During the preceding 20 years, I have had the opportunity to observe an average of 20 to 25 patients yearly who presented themselves with a similar group of complaints, ie, vague abdominal discomfort, distention, at times radiating to the chest, rarely associated with palpitations, heart bum, frequent eructations. These gastroesophageal refluxrelated symptoms frequently occur 2 or 3 hours after meals. The patients are middle-aged men or older who have always appeared healthy except for these on-and-off digestive complaints, most of which have been previously investigated by means of roentgenographic contrast studies, computed tomographic scans, gastroscopy, treadmill exercise tests, Holter monitoring, and rarely referred to psychiatrist.
The diagnosis can be made easily in the office by comparing the size of the trousers with the abdominal girth. There is usually a discrepancy of 7.5 cm or more. Confirmation of this medical curiosity can be made by the use of suspenders with a