AEROPHAGIA (aerophagia; grech, aer air + phagein to eat, eat) — swallowing excess amount of air and the subsequent its regurgitation.
Swallowing nek-ry amount of air is the physiological mechanism, with the help to-rogo intragastric pressure is regulated, and the eructation usually is not observed owing to passing of gases from a stomach in intestines. However at bystry filling of a stomach gas, napr, at drink of soda water, beer, or at the increased formation of CO2 in a stomach after reception of soda the eructation is observed and is normal.
The increased and systematic swallowing air and a frequent eructation are observed by it or owing to violation of the rules of meal (bystry food, a talk during food) or as a pathological symptom.
And. can be at the complicated nasal breath, at diseases of the digestive device (a disease of teeth, an oral cavity, plentiful salivation with frequent swallowing of saliva etc.) or represents a pathological conditioned reflex (neurosis). In the latter case swallowing air often happens also out of process of meal.
And. quite often develops at disorders of motility and a tone of a stomach, a piloro-duodenal stenosis, chronic gastritis, a peptic ulcer (in particular at a high arrangement of a canker). The sources of pathological irritation bringing And., cardiovascular insufficiency, aneurisms of the descending part of an aorta, a cardiospasm, esophageal stenoses quite often are.
A clinical picture
Patients complain of a frequent empty and inodorous loud eructation; sometimes the eructation «multi-storey», and at the patients having hysteria in some cases is followed by loud screaming. The eructation is observed both after food, and regardless of meal; in more hard cases it is almost constant and disappears only during sleep. Patients are disturbed by the heavy feelings, raspiraniye which are localized preferential in an anticardium, but quite often gastric gases, getting through the gatekeeper into intestines, lead to swelling of all stomach, in hard cases very considerable that reminds a picture of intestinal impassability. In some cases arises gastrocardial syndrome (see). At the same time premature ventricular contraction and unpleasant pain in heart reaching attacks of stenocardia take place. These symptoms are observed more often at the persons having coronary heart disease. More rare at And. the difficulty of breath reaching sometimes attacks of suffocation — asthma dyspepticum (the old name) is observed.
Diagnosis And. it is based on the anamnesis and data of an objective research. Quite often typical eructation takes place during medical examination, and its termination at derivation of attention of the patient is characteristic; sometimes the doctor observes preparation for swallowing air: the patient extends the head forward, presses a chin to a breast and makes the empty deglutitory movements.
At survey the stomach is blown up, more in an upper half is frequent. The phenomena of irritation of a peritoneum are absent. At X-ray inspection high standing of a diaphragm, in particular the left dome, at the expense of a big air bubble of a stomach and plentiful accumulation of gases in intestines is defined (it is preferential in the field of a splenic corner). Due to the expressed pneumatosis the functional cascade of a stomach quite often is observed.
At symptomatic And. the main attention is paid to the disease which caused its emergence. At the neurotic nature And. the psychotherapy has major importance. The patient should explain essence of a disease. It is necessary to mobilize his will to suppression of a pathological conditioned reflex. It is a complex challenge since usually swallowing air happens involuntarily and imperceptibly for the patient. But also here self-education can result in the known progress. It is much easier to suppress semi-any eructation: patients And. usually aim to cause it, hoping to get rid in such way of burdensome feeling of swelling. The termination of an eructation breaks integrity of a pathological conditioned reflex and promotes its attenuation, at the same time one of the mechanisms promoting swallowing air is liquidated. All types of psychotherapy are admissible, up to hypnotic suggestion. Spitting, but not swallowing saliva, slow meal is recommended to the patient, without any arguments during food.
The diet for the purpose of reduction of the heavy feeling and a raspiraniye connected with meal is appointed. The drinks containing carbonic acid, and foodstuff are excluded, it is long late in a stomach. Food should be eaten often, small portions. In more hard cases resort to separate reception of dense and liquid food. Sometimes bring benefit of a gastric lavage probably in connection with psychotherapeutic influence of this procedure, in particular in cases when at pumping out with noise a large amount of air departs. The systematic respiratory gymnastics, exercises is reasonable. Treatment of the basic disease promoting development is of great importance And. At And., as well as at other neurosises, use of all methods of treatment directed to calm and strengthening of a nervous system is shown.
An aerophagia at children
At nek-ry newborns and children of chest age owing to imperfection of regulation of the digestive device from a nervous system, and also at suction of an empty pacifier or a low-milk breast the amount of the swallowed air sometimes is quite high and can be the reason of heavy frustration of the food which is followed by persistent vomiting with progressive falling of weight. Signs And. at babies shout is during food, bystry abdominal distention and failure from food. At a postural change, and sometimes and independently the child has an eructation air then he calms down and starts over again sucking. The diagnosis can be confirmed radiological. At nek-ry children the proglatyvaniye of air is a habit, it is possible to disaccustom from a cut, strictly regulating meal, and sometimes even applying feeding via the probe. The disease has mostly communication with the general neuropathy of the child or with an underdevelopment of the device of nervous control of digestive organs and passes with age.
See also Eructation .
Bibliography: Vasilenko V. of X., also Salyian M. M. Is guilty e of A. L. Diseases of a gullet, page 25, M., 1971; JI at r and I am P. A. Diseases of a gullet and a stomach, page 97, etc., M. — D., 1941; Boas I. Diagnostik und Therapie der Magenkrankheiten, S. 722, Lpz., 1925; Leven G. L’aörophagie, P., 1934; Roemheld L. Pneumatose des Magens und gastrokardialer Symptomenkom-plex, Ther. d. Gegenw., Bd 21, S. 344, 1919.
O. L. Gordon, G. H. Speransky (ped.).