Can’t Burp? You Might Have This Rare Health Condition

It's more mentally distressing than you might think.

Asian woman feeling stomachache and touching her belly sitting on armchair in living room at home.
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Depending on your personal stance, burping is either hella rude or an imperative life skill to earn yourself Guinness World Record fame. There’s no denying, however, that letting out a burp or two is a natural physiological response to gas building up in the digestive tract (like from drinking carbonated beverages) or swallowing excess air.

Now, what if you couldn’t burp? While that might sound trivial, it’s anything but for people living with a rare medical condition called retrograde cricopharyngeus dysfunction (R-CPD) or No Burp Syndrome. Due to the cricopharyngeus muscle in the esophagus not relaxing properly, these folks can’t relieve themselves of that excess gas or air. This results in a whole host of uncomfortable symptoms like bloating in the neck, chest, and abdomen, as well as excessive farting.

A study published Wednesday in the journal Neurogastroenterology and Motility looked into what life is like for those with R-CPD, which was first described in 2019 and still remains poorly understood. To address gaps in our understanding of what sort of symptoms people experience and how the condition impacts their lives, researchers at Texas Tech University took to the popular online community Reddit. They sent out a survey to netizens of the “r/noburp” subreddit, a community of over 27,000 strong sharing information on R-CPD.

Among the 199 adults experiencing R-CPD symptoms who responded, nearly all reported they couldn’t burp (99 percent) and had abdominal bloating (98 percent) and excessive farting (89 percent). Around 55 percent of individuals reported difficulty vomiting.

Tacked on top of that was R-CPD’s impact on their mental health. Ninety-three percent of respondents felt socially awkward about the gurgling noises emanating from the neck and chest that can happen with the condition. People also expressed embarrassment and R-CPD having a negative impact on their relationships or disrupting their work life. Other recent studies have also found a higher prevalence of mood disorders like anxiety among individuals with R-CPD.

Unsurprisingly, due to R-CPD’s rarity and, therefore, many healthcare providers’ unfamiliarity with it, over half of respondents said they were willing to talk about their symptoms with their primary care physician. Ninety percent said they weren’t receiving adequate medical help at all.

Currently, the only treatments for R-CPD are Botox injections into the cricopharyngeus muscle (which is also used as a diagnostic test for the condition) or partially cutting through the muscle in order to get it to work properly. The latter treatment, called a partial myotomy, is usually an option for people who don’t get better after Botox injections.

The researchers hope studies like theirs will raise awareness of R-CPD among people who may have it, guide healthcare providers to make appropriate diagnoses and treatments and propel further research.

“R-CPD encompasses more than just the physical challenge of being unable to burp; it also significantly impacts people’s daily lives, relationships, and mental well-being,” Jason N. Chen, the study’s first author and a medical student at Texas Tech University Health Sciences Center, said in a press release. “Future efforts should concentrate on raising awareness about R-CPD, which can help increase identification and treatment rates.”

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