Dysfunction of the Belch Reflex Question Title * 1. Sufferers of DBR cannot burp naturally. Do you feel pain/pressure in your throat/oesophagus/behind your breast bone when it feels like you need to burp and it won't come out? Yes No Sometimes It depends Other (please specify) Question Title * 2. How can you relieve this pain/pressure? Induce gagging to cause burp Squeeze throat to cause burp Lie down I can't! Other (please specify) Question Title * 3. Do you think you fart more often than others? Yes No Sometimes How would I know?! Other (please specify) Question Title * 4. Do you suffer from anxiety/stress? Please give a little detail about duration, severity, type... Question Title * 5. Do you have a hiatus/hiatal hernia? An endoscopy/x-ray may have shown this. Yes! No I had an endoscopy and they didn't say anything about one... I haven't had an endoscopy/x-ray so I don't know... I used to but then it went away! I think I might have one! Other (please specify) Question Title * 6. Do you hiccup a lot/more than others? Yes! Loads! Yes...a few times every day Yes...when I drink/eat certain things No more than others It depends... Other (please specify) Question Title * 7. Do you suffer from acid reflux/heartburn? Yes, constantly Yes, when I drink/eat certain things Quite often Occasionally No, not as far as I'm aware... Other (please specify) Question Title * 8. Can you throw up? Yes...obviously Yes, but I haven't in years! Yes, but only extremely rarely Yes, but only ever from too much alcohol... No actually! Not since I've had DBR symptoms! Other (please specify) Question Title * 9. Do you feel the need to swallow often? Do you find yourself swallowing for no reason? Yes, it's really weird! Yes, it feels like there is something in my throat that I need to swallow down Yes, the air that builds up in my throat makes me involuntarily try to swallow it Yes, I feel like I have a lot of saliva all the time No...I don't think so Other (please specify) Question Title * 10. Please list foods, drinks, activities, and your thoughts about what makes your DBR worse. Please also list what makes your symptoms better Done