Study Says Inability To Burp May Affect Quality Of Life

A unique syndrome leaves people incapable of burping, disrupting their daily routines with symptoms such as bloating, excessive flatulence, and audible gurgling noises in the neck and torso. 

Despite the challenges, a recent survey-based study suggests that those affected by the condition, known as "retrograde cricopharyngeus dysfunction" (R-CPD) or "no-burp syndrome," may be hesitant to seek assistance. Even when seeking help, they may encounter difficulties in obtaining proper treatment. The formal recognition and naming of R-CPD occurred in 2019, though isolated case reports describing the condition date back to 1987.

R-CPD stems from issues with the cricopharyngeus muscle, a ring-shaped muscle located at the top of the windpipe. In the typical burping process, this muscle relaxes to permit the release of excess gas from the stomach through the throat. However, in individuals with R-CPD, the muscle remains tightly contracted, preventing the expulsion of air. The condition can be effectively treated with injections of botulinum toxin (Botox), which relaxes the muscle and enables individuals to belch.

The condition, R-CPD remains relatively unknown among medical providers. The study was published in the journal Neurogastroenterology & Motility.

"By raising awareness about its symptoms and their consequences, we can increase diagnosis and treatment rates, ultimately enhancing overall quality of life," the authors wrote in the report.

For the study, the researchers reached out to Redditors. The subreddit "r/noburp" includes about 26,000 members who share information about R-CPD. "Although many [members] are self-diagnosed, it provides the largest population to gain preliminary insight into the disease directly from those who are afflicted," the study authors noted, acknowledging this limitation of the research, LiveScience reported. 

The researchers invited the subreddit members ages 18 and older to complete a survey about their experiences, and 199 participated. 

The 197 participants said that their inability to burp and 195 reported abdominal bloating or chest pain after eating. Around 90 per cent reported socially awkward gurgling noises from the chest and lower neck or excessive flatulence, and 110, or 55%, reported difficulty vomiting.

Yakubu Karagama, an ear, nose and throat consultant at London's Guy's and St Thomas' Hospital, told BBC that the condition had been "tormenting people for a long time".

"When you eat something or drink, you have this pain. Some patients have to lie down so that the gas will come up, and some people have to stick their finger in their mouth to force themselves to be sick so that the gas will come out with it."

Mr Karagama told the BBC that since 2016 he had been treating people with this condition with Botox injections, which work by relaxing the cricopharyngeus muscle.

He said the treatment had been "life-changing" for "almost every single patient" on whom he had operated.

"You can imagine if I said to you 'I can't burp'. This is the problem. Most people would laugh at it.

"People don't understand the physiology of burping," he said.