How does the inability to burp affect daily life?

Burping in public is not only embarrassing, but people who are unable to release gas from their stomach are unfortunate in other ways.

The inability to burp, officially called “retrograde cricopharyngeus dysfunction (R-CPD),” is caused by the failure of the throat’s cricopharyngeal muscle to relax and allow the outward passage of gas. 

A burp or belch can help ease an upset stomach. But if it happens often, it can be a sign of a health problem. When you swallow your food, it goes through the esophagus into your stomach. There, your body uses acid, bacteria, and chemicals called enzymes to break it down into nutrients it uses for energy.

If you drink something like a soda or beer with bubbles in it or swallow air with your food, those gases can come back up through your esophagus. Most of the time, that gas doesn't make it to your stomach; instead, it stays trapped in your esophagus.

The chronic condition is not easily treated, but some cases may just be due to bad habits. 

You’re more likely to swallow air and burp if you chew gum, smoke, eat too quickly, suck on hard candies, or have dentures that don’t fit well.

Now, a team at Texas Tech University Health Sciences Center who studied 199 adults with the chronic condition has reported on it and the quality of life of sufferers in the journal Neurogastroenterology & Motility in an article entitled “Retrograde Cricopharyngeus Dysfunction: How does the inability to burp affect daily life?” 

Most participants complained of abdominal bloating, socially awkward gurgling noises, excessive flatulence, and difficulty vomiting. Only half discussed their symptoms with their primary care clinician, and 90% felt they did not receive adequate help. Participants also reported embarrassment, anxiety/depression, negative impacts on relationships, and work disruption due to R-CPD.

“The condition involves more than just the physical challenge of being unable to burp; it also significantly impacts people’s daily lives, relationships, and mental well-being,” said corresponding author Jason Chen, a medical student at the university. “Future efforts should concentrate on raising awareness about R-CPD, which can help increase identification and treatment rates.”

The condition was first detailed only in 1987 and given a name four years ago. Limited research exists on the fundamental characteristics of this condition, including its impact on a person's life. 

The team distributed a questionnaire on the subreddit “r/noburp,” a community of 26,000 individuals sharing information about R-CPD. Adults aged 18 to 89 experiencing symptoms were invited to participate. Participants reported on their experiences with the dysfunction and its effects on social life on a 4-point Likert scale (1 = strongly disagree to 4 = strongly agree).

Among the 199 respondents, the mean age was 30.9, and gender identity was 74% female and 25% male. Almost everyone (99%) reported an inability to burp and abdominal bloating (98%), some 93% reported socially awkward gurgling noises, 89% excessive flatulence, and 55% difficulty vomiting. As previously mentioned, only half discussed their symptoms with their primary care provider, and 90% maintained that they received adequate help from their doctors.

On a scale of five, the average score for being embarrassed was 3.4, anxiety/depression 3.1, work disruption 2.7 due to their condition, and negative impact on relationships 2.6. 

R-CPD is unfamiliar to many healthcare providers, leaving patients underserved. It not only affects daily life but also personal and professional relationships. Raising awareness by understanding the disease's basic features may increase diagnosis and treatment rates, and improving quality of life, the team concluded.