Retrograde cricopharyngeal dysfunction (R-CPD): What do we know so far?

Area of Science:

• Gastroenterology
• Otolaryngology
• Neurology

Background:

• Retrograde cricopharyngeal dysfunction (R-CPD) is a recently described clinical entity.
• It stems from the inability of the cricopharyngeus muscle to relax.
• Unlike typical cricopharyngeal dysfunction (CPD) causing dysphagia, R-CPD is primarily marked by an inability to belch.

Purpose of the Study:

• To review the pathophysiology, clinical presentation, and management of R-CPD.
• To elucidate the diagnostic criteria and treatment outcomes for R-CPD.
• To consolidate current knowledge on this emerging condition.

Main Methods:

• A systematic literature review was conducted across Medline, Scopus, Web of Science, and Cochrane databases.
• Search terms included 'Retrograde', 'Cricopharyngeus muscle', 'Dysfunction', 'Abelchia', and 'inability to burp'.
• Eleven relevant articles were selected from an initial 68 identified.

Main Results:

• R-CPD is characterized by the inability to belch, serving as a diagnostic hallmark.
• The underlying cause is the failure of the cricopharyngeus muscle to relax.
• This condition is distinct from well-established CPD, which presents with dysphagia.

Conclusions:

• High-resolution manometry (HRM) is identified as the definitive diagnostic tool for R-CPD.
• Treatment with botulinum toxin injections has demonstrated positive responses in most reported cases.
• Further research into R-CPD pathophysiology and treatment is warranted.