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Not Being Able to Burp Actually Sounds Pretty Horrific

A life without burps might sound like a blessing, but a new study shows it’s anything but. Researchers interviewed patients with the rare condition retrograde cricopharyngeus dysfunction (R-CPD), which makes them unable to burp or belch, about how it affected their daily life. Not only did patients report unpleasant symptoms like constant farting and gas, they also often felt embarrassed, depressed, and socially awkward.

Burping plays an important biological function. When food and water goes from the mouth to the stomach, it first passes through the cricopharyngeus, a muscle at the top of the esophagus that opens and closes as needed. Sometimes we swallow air or carbon dioxide while eating, and this can lead to a build-up of gas in the esophagus or stomach. Normally, this excess air is sent back through the cricopharyngeus, and we burp it out. In those with R-CPD, the cricopharyngeus still opens up to let food through, but for some reason, it can’t relax to let burps out.

Though the first case reports of R-CPD date back to 1987, the condition itself was only formally named and classified in 2019. And there’s still been very little research into it, including on the personal experiences of sufferers. For lead author Jason Chen, a MD candidate at Texas Tech University Health Sciences Center, it’s a topic that hits close to home.

“I actually have had this condition myself for as long as I could remember. I was driven to start this project given my experiences of living with the uncertainty, frustration, and lack of definitive answers for most of my life,” Chen told Gizmodo in an email. “This study is an introductory study to understand the basic characteristics of the disease from a larger study population, which has not been done before.”

The team decided to conduct an online survey of people with the condition. They recruited people through a Reddit community of self-identified R-CPD sufferers—aptly called “r/noburp”—and ultimately interviewed 199 people. The volunteers were asked a variety of questions about how the condition affected their daily lives.

A vast majority of respondents (90% or more) reported symptoms commonly seen with R-CPD, such as bloating and chest pain after eating, excessive farting, and “socially awkward gurgling noises” from their chest and lower neck. Slightly more than half reported not being able to vomit. And over 87% reported having symptoms daily. Most also recalled having their symptoms as long as they could remember, or first noticing it when they were children, with no cases discovered after the age of 35—a finding that supports the idea that R-CPD is a congenital disorder, rather than one that can appear later in life.

Their quality of life was greatly affected by the disorder. More than three-quarters of respondents agreed that they felt embarrassed or socially awkward due to their R-CPD, as well as depressed or anxious. Slightly over half felt that their R-CPD had negatively impacted their personal relationships, while around 60% reported that it disrupted their work.

“The condition 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.” Chen said. The team’s results are published in the journal Neurogastroenterology & Motility.

At the same time, many sufferers felt unable to get help. Only about half of respondents reported talking about their condition with their primary care provider, and about 90% of that group reported that they didn’t get adequate support or advice from their doctor. While R-CPD may be a newly described condition, there are existing treatments for it, such as Botox injections that can help the cricopharyngeus relax more easily.

The findings, the study authors say, show that R-CPD is no picnic. They hope their research can bring greater recognition for the condition, both among the general public and with doctors.

“This is absolutely an area that warrants further research and attention, which will help with identification and treatment of the condition,” Chen said. “More efforts are needed to minimize and normalize this to encourage patients to seek help.”

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