Reflux, belching, rumination and their interrelationships

Patients with gastroesophageal reflux disease (GERD), excessive belching and the rumination syndrome are all characterized by troublesome symptoms due to retrograde flow of material (liquid, solid and/or gaseous) through the esophagus. In this thesis, we present a number of studies in which we provide novel insights into the pathophysiology, diagnosis and treatment of these diseases.
We demonstrate in this thesis that GERD, belching and rumination are three distinct disorders but with many interrelationships. The studies described in this thesis contribute to a better identification of patients in whom the treatment can be aimed at the mechanism underlying their belching complaints or complaints of regurgitation. Moreover, these studies could also result in new treatment modalities for patients with "true" GERD such as prokinetics or anxiolytics or affect the treatment for patients in whom anti-reflux surgery appears to have failed.