndrome had a significantly higher incidence rate of air swallowing symptoms (67% vs 6%, P<0.001), but there were no significant differences in other symptoms and the results of 24-hour esophageal impedance. Dietary adjustment, psycho-behavioral therapy, and drug intervention significantly improved the scores of clinical symptoms and quality of life, among which psycho-behavioral therapy was an important intervention measure.
CONCLUSIONS
Some children with aerophagia may have Tourette syndrome, and such children are more likely to have air swallowing symptoms. Psycho-behavioral therapy is one of the most important treatment methods, and children with aerophagia tend to have a good prognosis after treatment.
Topics: Aerophagy; Child; Electric Impedance; Gastroesophageal Reflux; Humans; Quality of Life; Retrospective Studies
PubMed: 32933629
DOI: 10.7499/j.issn.1008-8830.2003006 -
Balkan Medical Journal Oct 2019
Topics: Abdomen; Aerophagy; Child, Preschool; Female; Humans; Radiography
PubMed: 31397143
DOI: 10.4274/balkanmedj.galenos.2019.2019.6.66 -
Revista Espanola de Enfermedades... May 2018We report the case of a previously healthy 2-year-old child who presented with significant abdominal distension. After several interventions that proved ineffective,...
We report the case of a previously healthy 2-year-old child who presented with significant abdominal distension. After several interventions that proved ineffective, pathologic aerophagia was eventually diagnosed. In pediatrics, pathologic aerophagia is an uncommon disorder that almost exclusively affects children with an underlying neurological condition. It may lead to multiple diagnostic tests and unnecessary aggressive therapies. A recent case report associated aerophagia with a novel concept of abdomino-phrenic dyssynergia.
Topics: Aerophagy; Ataxia; Child, Preschool; Humans
PubMed: 29685045
DOI: 10.17235/reed.2018.5444/2017 -
Ear, Nose, & Throat Journal Mar 2018A patient with Rett syndrome presented to our Emergency Department with extensive subcutaneous emphysema in the cervical region, chest wall, upper extremities, and back....
A patient with Rett syndrome presented to our Emergency Department with extensive subcutaneous emphysema in the cervical region, chest wall, upper extremities, and back. Diagnostic evaluation revealed a mucosal tear in the posterior pharyngeal wall and an abscessed retropharyngeal lymph node, but she had no known history of trauma to account for these findings. This report discusses the occurrence of subcutaneous emphysema in the context of a rare neurodevelopmental disorder and proposes accentuated aerophagia, a sequela of Rett syndrome, as the most likely underlying mechanism.
Topics: Adult; Aerophagy; Female; Humans; Pharynx; Rett Syndrome; Subcutaneous Emphysema
PubMed: 29554407
DOI: 10.1177/014556131809700304 -
Journal of Clinical Sleep Medicine :... Jul 2017
Topics: Aerophagy; Continuous Positive Airway Pressure; Cross-Over Studies; Humans; Masks; Sleep Apnea, Obstructive
PubMed: 28633717
DOI: 10.5664/jcsm.6650 -
Journal of Clinical Sleep Medicine :... Jul 2017To assess the benefit and tolerance of autotitrating positive airway pressure (APAP) versus continuous positive airway pressure (CPAP) in subjects who experience... (Comparative Study)
Comparative Study Randomized Controlled Trial
A Randomized Crossover Trial Comparing Autotitrating and Continuous Positive Airway Pressure in Subjects With Symptoms of Aerophagia: Effects on Compliance and Subjective Symptoms.
STUDY OBJECTIVES
To assess the benefit and tolerance of autotitrating positive airway pressure (APAP) versus continuous positive airway pressure (CPAP) in subjects who experience aerophagia.
METHODS
This is the report of a prospective, two-week, double-blinded, randomized crossover trial set in an Australian clinical sleep laboratory in a tertiary hospital. Fifty-six subjects who reported symptoms of aerophagia that they attributed to CPAP were recruited. Full face masks were used by 39 of the 56 subjects recruited. Subjects were randomly and blindly allocated to either CPAP at their treatment recommended pressure or APAP 6-20 cm HO, in random order. Subjects spent two weeks on each therapy mode. Therapy usage hours, 95th centile pressure, maximum pressure, 95th centile leak, and residual apnea-hypopnea index (AHI) were reported at the end of each two-week treatment period. Functional Outcome of Sleepiness Questionnaire, Epworth Sleepiness Scale, and visual analog scale to measure symptoms of aerophagia were also completed at the end of each 2-week treatment arm.
RESULTS
The median pressure ( < .001) and 95th centile pressure ( < .001) were reduced with APAP but no differences in compliance ( = .120) and residual AHI were observed. APAP reduced the symptoms of bloating ( = .011), worst episode of bloating ( = .040), flatulence ( = .010), and belching ( = .001) compared to CPAP. There were no differences in Epworth Sleepiness Scale or Functional Outcome of Sleepiness Questionnaire outcomes between CPAP and APAP.
CONCLUSIONS
APAP therapy reduces the symptoms of aerophagia while not affecting compliance when compared with CPAP therapy.
CLINICAL TRIAL REGISTRATION
Australian and New Zealand Clinical Trials Registry at https://www.anzctr.org.au, trial number ACTRN12611001250921.
COMMENTARY
A commentary on this article appears in this issue on page 859.
Topics: Aerophagy; Aged; Australia; Continuous Positive Airway Pressure; Cross-Over Studies; Double-Blind Method; Female; Humans; Male; Patient Compliance; Polysomnography; Prospective Studies; Surveys and Questionnaires; Treatment Outcome
PubMed: 28558864
DOI: 10.5664/jcsm.6658 -
The Korean Journal of Gastroenterology... Nov 2015Aerophagia is a disorder caused by abnormal accumulation of air in the gastrointestinal tract as a result of repetitive and frequent inflow of air through the mouth. For...
Aerophagia is a disorder caused by abnormal accumulation of air in the gastrointestinal tract as a result of repetitive and frequent inflow of air through the mouth. For the diagnosis of this condition, it is difficult to objectively measure the air swallowing. However, multichannel intraluminal impedance monitoring facilitates the differential diagnosis between normal air swallowing and pathologic aerophagia, and can aid in the determination of the frequency and amount of air swallowed. In this report, in addition to a literature review, we describe a case of 36-year-old man with abdominal distension who was diagnosed with aerophagia using esophageal impedance monitoring and was treated with clonazepam.
Topics: Adult; Aerophagy; Anticonvulsants; Clonazepam; Diagnosis, Differential; Electric Impedance; Humans; Male; Mental Disorders; Tomography, X-Ray Computed
PubMed: 26586352
DOI: 10.4166/kjg.2015.66.5.282