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SGB may be present in up to 40% of reflux symptoms in PPI-refractory GERD. Most reports on SGB have come from Western countries, and little is known about the prevalence and relevance of SGB in Asian\u00a0refractory GERD patients. This study aimed at comparing the role of SGB in GERD patients in Japan and the UK.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We re-analyzed impedance-pH monitoring tracings from patients who were referred to tertiary centers in Japan and the UK due to PPI-refractory reflux symptoms. The prevalence of excessive SGB and the impact of SGB on reflux symptoms were compared between the two countries.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Impedance-pH tracings from124 Japanese and 83 British patients were re-analyzed. Japanese patients were significantly younger and had smaller body mass index than the British (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Japanese patients had significantly lower prevalence of excessive SGB (18.5%) than the UK (36.1%) irrespective of reflux phenotype (<jats:italic>P<\/jats:italic>\u2009=\u20090.006). Logistic regression analysis showed that the geographical\/cultural difference was the only factor associated with the different prevalence of SGB (odds ratio; 2.91, 95% CI 1.09\u20137.73, <jats:italic>P<\/jats:italic>\u2009=\u20090.032). SGB were related to typical reflux symptoms very rarely in Japan [0% (0\u20134.9)] compared to the UK [35% (0\u201354.1)] (<jats:italic>P<\/jats:italic>\u2009=\u20090.071).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The prevalence of SGB and their impact on reflux symptoms is significantly lower in Japan compared to the UK. The difference is not related to reflux parameters but might come from ethnic\/cultural factors to be further characterized.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00535-020-01720-9","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T20:02:37Z","timestamp":1598299357000},"page":"1046-1053","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Supragastric belching in Japan: lower prevalence and relevance for management of gastroesophageal reflux disease compared to United Kingdom"],"prefix":"10.1007","volume":"55","author":[{"given":"Akinari","family":"Sawada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Itami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Hirano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Kitamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rieko","family":"Nakata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Takashima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuaki","family":"Abe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Saito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etsuro","family":"Yazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Kawamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumio","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihisa","family":"Takeuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Koike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Masamune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhide","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Sifrim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,24]]},"reference":[{"key":"1720_CR1","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1053\/j.gastro.2016.02.011","volume":"150","author":"V Stanghellini","year":"2016","unstructured":"Stanghellini V, Chan FK, Hasler WL, et al. 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C. Atsushi Masamune receives research grant from Otsuka Pharmaceutical Co., Ltd., EA Pharma Co., Ltd., Gilead Sciences, Inc., Asahi Kasei Pharma Corp., Eisai Co., Ltd., AbbVie GK, Takeda Pharmaceutical Co., Ltd., and Daiichi Sankyo, Inc. and lecture fees from EA Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Daiichi Sankyo, Inc and Mylan. Toshihisa Takeuchi receives lecture fees from AstraZeneca K.K, Daiichi Sankyo, Inc. and Takeda Pharmaceutical Co., Ltd. The remaining authors declare no conflicts of interest with this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}