Not being able to burp can harm quality of life – study

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R-CPD can be painful and cause “socially awkward” symptoms, researchers said
By Aurelia Foster
Health reporter

People who cannot burp suffer embarrassment, anxiety and depression because of the condition, on top of physical pain, researchers say.

Retrograde cricopharyngeus dysfunction (R-CPD) causes abdominal bloating, “socially awkward” gurgling noises from the chest and neck, and flatulence.

The research was carried out by a group of Texan university academics.

They said many doctors are “unfamiliar” with the disease, leaving patients “underserved”.

They added that more research into, and more awareness of, R-CPD were needed.

The group added there is a need to investigate “the severity that this syndrome has on a patient’s daily life, including its mental and social implications”, because it can negatively affect sufferers’ quality of life,.

R-CPD, also known as “no burp syndrome”, occurs when the cricopharyngeal muscle in the throat is unbale to relax to allow gas to pass upwards.

‘Tormenting people’

Yakubu Karagama, an ear, nose and throat consultant at London’s Guy’s and St Thomas’ Hospital, said 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.

However, it is currently available as a private treatment only because there is little awareness of the condition among the health profession, Mr Karagama said.

“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.

Mr Karagama said it was not known how many people have the condition, but he believed it was common.

“A lot of people don’t even know that the symptoms they’re having is because of this condition. The majority of the patients that have presented to my clinic said that they’ve had this all their life.”

He said funding was needed to undertake clinical research into the condition, which he said people were suffering with “unnecessarily”.

An NHS England spokesperson said: “While the clinical evidence of this condition is extremely limited due to the small number of people who have come forward with it, NHS staff enact clinical advice from NICE [the National Institute for Health and Clinical Excellence], which sets out the care and services suitable for patients with a specific condition or need.”

This study, based on their survey of 199 people unable to burp, concluded there was “very limited awareness” of the condition among health professionals, and improved understanding of the disease could increase diagnosis and treatment rates.

This would lead to an improved quality of life for patients, the authors said.

Researchers found half of people with symptoms of R-CPD discussed them with their primary care provider, but that 90% of those said they did not receive adequate help.

The study notes a general “prevalence of psychiatric symptoms” in people with disorders which are difficult to diagnose.

“Therefore, it is paramount to explore the mental health implications of this condition,” the authors say.

R-CPD was only recently officially given a name by a US academic 2019 when the first scientific paper on it was published.

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30 September 2021

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