Retrograde cricopharyngeal dysfunction is a medical condition that causes an inability to burp. This can result in excess gas and discomfort in the chest or throat.

“Retrograde cricopharyngeal dysfunction” (RCPD) is a relatively new medical term that doctors first described in 2019. There is still a lot that researchers do not know about the condition.

The researchers who first identified RCPD think it is likely a disorder of the cricopharyngeus muscle, which is part of the upper esophagus and helps control swallowing and belching. Some people have the condition from birth.

Read on to learn more about RCPD, how common it is, the symptoms, and potential treatments.

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RCPD is a digestive disorder that affects the upper part of the esophagus. The esophagus is the tube through which food travels to the stomach.

People with RCPD cannot burp or belch. They may also be unable to vomit.

These issues can cause:

Doctors believe the cause of RCPD is a problem with the cricopharyngeus muscle, which is in the upper part of the esophagus.

Doctors only identified RCPD in 2019, so there are no large studies yet on how common it is. Researchers have only published review articles describing the condition and some case studies.

However, the fact that it is a recent discovery may suggest that it is either uncommon or that many people with the condition have milder symptoms and do not seek treatment.

RCPD can be present in children and adults. However, most research to date has focused on adults.

The main symptom of RCPD is being unable to burp and never having been able to burp.

Some other symptoms a person might experience include:

There is no approved diagnostic test for RCPD. However, some researchers recommend treating symptoms of the condition as if they result from RCPD. If the treatment works, it may confirm a diagnosis.

Doctors may also perform other tests to rule out other causes. However, if a person has never been able to burp, RCPD is the likely cause.

The primary treatment for RCPD is Botox injections. Botulinum toxin – the toxin in Botox – can paralyze muscles in very small doses.

Injecting botulinum toxin into the cricopharyngeus muscle may prevent it from tightening or closing at times when it should not, allowing a person to burp. Once they can burp, they may experience relief from any pain or discomfort.

Because botulinum toxin wears off after several months, people usually need repeated treatments. However, several studies suggest that the benefits can often last longer for RCPD. Some people may need more regular treatments, while others will not.

Researchers do not know why this is. Still, although Botox is an off-label RCPD treatment, it seems safe and effective.

In another 2022 study of 85 people who had Botox treatment for RCPD, 88.2% responded to it. The most common side effect in the study was mild and temporary difficulty swallowing, which went away on its own. This affected 30.6% of the participants.

People with RCPD will need to discuss the potential benefits and risks of Botox treatment with their doctor.

Below are some answers to common questions about RCPD.

Is RCPD dangerous?

There are many unanswered questions about RCPD, including why it develops and whether it can cause any complications.

So far, researchers have not identified any harmful complications of this condition. However, it can cause intense pain, and there may be effects scientists are not aware of yet.

Can people with RCPD vomit?

Some people with RCPD report an inability to vomit as well as burp. In other cases, people say they can vomit only after violent retching.

However, some reports suggest that vomiting could also be a symptom of RCPD. A 2022 case report of a 19-year-old with RCPD indicates that his inability to burp as an infant sometimes caused vomiting.

Researchers do not yet understand what factors may affect vomiting in RCPD.

It is best for a person to contact a doctor if:

  • they cannot burp, especially if they have never been able to burp
  • their symptoms cause pain or distress
  • they have other digestive symptoms, such as stomach pain

Because RCPD is so new, many doctors may not know about this condition.

For this reason, people may want to consider consulting a gastroenterologist. If a person suspects they may have RCPD, printing out resources on the topic and taking them along to an appointment may be helpful.

Retrograde cricopharyngeal dysfunction (RCPD) is a condition that makes a person unable to burp. Scientists have only identified it fairly recently, so there is still much they need to learn to understand it.

Despite this, there are effective treatments for RCPD. Botox injections appear to be effective and low risk, paralyzing the cricopharyngeus muscle so that the throat can remain open while a person burps.

More research is necessary to understand why RCPD develops, how common it is, and whether it can result in any complications. If a person cannot burp, it is best for them to speak with a doctor.