This RCT compared 1 week of structured singing therapy vs. diaphragmatic breathing in 72 adults with Rome IV–diagnosed supragastric belching across 2 tertiary centers in China (Oct 2024–Apr 2025), with follow-up at 1 month.
Singing therapy achieved a higher response rate (≥50% reduction in belching VAS) than diaphragmatic breathing both immediately post-treatment (72.2% vs 38.9%; P=.004) and at 1-month follow-up (50.0% vs 30.6%; P=.032); older age and higher baseline VAS were also independent predictors of response.
Small sample (n=72) from 2 Chinese tertiary centers limits generalizability; open-label design makes blinding impossible; follow-up extends only to 1 month, leaving long-term durability unknown.
For patients with supragastric belching—especially older adults with severe symptoms—singing therapy may be a more effective and engaging alternative to diaphragmatic breathing. Clinicians can consider offering it as a first-line behavioral option, particularly when patients find diaphragmatic breathing monotonous.
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