Are there speech therapists in my area who specialize in treating excessive burping?

Finding Speech Therapists for Excessive Burping

Yes, speech-language pathologists (SLPs) with expertise in behavioral disorders can effectively treat excessive burping (supragastric belching), and you can locate them through the American Speech-Language-Hearing Association (ASHA) directory at www.asha.org or their ProSearch tool at www.asha.org/proserv. 1

Understanding Your Condition

Excessive burping is typically supragastric belching—a behavioral disorder where air is rapidly sucked into the esophagus from the pharynx and immediately expelled, rather than originating from the stomach. 2, 3 This occurs at high frequencies (sometimes 20+ times per minute) and is influenced by attention and distraction, confirming its behavioral nature. 2, 4

Why Speech Therapy Works

• Speech therapy leads to significant symptom reduction in 10 of 11 patients with excessive supragastric belching, with 6 patients experiencing >30% improvement. 2
• Treatment typically consists of 10 sessions focused on diaphragmatic breathing techniques that stop the complex muscle contractions generating the belching behavior. 5, 2
• The therapy works by retraining automatic movement patterns and redirecting attention away from the dysfunctional behavior. 1

How to Find the Right Therapist

• Contact ASHA's Action Center at 1-800-638-8255 (Monday-Friday, 8:30 AM-5:30 PM) or email [email protected] to locate certified speech-language pathologists. 1
• Specifically request an SLP familiar with behavioral disorders, functional communication disorders, or belching/aerophagia treatment. [@1@, @11@]
• The therapist must understand that supragastric belching is a behavioral disorder requiring distraction techniques and diaphragmatic breathing, not traditional voice therapy. [@10@, 2]

What to Expect in Treatment

• Therapy involves 1-2 sessions per week for 4-8 weeks, though belching disorders may require approximately 10 sessions. [@2@, @11@]
• The SLP will teach you to identify the muscle contractions causing belching and use diaphragmatic breathing to interrupt the pattern. [@10@, 2]
• Distraction techniques and dual-tasking exercises help break the behavioral cycle by diverting attention from the dysfunctional pattern. [1, @4@]
• You'll practice positive/negative comparisons—learning how the new breathing pattern feels compared to the old belching pattern. [@4@]

Insurance Coverage

• Medicare generally covers speech therapy when provided by a certified/licensed SLP, ordered by a physician, and deemed medically necessary. 1
• Medicaid coverage varies by state but typically covers speech therapy up to age 18; contact your local Medicaid office for adult coverage details. [1, @3@]
• Private insurance coverage varies—verify with your specific plan before beginning treatment. [1, @3@]

Important Diagnostic Considerations

• Before starting speech therapy, you should have respiratory assessment by a physician including spirometry to rule out other causes. [@5@]
• Ambulatory impedance monitoring with or without high-resolution manometry can objectively confirm supragastric belching versus gastric belching. [@8@, @10@]
• If your belching is associated with GERD symptoms, you may need combined treatment with PPIs and behavioral therapy. [@7@, 5]

Common Pitfalls to Avoid

• Do not undergo exploratory surgery—excessive belching is a behavioral disorder, not a structural problem requiring surgical intervention. [@12@]
• Avoid focusing solely on the belching while ignoring coexisting anxiety or depression, as these significantly worsen outcomes and must be addressed concurrently. [@1@, @9@]
• Do not expect PPIs alone to resolve belching unless it's directly associated with acid reflux episodes—supragastric belching involves non-acidic air movement. [6, @10