What is RCPD? (Symptoms, Treatments, Outlook)

Retrograde cricopharyngeus dysfunction (RCPD) is a medical condition also known as no burp syndrome in which affected people are not able to belch. This leads to significant discomfort, bloating, and excessive flatulence.

People who struggle with this problem often feel unsure of what treatments may be available or what their outlook is. Learn more about RCPD, how you can get an accurate diagnosis, and what treatments may suit you best.

What is RCPD?

RCPD is a condition that occurs when the cricopharyngeus muscle, which sits at the top of the esophagus, does not relax. This means it doesn’t allow air to exit, making it impossible to burp.

When you swallow food or liquid, it moves through the mouth to the end of the throat and to the esophagus. The cricopharyngeus muscle, which is a sphincter muscle, relaxes just enough to allow the food or liquid to pass so that it can get to the stomach.

Each bite of food or sip of liquids introduces a bit of air into your body and also makes its way to your stomach. When enough air builds up, your body will attempt to release it by making it travel back up the esophagus, where it prompts the cricopharyngeus muscle to relax again. You can then belch out the air.

Someone with RCPD has a cricopharyngeus muscle that doesn’t work as it should. It allows food, liquids, and air in, but it doesn’t let air back out. This causes it to accumulate in the stomach.

Symptoms of RCPD

The buildup of air that RCPD causes can lead to significant discomfort. Some of the most common RCPD symptoms include:

• Excessive flatulence

• Nausea

• Abdominal bloating

• Abdominal or chest pain

• Gurgling noises from the chest and neck

• Trouble vomiting

  
  

This condition can seriously impact our quality of life, making it vital to seek help. But how do you know for certain that you have the condition, and what treatment options are available for RCPD?

Diagnosing Retrograde Cricopharyngeal Dysfunction

If you suspect you have this condition, the first step is to go to your doctor, usually a specialist in otolaryngology, to get an official diagnosis. Your doctor will perform a physical exam and a few diagnostic tests.

The process will begin with a medical history review and a look at the symptoms you’re experiencing. Let the physician know about the severity of the symptoms, whether they have worsened over time, and anything else you think could be relevant.

Your doctor will then examine your throat and might perform a flexible nasopharyngoscopy, which involves the use of an endoscope. An endoscope is a thin tube that has a camera and light and is inserted through your nose into your throat, allowing your doctor to see how the cricopharyngeus muscle functions.

The otolaryngology expert will inject the muscle with Botox to see if it relaxes. If the botulinum toxin injection allows you to burp and relieves some or all of the symptoms, you have an official diagnosis of RCPD.

If an esophagoscopy is not the best way of injecting Botox, your physician can perform an EMG-guided injection. This requires them to use an EMG device to find the cricopharyngeus muscle and perform the injection through the skin.

RCPD Treatment Options

If you’re living with this condition, it’s important to understand what treatments are available.

Botox Injections

The main treatment option is Botox injections. Botox is a neuromodulator made of botulinum toxin that temporarily interrupts the signals the brain sends to the targeted muscles, telling them to contract. The Botox is injected into the cricopharyngeus muscle under general anesthesia or via an EMG-guided injection.

Partial Cricopharyngeal Myotomy

RCPD patients who don’t see an improvement with Botox injections have the option to receive a partial myotomy of the cricopharyngeal muscle. 

This is a neck surgery that requires a surgeon to insert an endoscope into the throat so that they can cut partially into the cricopharyngeus muscle. The cut allows the muscle to relax so that air can exit the stomach.

Treatment Side Effects

If you receive a Botox injection for the treatment of RCPD, what can you expect in the days after? Typically, the side effects won’t be severe, but they can include acid reflux as well as a feeling that food gets stuck in the back of the throat. Some people also have the sensation that there’s a lump they can’t seem to swallow.

These side effects typically resolve on their own within a few days. If they don’t, they get worse, or you experience difficulty swallowing (dysphagia), speak with your doctor.

Botox injections are preferable to a myotomy because there tend to be more complications with surgical procedures. Infections can occur, as can damage to the esophagus. In rare cases, nerves in the area can suffer damage, too, potentially leading to vocal cord weakness or hoarseness.

Outlook for Those Living With RCPD

Living with RCPD can be frustrating, but receiving a Botox injection for the problem offers lasting relief. 

The injections often last close to eight months, and many people don’t require a second injection because the botulinum toxin can teach the muscle to remain relaxed. If you feel symptoms begin again, however, visiting your clinician for further treatment is necessary.

RCPD Treatment in NYC

If you have been struggling with symptoms of RCPD that are severe enough to impact your quality of life, it’s time to reach out to professionals who can help you address the problem. In NYC, the team at New Look New Life provides RCPD treatment in the form of Botox injections. 

Our physician performs these treatments under general anesthesia to ensure your comfort.

You don’t have to struggle with discomfort, bloating, and excessive flatulence when there are options. Contact our team at New Look New Life to schedule your consultation with our experts.