Burping is often considered a "faux pas," as it can be embarrassing and off-putting, especially in social situations.
But for some, the inability to belch can be an issue that can cause discomfort. There is even a medical name for the condition: retrograde cricopharyngeal dysfunction (R-CPD), also known as "no burp syndrome."
The cricopharyngeus is the main muscle of the upper esophageal sphincter, the top gate of the food pipe. With no burp syndrome, this muscle does not relax, which interferes with the burping process, according to Neil Chheda, MD, associate professor and vice chair in the department of otolaryngology and chief of the division of laryngology at UF Health in Gainesville, Florida.
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"Both men and women can be affected, and risk factors for developing this condition are not known," Chheda told Fox News Digital.
It may not seem like an inability to burp is a big deal, but it can bring severe challenges, the doctor said.
"Those who can’t burp may report quality of life issues, such as bloating, a gurgling noise, and discomfort with certain foods and drinks, such as carbonated beverages," Chheda said.
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Priya Krishna, MD, an otolaryngologist in the department of head and neck surgery at Loma Linda University in California, agreed that no burp syndrome can cause "significant psychological distress" in the affected person.
"It actually severely impacts the life of an individual, making social situations embarrassing because the gurgling can be loud and the flatulence excessive," she told Fox News Digital.
If over-the-counter options, prescription medications and lifestyle tweaks don’t solve the burping issues, patients can turn to Botox for a potential remedy, medical experts say.
Whether it’s injected into the face for a cosmetic procedure or elsewhere in the body for a functional reason, Botox works by preventing a motor nerve from releasing the chemical transmitter that signals a muscle to contract, explained Dr. Chheda with UF Health.
"When Botox is injected into the cricopharyngeus, the muscle can’t contract, and thereby relaxes and permits the venting of the esophagus."
As a result, this can help a patient burp.
Dr. Krishna of Loma Linda University told Fox News Digital that a Botox injection can be a very safe procedure as long as it is injected into the correct and intended muscle.
"That means having a surgeon familiar with the anatomy — as all otolaryngologists are — injecting the cricopharyngeus muscle," she said.
The remedy was discovered by Robert Bastian, MD, an otolaryngologist (ear, nose and throat doctor) and director of Bastian Voice Institute in Downers Grove, Illinois.
"I have subspecialized in laryngology (the ‘T’ of ENT), which means voice, swallowing, upper airway, sensory neuropathic cough and inability to burp, or R-CPD," he told Fox News Digital. "So I describe myself as a ‘laryngologist.’"
Bastian said he pioneered the procedure that involves injecting Botox into the cricopharyngeal muscle, which enables it to loosen and permits burping.
There are two methods of using Botox to induce burping, according to Bastian.
The first is a brief procedure under general anesthesia in an outpatient operating room.
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"A simple ‘scope’ procedure allows one to see the sphincter, at the junction between the low throat and opening of esophagus," the doctor told Fox News Digital. "A tiny needle is then inserted into the muscle to inject Botox."
Because of the anesthesia, someone must drive the patient home after the procedure.
The second method is to inject the muscle while the patient is sitting in a chair in a doctor’s office.
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"A needle is passed into the muscle from the side of the neck. Surface landmarks and three-dimensional visualization are used by the surgeon, and an EMG device monitors and verifies muscle placement," Bastian described.
The patient can drive to and from the procedure since only local anesthesia is used.
Bastian said it has been rewarding to pioneer the Botox method.
"It has been a great privilege to be the one to ‘discover’ and codify the diagnosis and help spread the information to other doctors … and above all, it has been an honor to work with lovely patients who have suffered so much and for so long with this terrible disorder," he told Fox News Digital.
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A patient of Bastian spoke about the effectiveness of the procedure, saying it has allowed them to burp, that "any gurgling is gone," and that "bloating has diminished almost entirely," the doctor shared.
The patient also noted that getting the procedure has "drastically" improved their day-to-day life.
Fox News Digital reached out to the manufacturer of Botox and the U.S. Food and Drug Administration (FDA) requesting comment.
