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Outcomes in the Management of Pediatric Retrograde Cricopharyngeal Dysfunction

Aidan P Wright1, Vivian Jin1,2, Nathaniel B Hunter1

  • 1McGovern Medical School, UTHealth Houston, Houston, Texas, USA.

The Laryngoscope
|March 23, 2026
PubMed

Insights

Pediatric retrograde cricopharyngeal dysfunction (RCPD) is effectively treated with botulinum toxin injections. Most children experience complete symptom resolution, showing better long-term outcomes than adults.

Area of Science:

  • Otolaryngology
  • Pediatric Gastroenterology

Background:

  • Retrograde cricopharyngeal dysfunction (RCPD) is a condition affecting the ability to belch.
  • Symptoms in children can be misdiagnosed or overlooked due to communication challenges.

Purpose of the Study:

  • To review the presentation and treatment outcomes of pediatric patients with RCPD.
  • To evaluate the efficacy and safety of cricopharyngeal botulinum toxin injection (CPBTI) for pediatric RCPD.

Main Methods:

  • Retrospective chart review of pediatric patients diagnosed with RCPD and treated with CPBTI.
  • Data collected included demographics, clinical presentation, treatment outcomes, and complications.

Main Results:

  • Twenty-five pediatric patients (ages 4-17) were analyzed; 72% were female.
  • Common symptoms included inability to belch, bloating, flatulence, and throat gurgling.
  • 100% of patients experienced symptomatic improvement, with 88% achieving complete resolution after CPBTI.

Conclusions:

  • Pediatric RCPD presentation is similar to adults, but recognition may be delayed in younger children.
  • Pediatric patients demonstrated higher long-term success rates and better tolerance to CPBTI compared to adult literature.
  • Early recognition and treatment of pediatric RCPD can reduce long-term sequelae and treatment morbidity.
Abstract

Keywords:
RCPDR‐CPDabelchiabotulinum toxinchildrencricopharyngeus muscleinability to belchpediatricsretrograde cricopharyngeal dysfunctionretrograde cricopharyngeus muscle dysfunction

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