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Physiological belching during impedance-pH monitoring: a meal with Coca-Cola provokes a prompt gastroesophageal reaction with increased prandial belching

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Published/Copyright: July 21, 2025
Journal of Basic and Clinical Physiology and Pharmacology
From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 37 Issue 1

Abstract

Objectives

To assess the belching-related esophageal events in healthy volunteers during and after fast-food meals.

Methods

Ten adult healthy volunteers had two lunches with a Big Mac® on different days, accompanied or not by Coca-Cola (500 mL, pH<3) in a random way. We assessed prandial and 2 h postprandial esophageal events using impedance-pH monitoring.

Results

During meals with Coca-Cola, most signed belching (68 %) were concomitant with prolonged esophageal acidification or acid reflux, and the belching number was superior [median: 9.5 (IQR 4.7–14) vs. 0 (0–3); p=0.002] and less frequently represented by pure gas (24 % vs. 92 %; p<0.001) than in meals without Coca-Cola. Postprandial belching did not differ either in frequency [median: 15.5 (6–20.2) vs. 13.5 (10.7–20.5); p=0.739] or in type [(median %) pure gas: 6.7 % vs. 11.7 %; during acid reflux: 64.6 % vs. 51.7 %; during nonacid reflux: 22.5 % vs. 22.2 %; p=0.300), with more than 80 % of belching coincident with asymptomatic liquid reflux, regardless of Coca-Cola intake. Postprandial gastroesophageal reflux and esophageal acid exposure were similar, irrespective of Coca-Cola intake.

Conclusions

In healthy volunteers, a fast-food meal with Coca-Cola provoked a prompt reaction with increased prandial belching and esophageal acidification. Coca-Cola did not change postprandial belching, often accompanied by silent gastroesophageal liquid reflux.

Keywords: belching; beverages; gastroesophageal reflux; healthy volunteers
Corresponding author: Fernando Fornari, PhD, Faculdade de Medicina, Universidade de Passo Fundo, Passo Fundo, RS, Brazil; and Gastroenterology Department, School of Medicine, University of Passo Fundo, Rua Teixeira Soares, 817, 99010-080, Passo Fundo, RS, Brazil, E-mail:

Funding source: Conselho Nacional de Desenvolvimento Científico e Tecnológico

Award Identifier / Grant number: 473004/2012-7

  1. Research ethics: The local Institutional Review Board deemed the study exempt from review.

  2. Informed consent: Informed consent was obtained from all individuals included in this study.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of large language models, AI and machine learning tools and data availability: During the study preparation, the authors used the app Grammarly for English review. After using this tool, the authors reviewed and edited the content as needed and took full responsibility for the publication content.

  5. Conflict of interest: Authors state no conflict of interest.

  6. Research funding: This study was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq nº 473004/2012-7).

  7. Data availability: Not applicable.

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Received: 2024-03-29
Accepted: 2025-07-01
Published Online: 2025-07-21

© 2025 Walter de Gruyter GmbH, Berlin/Boston

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  12. Physiological belching during impedance-pH monitoring: a meal with Coca-Cola provokes a prompt gastroesophageal reaction with increased prandial belching
https://doi.org/10.1515/jbcpp-2024-0050
Keywords for this article
belching; beverages; gastroesophageal reflux; healthy volunteers

Articles in the same Issue

  1. Frontmatter
  2. Minireview
  3. Mental toughness and athletic performance: a narrative review
  4. Reviews
  5. The role of the urinary microbiome in diabetes-associated UTIs: current understanding and future directions
  6. Interleukin-23 (IL-23) inhibitor, mirikizumab in the treatment of ulcerative colitis (UC): a promising therapy?
  7. Original Articles
  8. Menopause, estrogen, and GERD: an exploration of symptoms and endoscopic correlations
  9. A study of pulmonary function in hypothyroid female patients of reproductive age group and its correlation with free T3, T4 and TSH
  10. A retrospective observational study to evaluate the association between self-reported binge alcohol drinkers and asthma
  11. Two hours of urine output are a reliable parameter for intravenous furosemide adequacy and the need for doubling dose in acute heart failure: a prospective study
  12. Physiological belching during impedance-pH monitoring: a meal with Coca-Cola provokes a prompt gastroesophageal reaction with increased prandial belching
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