Año 2025 / Volumen 117 / Número 7
Carta
The inability to belch — A neglected disease in the era of high-resolution esophageal manometry

412-413

DOI: 10.17235/reed.2024.10478/2024

Raúl Alberto Jiménez-Castillo, Gustavo Torres-Barrera, María José Sánchez-Otero, Karla Rocío García-Zermeño, Jose María Remes-Troche,

Resumen
Retrograde upper esophageal sphincter dysfunction (R-UESD) is characterized by the inability to belch. Evidence of using high-resolution manometry (HRM) in diagnosing R-UESD has emerged in recent years. We describe the clinical picture and HRM patterns of two patients with R-UESD. Case 1: A 23-year-old female presented with a two-year complaint of inability to belch. We performed HRM with a belch provocation test for which the patient drank 500 ml of carbonated water. The study revealed increased esophageal pressure, an absence of UES relaxation and secondary peristalsis once the patient mentioned the need to belch. Case 2: A 21-year-old male presented to our medical office with a history of an incapacity to belch during the last three years. We performed HRM with a belch provocation test. During the study, he reported an incapacity to belch and his symptoms coincided with increased esophageal pressure, an absence of UES relaxation, and secondary peristalsis. Retrograde upper esophageal sphincter dysfunction is a rare condition characterized by a lack of UES relaxation during esophageal distension. The incapacity to belch is the hallmark of the disease. We encourage the use of HRM, looking for an increase in esophageal pressure to the level of gastric pressure, failure of UES relaxation with consequently no venting of air across the UES, and secondary peristalsis. In conclusion, diverse R-UESD clinical presentations represent a diagnostic challenge for physicians. This case series highlights the need to actively search for typical HRM findings when encountering patients referring an incapacity to belch.
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Bibliografía
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Instrucciones para citar
Jiménez-Castillo R, Torres-Barrera G, Sánchez-Otero M, García-Zermeño K, Remes-Troche J. The inability to belch — A neglected disease in the era of high-resolution esophageal manometry. 10478/2024


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Ficha Técnica

Recibido: 14/04/2024

Aceptado: 22/04/2024

Prepublicado: 20/05/2024

Publicado: 08/07/2025

Tiempo de prepublicación: 36 días

Tiempo de edición del artículo: 450 días


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