Thank you for the detailed answer, first time I’ve heard of anyone not being able to burp but it sounds very unpleasant. So the Botox treatment can solve or at least alleviate the issue?
Yeah, there’s basically a “valve” muscle in the esophagus called the upper esophageal sphincter (either a part of the cricopharynx, vice versa, or they’re the same… Not sure). It stays closed for the most part, but opens for swallowing and burping. Swallowing is generally fine, but burping not so much. You may have seen the term R-CPD in the thread, that stands for Retrograde (outward direction) Cricopharyngeal Dysfunction. There’s a similar condition called achalasia, which is also treated with Botox, but that also has swallowing issues unlike R-CPD.
Anyway, the Botox helps that muscle relax. The body metabolizes it after several months, but in that time you have “training wheels” that help develop muscle memory to burp. About 80% of people are “one and done” with that one shot. I personally had a second and don’t really have “tasteable” burps, but I do have small ones that seem to help.
It’s funny, because before I suspected that issue in my daughter we saw a pediatric ENT (the type of doctor who performs the procedure). Knowing it’s an obscure thing many doctors have a hard time grasping, I told him about it figuring it may plant a seed for some parent in the future. His response? “That’s funny, I don’t burp either. What you said makes sense though.” I would have loved to go back to him, but unfortunately he moved across the country in the meantime. Ended up going to another doctor in the practice who is amazing though!
Thank you for the detailed answer, first time I’ve heard of anyone not being able to burp but it sounds very unpleasant. So the Botox treatment can solve or at least alleviate the issue?
Yeah, there’s basically a “valve” muscle in the esophagus called the upper esophageal sphincter (either a part of the cricopharynx, vice versa, or they’re the same… Not sure). It stays closed for the most part, but opens for swallowing and burping. Swallowing is generally fine, but burping not so much. You may have seen the term R-CPD in the thread, that stands for Retrograde (outward direction) Cricopharyngeal Dysfunction. There’s a similar condition called achalasia, which is also treated with Botox, but that also has swallowing issues unlike R-CPD.
Anyway, the Botox helps that muscle relax. The body metabolizes it after several months, but in that time you have “training wheels” that help develop muscle memory to burp. About 80% of people are “one and done” with that one shot. I personally had a second and don’t really have “tasteable” burps, but I do have small ones that seem to help.
It’s funny, because before I suspected that issue in my daughter we saw a pediatric ENT (the type of doctor who performs the procedure). Knowing it’s an obscure thing many doctors have a hard time grasping, I told him about it figuring it may plant a seed for some parent in the future. His response? “That’s funny, I don’t burp either. What you said makes sense though.” I would have loved to go back to him, but unfortunately he moved across the country in the meantime. Ended up going to another doctor in the practice who is amazing though!