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Swallowing air while eating, drinking and speaking is completely normal. However, when talking about aerophagy, too much of it gets into the body, which can lead to bloating, abdominal pain and constant regurgitation. In babies, this buildup of excessive air is physiological in the first few months of life.
If too much air gets into the stomach, the body tries to get rid of it by belching. This can be so uncomfortable that those affected avoid contact with other people. If the air moves further into the small intestine, pressure develops in the lower abdomen - this causes bloating and cramps. From there, the air continues to enter the large intestine and rectum.
In addition, symptoms such as feeling of fullness, general malaise, reflux (reflux of stomach contents towards the esophagus) and rolling bowel sounds can occur. Vomiting may also be present in children. In the worst case, intestinal obstruction develops in children from pronounced aerophagy.
If the patient suffers from aerophagy, a doctor should be consulted. Especially if swallowing the air causes major problems, this should definitely be clarified.
Possible causes of aerophagy include speaking too quickly, eating too quickly, chewing gum, fizzy drinks, excessive breathing (e.g. in connection with a stuffy nose), poorly fitting dentures, anxiety, stress, nervousness, lactose intolerance and smoking. Aerophagy can also be a concomitant symptom in gastric diseases.
The causes of too much gas formation in the gastrointestinal tract are not only the air swallow, but also certain foods. This includes onions, legumes, peppers, leeks, unripe fruit, coffee, beer, yeast products, sugar, cream and whole grain bread. But an imbalance in the intestinal flora can also lead to air accumulation.
A so-called “vicious circle” can develop through aerophagy. The excessive swallowing of air is often accompanied by restlessness, nervousness and overload. That means the patients are under pressure. Those affected try to avoid or ignore the constant eructation or severe flatulence, which creates additional suffering.
Patients who are bedridden for a long time are more prone to aerophagia because lying down does not allow the swallowed air to escape so easily. As a result, an uncomfortable heartburn may develop. A doctor should be called in at the latest now, as serious indigestion can develop.
Appearance - Roemheld Syndrome
The so-called Roemheld Syndrome arises from excessive gas accumulation in the gastrointestinal area, possibly also triggered by aerophagy. Another term is gastrocardial syndrome or gastro-heart syndrome. Here the connection between heart and stomach becomes clear. With this disease, complaints occur in the area of the heart, the trigger being located in the gastrointestinal tract. Tightness, pressure in the area of the heart and burning pain behind the breastbone as well as pain that can radiate into the left arm, the shoulder and the lower jaw are felt. All of this is also reminiscent of the symptoms of angina pectoris. There may also be complaints such as hot flashes, dizziness and anxiety.
The increased air in the stomach and intestines pushes the diaphragm towards the chest cavity. This reduces the space of the heart and lungs for their development. This is the reason for the heart problems described. There may also be shortness of breath and difficulty breathing.
The Roemheld Syndrome has other causes, which have to do with an increased gas accumulation. These are food intolerances, inflammation in the stomach, a hiatal hernia (diaphragmatic rupture) and irritable bowel syndrome. But fat, sumptuous meals can also lead to this. Roemheld syndrome is one of the exclusion diagnoses. This means that the doctor first excludes all diseases related to the heart before the diagnosis can be made to Roemheld.
Treatment depends on the cause. If there is inflammation, an antibiotic may be necessary. To reduce gas accumulation, so-called defoamers are prescribed.
Treatment of aerophagy depends on the cause. Diseases must first be excluded. This includes a detailed medical history, laboratory examinations and possibly still imaging procedures.
Patients are encouraged to drop some “bad” habits. You should strive to eat calmly and slowly. Each bite is best chewed at least thirty times. This is not so easy if you have eaten very quickly beforehand.
Carbonated drinks should be completely banished - or at least only consumed from time to time. It is also important to keep an eye on coffee consumption. Because coffee is one of the possible triggers for aerophagy. Furthermore, you have to pay attention to a calm, not too fast way of speaking. Speech therapy exercises help reduce or stop breathing excessively when speaking. Aerophagy can also take place completely unconsciously. This is often the case with stressed patients. Relaxation exercises, yoga and conscious breathing techniques help here. Psychoanalysis may be necessary to find out the reasons for the general stress intolerance and nervousness of those affected.
Aerophagy in naturopathy
Also in naturopathic practice, those affected by aerophagy are recommended to try to calm down with the help of suitable relaxation techniques. Plants such as lavender, lemon balm, St. John's wort and passion flower help with this. These are prescribed individually, in the form of tea, as a tincture or as a mixed preparation. With the help of a detailed medical history, an attempt is made to find the causes of the nervousness and restlessness in order to be able to derive the appropriate therapeutic methods.
Ear acupuncture or body acupuncture are also helpful therapy methods. Foot reflexology therapy is also used successfully in the treatment of aerophagy.
In order to strengthen and calm the nerves, homeopathic single remedies such as Nux vomica, Staphisagria, Chamomilla, Bryonia and Colocynthis are prescribed.
Flatulence caused by aerophagy reacts very positively to anise, fennel, caraway and coriander. These four seeds are lightly toasted and a delicious tea is made from them.
With recurrent flatulence, a stool examination is usually ordered to get an idea of the intestinal flora. It may not just be the swallow of air that is "to blame" for the unpleasant symptoms. Here intestinal rehabilitation can help.
The Schüßler Salt Therapy uses the following agents in the treatment of aerophagy: No. 7 Magnesium phosphoricum, No. 5 Kalium phosphoricum, No. 14 Kalium bromatum and No. 20 Kalium Aluminum sulfuricum.
Anyone who uses Hildegard von Bingen's knowledge in practice recommends the gentian root, in the form of a powder or as a tincture, for the symptoms. This plant is quite versatile in its effects. This not only relaxes the digestive tract, but also has a calming effect on the nervous system. The combination with dandelions, centaury and wormwood is helpful. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Susanne Waschke, Barbara Schindewolf-Lensch
- Douglas A. Drossman: Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV, Gastroenterology, May 2016, Volume 150, Issue 6, Pages 1262–1279.e2, (accessed 09.09.2019), doi
- Jürgen Stein, Till Wehrmann: Functional diagnostics in gastroenterology, Springer Verlag, 2nd edition 2006
- Kristle Lee Lynch: Gastroesophageal Reflux Disease, MSD Manual, (accessed September 9, 2019), MSD
ICD codes for this disease: F45.3ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.