What is Cant-Burp Syndrome?
If you have never been able to burp — or lost the ability at some point — you may have a condition called retrograde cricopharyngeal dysfunction (RCPD), more commonly known as cant-burp syndrome or no-burp syndrome. RCPD occurs when the cricopharyngeus muscle — the small valve at the top of the esophagus — fails to relax in the retrograde direction, trapping swallowed air in the esophagus and stomach with no way to escape upward.
Though only formally named in 2019, RCPD has quickly gained recognition thanks in large part to online patient communities where thousands of people discovered they shared the same puzzling, often embarrassing, and frequently dismissed symptoms.
Common Symptoms of RCPD
- Complete or near-complete inability to burp
- Bloating, abdominal distension, and uncomfortable chest pressure
- Uncontrollable gurgling or bubbling sounds from the throat or chest — often audible to others
- Excessive flatulence as the only available route for trapped gas
- Worsening symptoms after eating, drinking, or consuming carbonated beverages
- Social anxiety and embarrassment related to gurgling sounds and bloating
Many of these symptoms overlap with conditions like IBS or GERD, which is one reason RCPD is so frequently missed or dismissed — sometimes for years — before the correct diagnosis is made.
Diagnosis & Treatment
RCPD is a condition where finding the right specialist makes all the difference. Dr. Benjamin Rafii has firsthand experience diagnosing and treating RCPD, and understands the relief that an accurate diagnosis — and effective treatment — can bring to patients who have long been told nothing is wrong.
Diagnosis is primarily clinical, based on a thorough history and flexible laryngoscopy. The standard and highly effective treatment is Botox injection into the cricopharyngeus muscle, which relaxes the valve and restores the ability to burp. For patients with incomplete response to Botox, the BERP (Behavioral Eructation Retraining Protocol) — a specialized behavioral therapy focused on facilitating eructation — has shown promise as a complementary approach.
Related Conditions: Cricopharyngeal Dysfunction & Zenker's Diverticulum | Swallowing Disorders / Dysphagia
Related Treatments: Cricopharyngeus Botox for RCPD
Related Services: Swallowing Evaluation
If you suspect you may have RCPD or cant-burp syndrome, Dr. Rafii and his team are here to help. Contact us today to schedule a consultation at The Laryngology & Voice Center of Beverly Hills — same- and next-day appointments are available.