Symptoms such as bloating and chest discomfort can cause many people to believe they have
gastroesophageal reflux disease (GERD). However, they may also be caused by
retrograde cricopharyngeal dysfunction (RCPD).
Although these two conditions share some similar symptoms, their underlying causes and treatments are entirely different. Understanding these differences is important to ensure you receive the most appropriate treatment.
What Is Gastroesophageal Reflux Disease (GERD)?
GERD is a condition in which stomach acid flows back into the esophagus, causing symptoms such as heartburn, acid regurgitation, a burning sensation in the throat, hoarseness, or a chronic cough that makes a patient’s quality of life worse.
What Is Retrograde Cricopharyngeal Dysfunction (RCPD)?
RCPD occurs when the nerves that control the burping function of the upper esophageal sphincter do not function properly. As a result, the upper esophageal sphincter is not able to relax and does not allow excess air in the stomach and esophagus to escape through burping, leading to excessive gas accumulation in the stomach, esophagus, and intestines.
How Are RCPD and GERD Different?
Although the two conditions may cause some similar symptoms, their underlying causes and disease mechanisms are different.
| Category |
Retrograde Cricopharyngeal Dysfunction (RCPD) |
Gastroesophageal Reflux Disease (GERD) |
| Disease mechanism |
Air or gas accumulates in the stomach and esophagus because the upper esophageal sphincter fails to relax and does not release trapped air. |
Stomach acid flows back into the esophagus because the lower esophageal sphincter is weak or relaxes abnormally. |
| Main cause |
Dysfunctional nerve control of the upper esophageal sphincter responsible for burping. |
Dysfunctional nerve control of the upper esophageal sphincter responsible for burping. Dysfunction of the lower esophageal sphincter or abnormal movement of the esophagus or stomach, lifestyle factors and/or underlying medical conditions. |
| Main symptom |
Inability to burp |
Heartburn and acid regurgitation |
| Associated symptoms |
Excessive flatulence, difficulty vomiting |
Chronic cough, hoarseness, difficulty swallowing, chest pain, tooth decay, bad breath |
| Bloating |
Common |
May occur |
| Acid regurgitation |
Not present |
Common |
| Gurgling noises in the throat |
Common |
May occur |
Why Do Some Symptoms Not Improve After Treating for GERD?
If a patient has been treated for GERD but their inability to burp or bloating does not improve, these symptoms may be caused by another condition.
Because each condition requires a different approach, consulting a specialist for a thorough evaluation can help identify the true cause of the symptoms and ensure appropriate treatment.
When Should You See a Doctor?
You should consult a doctor if you experience any of the following:
- Inability to burp
- Bloating, abdominal fullness, or chest discomfort
- Excessive flatulence
- Symptoms similar to acid reflux that have not improved with treatment
- Symptoms that interfere with daily life
- Concerns about your symptoms
Care for Patients with RCPD and GERD at Bumrungrad
The Gastrointestinal Motility Center at Bumrungrad International Hospital emphasizes accurate diagnoses to distinguish between different gastrointestinal conditions. Our team of specialists focuses on identifying the underlying cause of each patient's symptoms in order to develop a safe and individualized treatment plan.
Sources
For more information please contact:
Last modify: August 28, 2026