Scientific high-resolution impedance-manometry simulation and respiratory biofeedback therapy
Supragastric belching (SGB) is a behavioral phenomenon, not a gastric reflux or acid oversecretion disorder. Patients rapidly suck or push ambient air into the esophagus and immediately expel it (within 1.0–2.0 seconds) without the air bubble ever crossing the lower esophageal sphincter into the stomach.
| Parameter | Supragastric Belch | True Gastric Belch |
|---|---|---|
| Air Origin | Ambient atmosphere | Ingested gastric bubble |
| Esophageal P | Negative drop (-15 to -30 mmHg) | Positive venting (+10 mmHg) |
| Impedance Flow | Top-down then bottom-up | Bottom-up (LES → UES) only |
| Sleep Pattern | Ceases entirely | Can persist postprandially |
Diaphragmatic excursion with lateral lower-rib expansion keeps intrathoracic pressure elevated, physically abolishing the abrupt negative pressure transient that sucks air through the UES. Practicing at 6 breaths per minute with glottic awareness breaks the somatic premonitory urge-to-belch cycle.