Aerophagia


Aerophagia (var. aerophagy) is a condition that occurs when a person swallows too much air. The air goes into the stomach and intestines causing abdominal bloating, belching, flatulence, discomfort and pain.

Causes

Aerophagia is associated with activities that cause one to swallow air while chewing gum, smoking, drinking carbonated beverages, eating too fast, wearing loose dentures, and CPAP therapy. In people with cervical spinal blockages, inhaling can cause air to enter the esophagus and stomach.

Aerophagia associated with CPAP therapy is a condition that usually arises when patients are new to the therapy, or when there has been a recent increase in the prescribed CPAP pressure. The condition usually subsides on its own as patients adapt to the CPAP therapy. In cases where it doesn't the prescribing physician may lower the patient's pressure or have the patient switch to a bilevel (BiPAP) machine.

Some CPAP patients report that they can get relief in one of two ways. One way is to keep the head aligned with the neck while sleeping so that there is a straight pathway for the air to enter the lungs. In this way the air passes straight into the lungs instead of being diverted to the stomach. Some ways to accomplish this are to lay on your back with your head on a thin pillow or no pillow at all so that your neck stays straight instead of being kinked. Another strategy is to sleep on a wedge or elevate the head of your bed by putting blocks of wood under the headboard.

Paradoxically, the other way some patients have reported getting relief is to do just the opposite! That is, keep the chin tucked up against the chest thus kinking the neck. In this way the air doesn't reach the stomach because the passageway is kinked by the bent neck. This can be accomplished by sleeping on your back with a thick pillow or a pair of pillows under your head, or sleeping on your side with your chin tucked against your chest.

Evidently these two strategies work differently in different people because of differences in their anatomy.

Temporary relief of the symptoms of aerophagia may be achieved by exercise or by drinking carbonated water. Patients undergoing CPAP therapy should consult with their medical care providers when experiencing the symptoms of aerophagia.

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

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.

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.




Donate to Apnea Board