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swallowing air (usually followed by belching and discomfort and flatulence)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/07/30 21:37:25」(JST)

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Aerophagia (var. aerophagy) is a condition of excessive air swallowing, which goes to the stomach.

Causes

Aerophagia is associated with chewing gum, smoking, drinking carbonated drinks, eating too fast, CPAP air pressure (if it is too high) and wearing loose dentures. In people with cervical spinal blockages, inhaling can cause air to enter the esophagus and stomach.^[1]

Aerophagia is diagnosed in 8.8% of cognitively delayed patients^[2] where the coordination between swallowing and respiration is not well defined.^[3]

Aerophagia is a dangerous side effect of noninvasive ventilation (NIV), commonly used in treatments of respiratory problems and cardiovascular critical care or in surgery when a general anaesthetic is required. In the case of aerophagia during NIV, it is normally diagnosed by experienced medical specialists who check on patients intermittently during NIV use. The diagnosis is based on the sound heard by listening through a stethoscope placed outside the abdominal cavity. Using this approach, the problem is sometimes detected later than when it develops, possibly also later than necessary. Belated detection of aerophagia may lead to gastric distension, which in turn could inflate the diaphragm or cause aspiration of the stomach contents into the lungs^[4] or pneumatic rupture of the oesophagus due to extreme gastric insufflation.^[5]

Aerophagia may also refer to an unusual condition where the primary symptom is excessive flatus, belching is not present, and the actual mechanism by which air enters the gut is obscure.^[6]

References

^ Krasiuk MM, Kratinov VP (July 1993). "The characteristics of aerophagy and its treatment". Likars'ka sprava 7 (7): 114–6. PMID 8209520.
^ Loening-Baucke V (2000). "Aerophagia as cause of gaseous abdominal distention in a toddler". J. Pediatr. Gastroenterol. Nutr. 31 (2): 204–7. doi:10.1097/00005176-200008000-00026. PMID 10941981.
^ Perlman AL, Ettema SL, Barkmeier J (2000). "Respiratory and acoustic signals associated with bolus passage during swallowing". Dysphagia 15 (2): 89–94. doi:10.1007/s004550010006. PMID 10758191.
^ RUBEN H, KNUDSEN EJ, CARUGATI G (1961). "Gastric inflation in relation to airway pressure". Acta Anaesthesiol Scand 5 (3): 107–14. doi:10.1111/j.1399-6576.1961.tb00089.x. PMID 14494855.
^ Meyerovitch J, Ben Ami T, Rozenman J, Barzilay Z (1988). "Pneumatic rupture of the esophagus caused by carbonated drinks". Pediatr Radiol 18 (6): 468–70. doi:10.1007/BF00974081. PMID 3186323.
^ Levitt MD, Furne J, Aeolus MR, Suarez FL (1998). "Evaluation of an extremely flatulent patient: case report and proposed diagnostic and therapeutic approach". Am J Gastroenterol 93 (11): 2276–81. doi:10.1111/j.1572-0241.1998.00635.x. PMID 9820415.

UpToDate Contents

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English Journal

Aerophagia increases the risk of ventilator-associated pneumonia in critically-ill patients.

Destrebecq A, Elia G, Terzoni S, Angelastri G, Brenna G, Ricci C, Spanu P, Umbrello M, Iapichino G.Author information Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, A.O. San Paolo - Polo Universitario, Milano - Italia - michele.umbrello@ao-sanpaolo.it.AbstractBackground: Gastric residual volume in ventilated critically ill may complicate gut function. Over the years studies suggested to tolerate progressively higher residuals. The relationship between such volumes and the development of ventilator-associated pneumonia (VAP) is still under debate. No reports deal with the relevant anecdotal finding of air in the stomach. Aim of the present study is to test the role of air in the development of VAPs. Methods: prospective observational trial in consecutive patients with a predicted length of ICU stay >3 days. The first 8 days of stay were studied. Sedation was targeted to have awake/cooperative patients. Early enteral nutrition was attempted. Gastric content was measured every 4 hours by 60ml-syringe suction. Upper digestive intolerance (UDI) was defined as >2 consecutive findings of liquid >200ml, aerophagia was defined as >2 consecutive findings of air >150ml. Results: 364 patients enrolled, 43 developed VAP (11.8%). Patients were sedated with enteral (76% total time), intravenous (6%) or both (28%) drugs. Conscious sedation was achieved in 54% of the observations. 326 patients began enteral nutrition during the first 24 hours (1000 kcal median calorie intake). 10% developed UDI, 15% had aerophagia. No association was found between VAP and UDI (p=0.78), while significant association was found between VAP and aerophagia (OR=2.88, p<0.01). A sensitivity analysis, excluding patients admitted with respiratory infection, confirmed the results. Conclusions: High volumes of air in the stomach significantly increased the risk of developing VAP, while gastric residual volumes were not associated with the incidence of pneumonia.
Minerva anestesiologica.Minerva Anestesiol.2013 Nov 26. [Epub ahead of print]
Background: Gastric residual volume in ventilated critically ill may complicate gut function. Over the years studies suggested to tolerate progressively higher residuals. The relationship between such volumes and the development of ventilator-associated pneumonia (VAP) is still under debate. No repo
PMID 24280810

Antiproliferative effects of lanreotide autogel in patients with progressive, well-differentiated neuroendocrine tumours: a Spanish, multicentre, open-label, single arm phase II study.

Martín-Richard M, Massutí B, Pineda E, Alonso V, Marmol M, Castellano D, Fonseca E, Galán A, Llanos M, Sala MA, Pericay C, Rivera F, Sastre J, Segura A, Quindós M, Maisonobe P; TTD (Tumores del Tracto Digestivo) Study Group.Collaborators (18)Massutí B, Martín-Richard M, Alonso V, Castellano D, Fonseca E, Galán A, García López JL, Llanos M, Maestu I, del Río Pazos L, Maurel J, Martínez de Prado MP, Pericay C, Rivera F, Sastre J, Segura Á, Valladares M, Velasco A.
BMC cancer.BMC Cancer.2013 Sep 20;13:427. doi: 10.1186/1471-2407-13-427.
BACKGROUND: Somatostatin analogues (SSAs) are indicated to relieve carcinoid syndrome but seem to have antiproliferative effects on neuroendocrine tumours (NETs). This is the first prospective study investigating tumour stabilisation with the long-acting SSA lanreotide Autogel in patients with progr
PMID 24053191

Stomach gas analyses in canine acute gastric dilatation with volvulus.

Van Kruiningen HJ, Gargamelli C, Havier J, Frueh S, Jin L, Suib S.Author information Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs.AbstractBACKGROUND: The origin of the gas in the stomachs of dogs with acute gastric dilatation or gastric dilatation with volvulus (GDV) often is disputed.
Journal of veterinary internal medicine / American College of Veterinary Internal Medicine.J Vet Intern Med.2013 Sep-Oct;27(5):1260-1. doi: 10.1111/jvim.12138. Epub 2013 Jul 19.
BACKGROUND: The origin of the gas in the stomachs of dogs with acute gastric dilatation or gastric dilatation with volvulus (GDV) often is disputed.HYPOTHESIS: We tested the hypothesis that gaseous distention resulted from aerophagia.ANIMALS: Ten cases of GDV that were submitted to an emergency clin
PMID 23869477