R-CPD: when someone can't burp

The common signs

• Can't burp, or hardly ever can, often for as long as they remember
• Gurgling or croaking noises from the throat or chest
• Bloating, chest pressure or pain, often worse after food or fizzy drinks
• A lot of wind

(Bastian 2019 (opens in a new tab)) It's often missed. In one study, 64% were first told it was something else, most often reflux (Cosentino 2025 (opens in a new tab)).

It's treatable

The usual treatment is a Botox injection into the muscle. It's done awake in clinic, or as a day case under general anaesthetic.

• Of the first 200 people treated, 99.5% could burp afterwards (Hoesli 2020 (opens in a new tab)).
• In a UK group of 72, 96% kept burping after the Botox wore off (Karagama 2021 (opens in a new tab)).

GPs: it's usually recognised from the symptoms (Laryngopedia (opens in a new tab)). Please consider a referral to an ENT (laryngology) team that treats R-CPD. There's no national NHS policy, so access is decided locally (UK Government, petition 770872 (opens in a new tab)).

Family and partners: the noises and the wind aren't rude, and they're not in the person's head. They can't stop them. Big meals and fizzy drinks can really hurt, so a little patience at mealtimes helps a lot.

Employers and schools: it can be uncomfortable after eating. A short break, a drink of water and somewhere quiet can help. Treatment under a general anaesthetic is usually a day case, so you go home the same day, and you may feel tired the next day (Sulis Hospital Bath (opens in a new tab)).

Anyone: if you can't burp and this sounds like you, you're not alone. Talk to your GP.