[Retrograde cricopharyngeal dysfunction (inability to belch) - a »new« diagnosis that deserves attention]

The belching reflex involves transient lower oesophageal sphincter relaxation and relaxation of the cricopharyngeus (CP). In some individuals, the  latter stage fails,leading to return of gas to the stomach. This pattern is then repeated, which is accompanied by chest pain and loud, gurgling noises. Abdominal distension, epigastric pain and excessive flatulence are other common symptoms. Since CP relaxation is normal during deglutition, the syndrome is called retrograde CP dysfunction (RCPD). The anamnesis should be supported by e.g. manometry under conditions stimulating belching to validate the diagnosis. First-line treatment is injection of botulinum toxin (botox) into the CP. The prevalence is unknown and although RCPD is rare, a large number of confirmed and self-diagnosed RCPD patients have emerged in social media after dissemination of the efficacy of botox. RCPD patients suffer considerably, and awareness of the disease must therefore increase in the medical community.