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“Looking back, I realized I had never burped in my entire life,” says Isabelle Zeidner, a 23-year-old Columbia social work grad student who lives in New York City. “I noticed it more as I got older. Whenever I ate or drank, I could never release any air. Instead, my throat would make a loud gurgling sound.”
Most people take burping for granted, but for those with a condition called retrograde cricopharyngeus dysfunction (RCPD), also known as “no-burp syndrome,” it’s physically impossible. Some people have a muscle in the throat that fails to relax, causing excess air to be trapped in the esophagus. Pressure in the chest can increase, and those living with the condition may also experience bloating and unusual gurgling sounds.
Until recently, RCPD wasn’t even on most doctors’ radar. The condition isn’t new, but it wasn’t officially recognized — or even named — until 2019. A community of more than 30,000 users with the same puzzling symptoms found each other on Reddit, and when Zeidner discovered the forum, she realized she wasn’t alone and that there might finally be a medical explanation for her symptoms.
With this new perspective, Zeidner developed a strong suspicion that she had RCPD. Still, it wasn’t until she met Seth Kaplan, MD, director of the Center for Voice, Airway and Swallowing at Northwell Health’s Lenox Hill Hospital, that she gained certainty: Dr. Kaplan could not only definitively diagnose her RCPD, but he could provide a treatment that would bring Zeidner long-lasting relief.
As the medical field gains more insight into RCPD, experts like Dr. Kaplan are diagnosing the condition with growing frequency. To understand why symptoms like Zeidner’s occur, how no-burp syndrome is diagnosed and what treatment looks like, it helps to learn more about RCPD itself.
What is RCPD?
RCPD occurs when a small muscle in the throat called the cricopharyngeus doesn’t relax properly.
“The cricopharyngeus muscle acts as a gateway between the throat and esophagus, opening and closing as we swallow to let food or drink pass down to the stomach,” Dr. Kaplan explains. “But for those with RCPD, this muscle remains tightly closed when air tries to escape, trapping pressure in the stomach and chest.”
Also known as the upper esophageal sphincter, the cricopharyngeus hugs the top of the esophagus and only relaxes briefly to allow food, liquids or trapped air through. Each time you swallow, small amounts of air travel down the esophagus along with food and drink. When enough air accumulates in the stomach, the cricopharyngeus normally relaxes to release it upward, a natural process we recognize as a burp.
While the exact cause of cricopharyngeus muscle dysfunction isn’t fully understood, researchers suspect it may