ROLE OF UPPER ESOPHAGEAL REFLEX AND BELCH REFLEX DYSFUNCTIONS IN NONCARDIAC CHEST PAIN

Fifty-four patients examined for noncardiac chest pain (NCCP), showing no esophageal motor disorder or gastroesophageal reflux disease compa tible with NCCP, were subjected to an intraesophageal balloon distensi on test and a study of the belching reflex provoked by intraesophageal air injection. Thirty-three control subjects were also studied, allow ing us to define high-threshold belchers (group I) as those who belche d during two of three 40-ml distensions and low-threshold belchers (gr oup II) as those who did not. The balloon distension test induced NCCP in 64% of the patients in group I, and in 14% of the patients in grou p II (P < 0.01). High-threshold belching was a factor favoring the pos itivity Of the balloon distension test. This result supports the hypot hesis that esophageal distension by air due to a belching disorder may be the mechanism responsible for NCCP in some patients with an abnorm al sensitivity to balloon distension.