Normally, burping is a natural process where excess air from the stomach and esophagus is expelled through the throat and out of the mouth. In people with RCPD, this process doesn't happen — they are unable to burp at all. The result is a buildup of gas in the digestive tract, leading to symptoms like:

• Bloating
• Chest or abdominal pressure
• Discomfort in the upper chest or throat
• Excessive flatulence
• Gurgling noises from the throat or chest
• Difficulty vomiting

The condition is caused by dysfunction of the upper esophageal sphincter (UES) — specifically, the cricopharyngeal muscle. In RCPD patients, the UES does not relax properly in response to rising gas, preventing the air from being released. This leads to the sensation of trapped air and often causes social and physical discomfort.

Diagnosing RCPD starts with a thorough medical history and physical examination. One of the key diagnostic tools is an esophageal manometry, a test that measures the pressure and function of muscles in the esophagus. Additional evaluations, such as swallowing tests with soda water, help determine whether gas is rising to the UES but not being released.

 

The most effective treatment currently available is a Botulinum toxin (Botox) injection into the cricopharyngeal muscle or the upper esophageal sphincter. At Gastrointestinal Motility Center, Bumrungrad International Hospital, this procedure is performed via upper endoscopy under sedation to ensure patient comfort. During the procedure, the physician injects Botox directly into the cricopharyngeal muscle, helping it relaxes and allowing the trapped air to be released through burping. 

This minimally invasive treatment carries very low risk. However, in rare cases, if the Botox affects nearby nerves controlling the vocal cords, it may cause temporary hoarseness. That’s why it is important to undergo this procedure with an experienced specialist. 

Most patients experience relief within a week after a single Botox injection. In some cases, a second dose may be needed. Long-term follow-ups show that the majority of patients enjoy sustained improvement with no need for repeated injections after a year.
 

At Bumrungrad International Hospital’s Gastrointestinal Motility Center, our team of highly specialized gastroenterologists offers expert diagnosis and treatment for RCPD and other functional disorders of the upper gastrointestinal tract. With advanced diagnostics and personalized care plans, we aim to restore your comfort and quality of life.