Retrograde cricopharyngeal dysfunction can significantly impair a person’s quality of life. It results from a dysfunction of the cricopharyngeus muscle, a sphincter located in the upper part of the esophagus. This sphincter remains closed and prevents the retrograde evacuation of gases in the form of burps. Fortunately, there are treatments for R-CPD. Find out what are the causes and treatments for retrograde cricopharyngeal dysfunction.
Retrograde cricopharyngeal dysfunction: what is it?
Retrograde cricopharyngeal dysfunction, also known as Retrograde Cricopharyngeal Dysfunction (R-CPD) syndrome, results in the inability to burp. This pathology was only identified recently, in 2019, by Dr Robert Bastian, specifies the journal Neurogastroenterology and Motility. The cause is the upper esophageal sphincter which does not relax to allow retrograde gas to pass. The gases then remain trapped in the esophagus, intestines and stomach. This leads to bloating, abdominal pain, flatulence and severe gurgling. This dysfunction, through the clinical signs it causes, considerably alters the quality of life of patients and can affect their mental health (anxiety, depression) and their social relationships.
Causes of Retrograde Cricopharyngeal Dysfunction (R-CPD) syndrome
To understand retrograde cricopharyngeal dysfunction syndrome, we must focus on the functioning of the upper esophageal sphincter. This circular sphincter, located at the upper mouth of the esophagus, is called the cricopharyngeus muscle. In a healthy person, this sphincter relaxes at two key times. During meals, to allow food to descend towards the stomach, or during the emission of gas, to allow their evacuation in the form of belching. The rest of the time it contracts. In a person subject to retrograde cricopharyngeal dysfunction, this sphincter cannot relax, or at least not in a coordinated way, to allow gas to rise and escape through the mouth, or to regurgitate. On the other hand, it functions correctly in the sense of swallowing.
Treatments for retrograde cricopharyngeal dysfunction
Retrograde cricopharyngeal dysfunction can be treated by injecting botox into the sphincter, explains Doctor Robert Bastian in Laryngopedia. This injection of botulinum toxin will allow the cricopharyngeal muscle to relax for several months and therefore the gas to be evacuated. This injection can be performed without general or local anesthesia, using the anterior cervical route.
Sources
- Supraesophageal swallowing disordersFrench Association for Continuing Medical Education in Hepato-Gastroenterology, 2023
- Throat motor disordersThe MSD Manual, March 2022
- Retrograde Cricopharyngeal Dysfunction: How Does the Inability to Burp Affect Daily Life?Neurogastroenterology and Motility Journal, December 2023
- Inability to burp?Laryngopedia, 2024
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