A Chinese randomized trial has found that structured singing therapy significantly improved response rates in patients with supragastric belching compared with diaphragmatic breathing. The findings suggest that structured vocal exercises may offer a promising behavioral treatment option for this condition. The study was published in the journal of Clinical Gastroenterology and Hepatology by Haitao S. and colleagues.
To assess if structured vocal therapy is clinically better than conventional breathing retraining in terms of patient outcome, researchers conducted a single-blind randomized superiority trial from October 2024 to April 2025. This study involved 72 adults diagnosed with supragastric belching according to strict criteria of Rome IV. Patients were randomly allocated on a 1:1 basis either to structured singing therapy or to diaphragmatic breathing for one week at 2 tertiary centers specializing in gastroenterology.
Primary endpoint was therapeutic efficacy, represented by ≥ 50% decrease in VAS belching scores. Secondary outcome measures included changes in quality of life using EuroQoL visual analog scale and anxiety/depression scores, as well as overall severity of gastrointestinal symptoms.
Key findings:
- In total, 72 patients diagnosed using Rome IV criteria were randomized into either one of the two groups in a 1:1 ratio at two tertiary gastroenterology clinics from October 2024 to April 2025.
- The use of singing resulted in a significantly better treatment response (≥ 50% improvement in belching VAS) in comparison to diaphragmatic breathing (72.2% vs 38.9%, P = .004).
- The superiority of singing was maintained after 1 month, where the use of singing maintained a superior treatment response compared to diaphragmatic breathing (50.0% vs 30.6%, P = .032).
In summary, singing therapy has been shown to be more effective compared to diaphragmatic breathing in case of supragastric belching, especially for older patients with more serious symptoms. Through addressing the physiological processes of air flow, as well as emotional distress associated with it, via a unique method, singing therapy is extremely effective, and at the same time, requires little effort from patients.
Reference:
Shang, H., Ma, H., Xu, Z., Liu, Y., Xu, Z., Zhao, L., Gao, Y., Bai, T., & Hou, X. (2026). Singing Therapy versus Diaphragmatic Breathing for Supragastric Belching: A Multicenter Randomized Controlled Trial.
Clinical Gastroenterology and Hepatology.
https://doi.org/10.1016/j.cgh.2026.03.047
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