Inability to burp is a dysfunction of the cricopharyngeal muscle failing to recognise and release the trapped gas below upper oesophageal sphincter leading to retrograde dysfunction of the cricopharyngeal muscle.
In people with no-burp syndrome, the cricopharyngeus muscle never relaxes for burping. The condition's medical name is retrograde cricopharyngeus dysfunction (R-CPD) and it wasn't discovered until 2019.
Botulinum Toxin (Botox®) injection to the Cricopharyngeus muscle remains the standard treatment for this condition and is curative in 80-90 percent of patients. This quick injection is performed through the mouth, and is traditionally done in the operating room under general anesthesia.
Cricopharyngeal dysfunction can be caused by esophageal muscle enlargement, changes in the nerve signaling pathways, scarring of the muscle, radiation, trauma, stroke, or gastroesophageal reflux disease (GERD).
R-CPD can be diagnosed syndromically, using a symptom complex; clinical diagnosis is validated by relief of symptoms after BT injection; and BT into the CPM is an efficacious treatment, whose benefit appears to often last longer than the pharmacologic duration of action of BT.
Cricopharyngeus muscle myotomy: The definitive treatment for cricopharyngeal dysfunction is a procedure called cricopharyngeus muscle myotomy. In this procedure, a doctor cuts the UES to prevent it from over-tightening, so food is no longer blocked from the esophagus.
How does the cricopharyngeal muscle relax? Swallowing helps to relax the cricopharyngeal muscle. This is why eating and drinking seems to temporarily ease symptoms.
Cricopharyngeal dysfunction is relatively rare . It affects the muscle at the top of the throat called the cricopharyngeal muscle (CPM). This causes problems with the upper esophageal sphincter (UES).
Individuals with cricopharyngeal spasm may describe a persistent sensation—usually felt precisely at the level of the cricoid cartilage—of something stuck in the throat, like a “wad of phlegm” or a “golf ball,” which the person cannot swallow or spit out.
Cricopharyngeal spasms can also be associated with acid reflux conditions, which include gastroesophageal reflux disease, GERD. Inflammation can also cause the esophageal and surrounding muscles to swell, leading to a feeling of restriction in the throat.
Patients have often seen multiple doctors complaining of these symptoms but as this is a newly described disorder it often goes undiagnosed or misdiagnosed as gastro-oesophageal reflux disease (GORD). The diagnosis is most often made by an ENT surgeon with expertise in recognising and treating the condition.
A few simply cannot vomit; more often it is possible but only after strenuous retching. Vomiting (spontaneous or self-induced) always begins with a very loud noise and major release of air in a phenomenon we call “air vomiting.” Emetophobia can be major.
Inability to burp is a dysfunction of the cricopharyngeal muscle failing to recognise and release the trapped gas below upper oesophageal sphincter leading to retrograde dysfunction of the cricopharyngeal muscle.
Inability to burp or belch occurs when the upper esophageal sphincter (cricopharyngeus muscle) cannot relax in order to release the “bubble” of air. The sphincter is a muscular valve that encircles the upper end of the esophagus just below the lower end of the throat passage.
Not being able to burp happens when the upper esophageal sphincter loses its ability to release air for some reason. The upper esophageal sphincter is a muscular valve surrounding the upper part of the esophagus (food pipe) just below the throat passage.
Control your stress – Esophageal spasms seem to be more common or more severe in people who are feeling stressed. Control stress by getting more sleep, using relaxation techniques and avoiding caffeine. Take a peppermint lozenge – Peppermint oil is a smooth-muscle relaxant and might help ease esophageal spasms.
Heartburn or indigestion can cause stomach acid to leak up into the esophagus and cause sharp chest pains from burping. Acid reflux, also known as gastroesophageal reflux disease (GERD), can cause air to become trapped in your esophagus.
Upper esophageal sphincter (UES) dysfunction occurs when the muscles of the upper esophagus, specifically the cricopharyngeus, develop impaired relaxation. Symptoms include progressive dysphagia from pills to solids and then liquids. Diagnosis is made from a thorough history and Modified Barium Swallow Study (MBSS).
Cricopharyngeal myotomy is a surgical procedure to improve swallowing function. Sometimes patients may have tightness or incomplete relaxation at the top muscle of the esophagus, the swallowing tube that goes to the stomach, which makes it difficult to swallow.
It can also cause cricopharyngeal spasm. Postnasal Drip – allergy resulting in excessive mucous production from the postnasal space can track down into the throat can cause globus sensation.
Motor innervation of the cricopharyngeus muscle by the recurrent laryngeal nerve.
Incoordination or hypertonicity of the cricopharyngeus muscle may lead to a range of symptoms, including dysphagia and aspiration [2,4].