Management of aerophagia needs to be tailored based on the severity of symptoms generated. Although generally felt to be a benign condition, aerophagia has been associated with development of colonic volvulus [19] and colonic perforation [20]. Most commonly, children with aerophagia are brought to the attention of care providers with complaints of noisy swallow, excessive belching, or abdominal distention. Once a diagnosis of aerophagia has been made, education about what generates the symptoms and effective reassurance that no serious underlying disease is present are the most often employed measures and may represent the most effective intervention [21]. Understanding the mechanisms underlying the excessive air swallows may be very reassuring for the parents and the child. Elimination of gum chewing and carbonated beverages and avoidance of drinking from a straw can be helpful. When the air swallowing is visible and/or audible during the clinic visit, the clinician can help the child and the caretakers become aware of air swallows so that the behavior is minimized. Keeping the mouth wide open after completion of a meal may minimize air swallow, as it is impossible to swallow with an open mouth. When patients with excessive belching are unaware that they are being observed or when they are distracted, the incidence of belching is significantly reduced [22]. These findings underline the importance of psychological factors and provide rationale for behavioral therapy. Hypnosis has been suggested as a mode of therapy in a case report [23]. When primary psychological disorders, especially an anxiety disorder, are present, they should be treated [24]. Different behavioral and mechanical techniques, incorporating biofeedback, have been tried, though only in small trials and rarely with children, to promote self-awareness of swallowing and limit its frequency [25, 26]. Pharmacologic therapy has a limited role in the treatment of children with aerophagia due to the lack of thorough understanding of the pathophysiology of this condition and the potential side effects of the medications that have been tried. Benzodiazepines have been employed on the basis that the emotional state may impact swallowing rates and due to their efficacy in the treatment of myoclonus. There have been two reports in which clonazepam was shown to be effective in children with aerophagia with and without mental retardation [8, 27]. Baclofen is a muscle relaxant used to treat spasticity and movement disorders. It has been shown to improve symptoms of rumination and supragastric belching [28] and may have a role in the treatment of aerophagia. In the most severe cases, nasogastric decompression, a venting gastrostomy or even an esophagogastric separation and abdominal esophagostomy via jejunal interposition may be justified [29].