If:

You are unable to burp, no matter how much pressure (peer or otherwise) is applied

Eating anything makes you so bloated you’re basically a walking balloon

The constant croaking from your esophagus sounds like a frog has taken up residency there

Then:

You may just have R-CPD.

What is R-CPD, exactly?

Going down, but not coming up

The quick answer: R-CPD is the inability to burp.

Formally, it’s known as retrograde cricopharyngeus dysfunction. Casually, it’s known as “Which ancient god have I angered, to be afflicted so?”

And for many of those who suffer, it’s known simply as “No-Burp.”

R-CPD occurs when the cricopharyngeus muscle cannot relax enough to let the gas in your stomach get out of your mouth.

You’ll note that the cricopharyngeus muscle can also be referred to as the upper esophageal sphincter. Brace yourself, because we’re about to use the word ‘sphincter’ at least three more times.

Each time a person swallows something (whether it’s saliva, a burger, or their pride), the aforementioned sphincter relaxes juuuuust long enough to allow it to happen. The rest of the time it’s contracted (read: closed for business).

When a person burps, that same sphincter needs to relax again to let the dang air out.

In short, the sphincter needs to release for either process to be successful. With R-CPD, it only happens in one direction (when swallowing) and not the other (when burping).

So what does this feel like to experience? Absolute garbage. More on that below.

No-Burp Symptoms You Probably Experience

So how do you know if you actually have R-CPD? Well, the first clue is that you’re still here. Some important symptoms include:

Realtalk: No-Burp is miserable.

We would consider wishing it on our enemies, but that’s about it.

Unlike the wearing of bucket hats, burping is a human necessity.

People who suffer from R-CPD, really do suffer. They need to burp, but simply can’t.

When air is released from the stomach, they can actually feel it sitting in their neck, like an obnoxious bubble with nowhere to go. When the constricted sphincter (hey, remember that?) refuses to release the “bubble,” the esophagus is left to unsuccessfully attempt to push it out.

This is typically accompanied by burbles, babbles, and gurgles—sounds that should be contained to a waterbody but instead are coming from the sufferer’s. 

For many, this leads to bloating so intense it feels like their abdomen is about to burst, as the air begrudgingly moves through the intestines and exits in the form of flatulence (gas).

Not only can this whole process be time-consuming and embarrassing, it can also be physically painful.

No-Burp Treatment

First, the good news: it exists.

There are a number of remedies and strategies that can help mitigate the effects of R-CPD, but by far the most effective is Botox.

And no, it isn’t used cosmetically in this case. This treatment can potentially be performed in an office environment, though some clinics recommend the patient is put under a brief general anesthetic. Who doesn’t love a good medically-induced nap?

In terms of serious complications, like a smile from your driving instructor — they’re rare. At most, during the first few weeks post-procedure, a person may have some trouble swallowing, or find they’re regurgitating.

It is close to 100% for validating the diagnosis (ability to burp restored and major reduction of symptoms). About 80% keep the benefit permanently. Some within that 80% don't burp quite as well a year or more later as they did early after the Botox, but they seem to never return to original level of symptoms. The 20% who lose the benefit can be reinjected or undergo myotomy.

No-Burp Treatment Providers

R-CPD is so misunderstood and dismissed that it didn’t even have a name until 2019.

That's when Dr. Robert W. Bastian, and his assistant, Melissa L. Wingo (formerly Smithson) wrote the literal first paper on the syndrome. He’s the first person on our list—literally.

Unfortunately, treatment providers are few and far between. We truly hope this changes, but in the meantime, here’s a directory.

No-Burp Community and Resources

Viva la No-Burp Revolution!

Though it may have taken you more than one search engine to find this page, we simply can’t have you leave without providing you some support and solidarity for the journey ahead.

It turns out people who can’t burp are cool, so here are some pretty legit resources.