Inability to burp
Also called: Retrograde cricopharyngeus dysfunction · R-CPD · No-burp syndrome
Some people have never burped in their lives. Gas cannot pass a ring of muscle at the top of the food pipe, so it stays trapped. This causes gurgling, bloating, and painful pressure. Since 2019 it has a name and a treatment.
How common
Does this happen to you?
These are answers from visitors, not a study.
How it works
A ring of muscle called the cricopharyngeus sits at the top of the food pipe. It stays closed most of the time. It relaxes to let food go down. In most people it also relaxes to let gas come up, which is a burp1.
In some people the muscle relaxes for food but not for gas. The gas has nowhere to go. It builds up in the food pipe and stomach and has to leave by the other end. The condition is called retrograde cricopharyngeus dysfunction, or R-CPD1. Retrograde means backward.
People with R-CPD report the same set of symptoms. Loud gurgling noises from the chest and throat, often described as a croaking frog. Bloating that gets worse through the day. A lot of flatulence. Painful pressure in the chest after fizzy drinks. Hiccups that hurt. Difficulty being sick1. Most have had it since childhood and many thought everyone lived this way.
The condition was named and described in 2019 by Robert Bastian, a throat specialist in Chicago, after he saw a series of patients with the same story1. Until then it had no name. Many doctors still have not heard of it.
Is it a problem?
It is not dangerous. It is uncomfortable, and it can affect eating, sleep, and social life. Many people with it avoid meals out and fizzy drinks.
A treatment exists. A doctor injects botulinum toxin into the cricopharyngeus muscle, usually under a short anaesthetic13. The muscle relaxes for a few months. During that time most patients learn to burp, and for many the ability stays after the drug wears off1. If you have never burped and you have the symptoms above, see a doctor and mention R-CPD by name.
History and culture
The subreddit r/noburp was where many people first found that others had the same problem2. The community gathered symptom reports, found doctors who would treat it, and pushed for medical recognition.