Understanding No Burp Syndrome

Isabel Zidner, 23, first sensed something was off with her body around the age of nine or ten. She often felt discomfort and an unusual sensation related to burping.

Reflecting on her experience, Zidner mentioned, “It was really strange.” She started noticing this issue in fifth grade and it persisted throughout her high school years.

Interestingly, she also realized that certain foods led to peculiar sounds when she ate, which became particularly noticeable during intimate moments.

Additionally, she faced bouts of bloating, heartburn, and vomiting when the discomfort intensified, but those close to her often dismissed it as mere acid reflux. In reality, she was dealing with retrograde pharyngeal dysfunction (R-CPD).

This condition means that the muscles in her esophagus weren’t working correctly, preventing her from burping properly.

To get to the bottom of her digestive issues, Zidner underwent various tests, including endoscopy, but those results came back normal, which added to the confusion.

Eventually, she consulted Dr. Seth Kaplan, an otolaryngologist affiliated with Northwell Health Voice and Swallowing Disorders Center. When he investigated her symptoms, he asked a series of questions to assess her condition.

• “Have you ever been able to burp?”
• “Do you feel bloated?”
• “Is your gas increasing?”
• “Do you hear any unusual noises in your throat or chest?”

After answering these questions, Zidner remembers him saying, “Yes, you definitely have this condition.”

With a background in social work from Columbia University, Zidner underwent a Botox treatment in April, which helped her muscles relax and enabled her to burp.

Dr. Kaplan explained that these muscles normally function as valves, allowing food into the esophagus while letting air out. “You need to relax them briefly to avoid reflux during swallowing,” he noted.

He also mentioned that awareness of R-CPD, sometimes referred to as “No Burp Syndrome,” is growing as more cases are recognized.

Zidner shared a TikTok video showcasing her journey, which garnered nearly 20 million views, with many viewers expressing relatable sentiments in the comments.

The reasons behind R-CPD aren’t entirely clear. Zidner indicated that her family had no similar conditions, and while she was a “cooly” baby, there were no obvious genetic links.

Dr. Kaplan pointed out that, while specific genetic or developmental factors haven’t been conclusively linked to R-CPD, potential causes could include neurological issues or heightened muscle tone, though these theories remain unproven.

Common symptoms include throat noises, abdominal bloating, and chest pressure, which can sometimes lead to pain. Unfortunately, R-CPD typically doesn’t resolve on its own and can cause significant discomfort if left untreated.

One treatment approach is a surgical procedure to reduce muscle mass, though this is rarely needed. Dr. Kaplan noted that Botox injections have a high success rate, with many patients experiencing relief after just one treatment.

These injections typically begin to work within two to three days. Some side effects might include a sore throat or occasional belching for a short period.

“After treatment, I can finally enjoy fizzy drinks without discomfort,” Zidner expressed. “It’s truly a lifesaver.”