R-CPD or reflux? How to tell it apart from IBS and globus
Quick summary
- R-CPD often gets mistaken for reflux, IBS or anxiety.
- The big clue is simple: can you burp at all?
- You can't diagnose yourself, but you can give your GP the right clues.
Bloating, chest pressure, odd noises, lots of wind. These could point to a few different things, which is why so many people ask: is it R-CPD or reflux? Or IBS? Or that "lump in the throat" feeling called globus? This guide walks through the differences in plain English.
Why R-CPD gets mixed up with other things
R-CPD (retrograde cricopharyngeus dysfunction) is when a little ring of muscle at the top of your food pipe won't open to let air out. So you can't burp (opens in a new tab).
It's only had a name since 2019 (opens in a new tab), and lots of its signs overlap with other conditions. A 2026 review says these symptoms are often put down to IBS or indigestion, apart from the gurgling noises in the chest (opens in a new tab).
It happens a lot. In one study of 67 people with R-CPD, 64% had been given a different diagnosis first (opens in a new tab). Of those:
- 51% were told it was reflux (opens in a new tab)
- 33% were told it was anxiety, mood or "functional" symptoms (opens in a new tab)
- 28% were told it was IBS (opens in a new tab)
And medicine didn't help much. Only 7.5% got better with the medicines they were given (opens in a new tab).
R-CPD or reflux?
Reflux is when stomach acid comes back up towards your throat (opens in a new tab). The NHS says the main symptoms are heartburn (a burning feeling in the middle of your chest) and a sour taste in your mouth (opens in a new tab).
Here's where it gets confusing. The NHS also lists bloating, and hiccups that keep coming back (opens in a new tab) as possible reflux symptoms. People with R-CPD get those too. In one survey, 80% had painful hiccups (opens in a new tab).
The difference? Never being able to burp isn't on the NHS list of reflux symptoms (opens in a new tab). With R-CPD, it's the main sign (opens in a new tab). If you've been given reflux medicine and you still can't burp, it's worth mentioning.
R-CPD or IBS?
IBS (irritable bowel syndrome) is a common gut condition (opens in a new tab). The NHS says its main symptoms are tummy pain or cramps, bloating, diarrhoea and constipation (opens in a new tab).
Bloating and wind turn up in both (opens in a new tab). But R-CPD also brings the "can't burp" part, plus gurgling in the throat and chest. In a 2024 survey of people with R-CPD, 99% couldn't burp and 93% had gurgling noises (opens in a new tab). Neither of those is on the NHS list of main IBS symptoms (opens in a new tab).
R-CPD or globus?
Globus is the feeling of a lump in your throat. NHS inform says it is usually not a sign of anything serious (opens in a new tab). It can feel like tightness, mucus you can't clear, or something stuck (opens in a new tab).
With globus, you can usually eat and drink normally (opens in a new tab). It's a feeling, not trapped air. R-CPD is about air that can't get out, so you get the gurgling, bloating and no burps.
Some people do feel throat tightness with R-CPD too. In a big review, globus feelings and throat tightness were among the "other" symptoms (opens in a new tab) some people reported.
So how do I tell?
You can't diagnose yourself, but these questions help:
- Have you ever been able to burp?
- Do you get loud gurgles or croaks from your throat or chest?
- Is the bloating worst after eating or fizzy drinks?
- Have reflux or IBS medicines not helped?
If you said yes to most of these, R-CPD is worth asking about. Lots of people get there first on their own. In a review of 17 studies, patients spotted the condition themselves in 78.9% of cases (opens in a new tab).
When to see a GP soon
Some signs need checking whatever the cause. The NHS says to ask for an urgent GP appointment or call 111 if you have lost a lot of weight for no reason, or you are bleeding from your bottom (opens in a new tab).
See a GP too if food gets stuck in your throat (opens in a new tab) along with heartburn.
The same goes if you are being sick often alongside heartburn (NHS (opens in a new tab)).
Frequently asked questions
Can reflux stop you burping?
Not being able to burp isn't one of the main reflux symptoms the NHS lists (opens in a new tab). If you've never been able to burp, ask about R-CPD.
Is R-CPD the same as IBS?
No. They share bloating and wind, but R-CPD is mainly about not being able to burp (opens in a new tab). IBS is more about tummy pain and changes in your poo (opens in a new tab).
Is globus the same as R-CPD?
No. Globus is the feeling of a lump in your throat (opens in a new tab). R-CPD is air that can't escape, so you can't burp.
Why was I told I had reflux?
It's common. In one study, half of those given another diagnosis were told it was reflux (opens in a new tab), because the signs overlap.
Key points
- R-CPD is often mistaken for reflux, IBS or anxiety.
- Never being able to burp is the big clue.
- Gurgling in your throat or chest also points to R-CPD.
- Globus is a lump feeling, not trapped air.
- Weight loss, bleeding or food sticking need a GP soon.
Read next: What is R-CPD? · Write a letter for your GP · Jargon buster
This is a free resource and not medical advice. Speak to your GP.
Sources
- Bastian and Smithson 2019, OTO Open (free full text) (opens in a new tab)
- Lehmann et al. 2026, narrative review (free full text) (opens in a new tab)
- Cosentino et al. 2025, Toxins (free full text, Table 3) (opens in a new tab)
- Chen et al. 2024, Neurogastroenterol Motil (opens in a new tab)
- Chen et al. 2026, J Clin Med (free full text) (opens in a new tab)
- Lechien et al. 2025, systematic review (free full text) (opens in a new tab)
- NHS: Heartburn and acid reflux (opens in a new tab)
- NHS: Symptoms of IBS (opens in a new tab)
- NHS inform: Globus (opens in a new tab)
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