Rome IV Diagnostic Criteria for Belching Disorders
Official Rome IV criteria for the diagnosis of excessive supragastric or gastric belching.
Use in patients with symptoms suggestive of a belching disorder, such as bothersome belching from the esophagus or stomach more than 3 days per week for at least 6 months.
Patients with any of the following features must be evaluated clinically for other diagnoses even though a belching disorder may be present:
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Signs or symptoms of GI bleeding.
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Unexplained iron deficiency anemia.
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Unintentional weight loss.
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Palpable abdominal mass or lymphadenopathy on exam.
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Family history of gastric cancer and no recent upper endoscopy.
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Dysphagia.
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Persistent vomiting.
If diagnostic criteria are not met (negative):
Symptoms are unlikely to be caused by a belching disorder. Consider further assessment for other diseases, or a different functional GI disorder.
If meets diagnosis (positive):
Symptoms are likely due to a belching disorder. Provide reassurance and explanation of symptoms to the patient.
Management of belching disorders should be based on the subcategorization.
For supragastric belching:
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Speech therapy.
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Diaphragmatic breathing.
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Behavioral therapy (e.g. cognitive behavioral therapy, hypnosis).
For gastric belching:
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Avoidance of carbonated beverages.
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Speech therapy.
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Diaphragmatic breathing.
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Simethicone.
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Baclofen.
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This calculator should only be used in patients after appropriate organic, systemic, and metabolic causes have been ruled out after careful investigation.
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Note: Other GI conditions, such as GERD, may coexist with belching disorders.