Breaking the silence: How one doctor is transforming No Burp Syndrome care

Retrograde cricopharyngeus dysfunction (R-CPD), also known as “No Burp Syndrome,” is a rare condition in which people are unable to burp or belch.

It occurs when the cricopharyngeus muscle, a sphincter muscle at the top of the esophagus, can’t relax and doesn’t open to allow air to exit the esophagus.

Along with the lifelong inability to burp or belch, symptoms can include abdominal and/or chest bloating and pain, excessive flatulence, nausea, gurgling noises from the neck or chest and difficulty vomiting or fear of vomiting (emetophobia).

“A lot of people may not have heard about R-CPD because it is a newly described condition,” explained laryngologist Michael Lerner, MD, director of the Voice Center at Greenwich Hospital and assistant professor of Surgery, Yale School of Medicine.

Dr. Lerner began treating R-CPD about four years ago and it’s now one of the most common conditions he treats. The main treatment is a Botox injection into the cricopharyngeus muscle that can be performed endoscopically under general anesthesia or with electromyography (EMG) guidance that allows doctors to inject Botox through the skin.

“I no longer suffer for hours every time I eat or drink,” said one of Dr. Lerner’s recent R-CPD patients. “I don't have to sit in meetings waiting to run to the bathroom to relieve the pressure in my chest and throat. I can enjoy relaxing conversations after dining out with friends and family, and my confidence has soared. Dr. Lerner and his staff are amazing.”

There is still much to be learned about No Burp Syndrome, but Dr. Lerner is optimistic about the future of treatment, especially at Greenwich Hospital.

“I am proud that the Yale Medicine Voice Center here in Greenwich has become a national hub for R-CPD treatment and research,” he said.