This form of belching is due to unconscious, repeated aspiration of air into the esophagus, often in response to stress, followed by rapid expulsion. When such habitual aspiration is suspected, patient education and behavior modification should be undertaken rather than extensive medical evaluation and drug therapy. In the splenic flexure syndrome, swallowed air becomes trapped in the splenic flexure and may cause diffuse abdominal distention. Left upper quadrant fullness and pressure radiating to the left side of the chest may result. There is increased tympany in the extreme left lateral aspect of the upper abdomen.
Relief occurs with defecation or passage of flatus.
Such infants appear to pass an excessive amount of gas. Hence, the cause of this syndrome remains unclear. Among those who are flatulent, the quantity and frequency of gas passage shows great variability. As with bowel frequency, persons who complain of flatulence often have a misconception of what is normal. On the other hand, one study noted a person who expelled gas as often as 141 times daily, including 70 passages in one 4-h period.