Background

Belching is one of the common symptoms encountered in clinical practice. A global study involving more than 73,000 adults found the prevalence of belching was 1%. Belching is defined as an audible escape of air from the esophagus or the stomach into the pharynx, the former is termed supragastric belching and the latter is termed gastric belching [1].

Belching can occur in otherwise healthy persons, but if it is excessive as to disrupt patient’s daily activities, occurring more than 3 days per week, or accompanied by pain, heartburn, or difficulty swallowing, which may indicate acid reflux or other digestive issues, medical consultation is needed [1,2].

This article is to share a unique case of spontaneous belching experienced by a therapist (coauthor SM) every time he treats his patients. The responsive belching occurs whenever his hand touches upon the patient’s body area reflecting internal organ abnormality. The possible mechanism behind this phenomenon is discussed based on the latest evidences.

Case Description

The therapist, aged 54 years, has practiced traditional Chinese medicine for three years. He has no complaint or history of gastrointestinal disease or any related disorder. He practiced breathing and meditative exercises as part of a self-defense martial arts since 1987. He began consistently experiencing spontaneous responsive belching while treating patients since 2002 after going through a meditation retreat. The tone of belching sound is related to the severity of the patient’s disease or disorder ‘detected’ by the him through an unrecognized sensory path.  The more severe the disease or the disorder, the louder the therapist’s belching sound and in some cases, it was accompanied by abdominal bloating. The loudness of the belching sound ranges from about 60dB to 70dB or like chatting sound to washing machine or toilet flush sound. Each belch lasted about one second, with frequency about once per 5 seconds.

When the patient’s condition improved, the tone of belching declined accordingly. The therapist can detect the patient’s condition either vis a vis or through telecommunication, with the same belching or bloating responses when disorders are detected. Similar phenomena of spontaneous belching happened to another fellow therapist but not as consistently and as pronounced as the one described herewith. The following two cases illustrate the phenomenon in details.

Case 1: Mr. A, 62 years old, suffered from post-stroke hemiplegia in 2018. The patient consulted the therapist through WhatsApp call. Trying to diagnose the patient’s condition, the therapist suddenly belched as he detected disorder at the left side of the patient’s head. The next day, the patient came to see the therapist face to face. The patient walked very slowly assisted by a walking stick. After getting the informed consent, the therapist tried to detect the patient’s problem by his right palm touching the patient from the top of his head all the way down. When the therapist touched the left side of the patient’s head, left shoulder blade area, belching occurred spontaneously, indicating a disorder there. Strong belching or bloating occurred when touching the lumbar region. The disorders indicated by the therapist’s belching turned out comparable to the patient’s medical examination’s results, i.e., left cerebral hemispheric stroke, heart and kidney problems. All the diagnostic procedure lasted about ten minutes.

Case 2: Ms. B, 76 years old, hospitalized for 4 days several months ago. Her complaint was fatigue and difficulty in moving her right leg. After informed consent, the therapist tried to detect the patient’s problem by using his right palm touching from the top of her head all the way down her back. The therapist’s spontaneous belching occurred while touching her head’s right side, mid-back (liver area), and right leg. The therapist concluded that she was suffering from overwhelming anxiety and negative emotions (as liver disorder is associated with negative emotions according to the theory of traditional Chinese medicine) [3,4]. The conclusion was acknowledged by the patient. The procedure lasted about ten minutes.

There are many conditions that can cause belching, some physiologic and others pathologic. The American Gastroenterological Association (AGA) Clinical Practice Update has declared that when belching, abdominal bloating, and abdominal distention are frequent or severe enough to impair daily activities, they are categorized as disorder of gut–brain interaction (DGBIs) [1]. According to Rome IV diagnostic criteria, there is a belching disorder when one experiences bothersome belching (severe enough to impact on usual activities) more than 3 days a week [5]. So the phenomenon of therapist’s belching described here does not belong to pathologic condition, as it did not impair the therapist’s daily activities.

Recent findings indicate that belching is a learned behavioral phenomenon in response to unpleasant feeling in the abdomen [6]. Psychological factors play an important role in symptom frequency and severity [5]. In the present case, the therapist might have felt unpleasant feeling while examining the patients which triggered the responsive belching or bloating. The phenomenon might be a form of physiological resonance in empathic stress or embodied autonomic response related to one’s ability to empathically share another person’s stress response. Recent studies have discovered the existence of such empathic stress and the human propensity to physiologically resonate with the stress responses of others [7-9]. The possibility is supported by the fact that the belching phenomenon happened after the therapist attended a meditation retreat. As studies have found various forms of meditation practice enhance empathy, compassion and prosocial behaviors [10,11]. Furthermore, other studies found that long term meditation practice could enhance the sensory processing and embodied cognition [12,13].

Besides, the therapist’s belching may be interpreted as an extrasensory perception (ESP)-like pheonomenon. ESP refers to the alleged processes of precognition, telepathy, and clairvoyance that take place via channels other than the sensory system that biologists and psychologists have been researching with scientific means [14]. ESP or ‘the sixth sense’ – communicate with distant objects and people by unknown mechanisms – has become a challenging subject among scientists [15]. By leveraging advanced neuroimaging technologies, Pelt SV reported compelling evidence for the neural basis of telepathic phenomena of synchronized oscillatory activity in brain regions implicated in social cognition, theory of mind, and language processing. The study contributed to the growing body of literature elucidating the mechanisms underlying non-verbal interpersonal communication and cognition [16]. Hence the telepathic phenomena and physiological resonance might stem from the same neural processes in the brain, which needs to be elucidated through mechanistic studies. On one side it might be physiological resonance like the therapist’s belching, but on the other side it could turn pathologic as the psychosomatic disorders.

The phenomenon of spontaneous belching experienced by the otherwise healthy therapist might be a form of embodied mind or somatization of his physiological resonance. The present observational case report has many limitations, such as no objective data to assess the relation between the therapist’s belching tone, area of the brain activated, and the pathologic condition of the patients. Hence, further study is required to elucidate its mechanism and clinical significance.

References:

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