J Neurogastroenterol Motil  
Belching in Irritable Bowel Syndrome: An Impedance Study
Tuba Obekli1, Filiz Akyuz2,*, Umit Akyuz3, Serpil Arici2, Raim ?liaz2, Suut Gokturk2, Sami Evirgen2, Bilger Cavus2, Cetin Karaca2, Kadir Demir2, Fatih Besisik2, Sabahattin Kaymakoglu2
1Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
2Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
3Department of Gastroenterology, Fatih Sultan Mehmet Educational and Research Center, Istanbul, Turkey
Correspondence to: Filiz Akyuz, MD
Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterohepatology, 34390 Capa, Istanbul, Turkey
Tel: +90-2124142000/31140, Fax: +90-2126319743, E-mail: filizakyuz@hotmail.com
Received: June 26, 2016; Revised: September 17, 2016; Accepted: September 25, 2016; Published online: October 27, 2016.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims
There are limited data about the relation between belching and irritable bowel syndrome (IBS). We aimed to evaluate belching in patients with IBS.
Methods
Twenty-five patients with IBS and 12 healthy volunteers were enrolled in the study. IBS was diagnosed in accordance with the Rome III criteria. All patients were questioned about the presence of symptoms for belching, gastroesophageal reflux disease, and dyspepsia. Esophageal manometry and 24-hour pH-impedance were performed in all patients and healthy volunteers. Each of the patients with IBS underwent gastroscopy and colonoscopy.
Results
Demographic features were similar in both groups (P > 0.05.) The belching rate was 32% in patients with IBS. The mean DeMeester score was significantly higher in IBS patients (13.80 ± 14.40 vs 6.04 ± 5.60, P = 0.027) and 24% of patients had pathologic acid reflux (DeMeester score > 14). Gastroscopy was normal in all patients. Symptom association probability positivity was detected in 24% of patients in the impedance study. The rate of weak acid reflux was also significantly higher in patients with IBS (97.00 ± 56.20 vs 58.20 ± 29.30, P = 0.025). The number of supine gas reflux (7.50 ± 6.40 vs 2.42 ± 2.80, P = 0.001) and supragastric belches was significantly higher in patients (51.20 ± 41.20 vs 25.08 ± 15.20, P = 0.035). Although number of gastric belching is higher in controls, the difference did not reach statistical significance (12.10 ± 17.60 vs 4.90 ± 3.80, P = 0.575). We did not found correlation between belching and any symptoms of IBS.
Conclusions
Belching is frequent in patients with IBS. Non-erosive reflux disease is frequent in IBS, which may be related to supragastric belching.
Keywords: Belching, Gastroesophageal reflux, Impedance, Irritable bowel syndrome


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