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Aerophagia Among Sri Lankan Schoolchildren: Epidemiological Patterns and Symptom Characteristics

Devanarayana, Niranga M.*; Rajindrajith, Shaman

Journal of Pediatric Gastroenterology & Nutrition: April 2012 - Volume 54 - Issue 4 - p 516–520
doi: 10.1097/MPG.0b013e318236051d
Original Articles: Gastroenterology

Objective: Aerophagia is a functional gastrointestinal disorder characterised by repetitive air swallowing, abdominal distension, belching, and flatulence. In severe cases, it can lead to pneumoperitonium, volvulus of the colon, and intestinal perforation. Little is known about the epidemiology and clinical profile of affected children. The main objective of the present study was to assess the epidemiology of aerophagia in 10- to 16-year-olds in Sri Lanka.

Methods: A school-based cross-sectional survey was conducted in 8 randomly selected schools in 4 randomly selected provinces in Sri Lanka. Data were collected using a pretested, self-administered questionnaire, which was distributed in an examination setting and collected on the same day. Trained research assistants were present during completion of the questionnaire, for any required clarification. Aerophagia was diagnosed using the Rome III criteria.

Results: In the present study, aerophagia was seen in 163 (7.5%) of the 2163 children evaluated. The prevalence was higher in older children (10.5% in 15-year-olds) and no sex difference was observed (boys 8.2% vs girls 6.8%, P > 0.05). Intestinal-related (abdominal pain, nausea, and anorexia) and extraintestinal symptoms (headache, limb pain, sleeping difficulty, photophobia, and lightheadedness) were more prevalent among affected children (P < 0.05). A higher percentage of affected children were found to be exposed to stressful events when compared with controls (P < 0.05).

Conclusions: The present study highlights the high prevalence of aerophagia among Sri Lankan children and adolescents. This condition is more common in those exposed to emotional stress. Intestinal-related symptoms and extraintestinal somatic symptoms are frequently seen in affected children.

*Department of Physiology

Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.

Address correspondence and reprint requests to Dr Niranga M. Devanarayana, Department of Physiology, Faculty of Medicine, University of Kelaniya, Talagolla Road, Ragama 10110, Sri Lanka (e-mail:

Received 21 May, 2011

Accepted 2 September, 2011

The authors received financial support from the University of Kelaniya, Sri Lanka.

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN