Botox for burping? Doctors use injections to treat ‘no burp syndrome’

Burping is often considered a “faux pas” because it can be embarrassing and off-putting, especially in social situations.

But for some, the inability to belch can be a problem that can cause discomfort. There’s even a medical name for this condition: retrograde cricopharyngeal dysfunction (R-CPD), also known as “no-burp syndrome.”

The cricopharyngeus is the main muscle of the upper esophageal sphincter, the upper gateway to the digestive tract. Without burping syndrome, this muscle does not relax, which interferes with the burping process, according to Neil Chheda, MD, associate professor and vice chair of the department of otolaryngology and chief of the division of laryngology at UF Health in Gainesville, Florida.

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“Both men and women can be affected, and the risk factors for developing this disease are not known,” Chheda told Fox News Digital.

It may not seem like a serious problem, but it can lead to serious problems, the doctor said.

“Those who cannot burp may report quality of life issues, such as bloating, gurgling, and discomfort with certain foods and drinks, like soda,” Chheda said.

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Priya Krishna, MD, an otolaryngologist in the department of head and neck surgery at Loma Linda University in California, agreed that no burping syndrome can cause “significant psychological distress” in the person affected.

“It actually seriously affects an individual’s life, making social situations awkward because the gurgling can be loud and the flatulence excessive,” she told Fox News Digital.

“Those who cannot burp may report quality of life issues, such as bloating, gurgling, and discomfort with certain foods and drinks.”

If over-the-counter options, prescription medications and lifestyle changes don’t solve burping problems, patients can turn to Botox for a potential cure, medical experts say.

Whether injected into the face for a cosmetic procedure or elsewhere in the body for a functional reason, Botox works by preventing a motor nerve from releasing the chemical transmitter that signals a muscle to contract, explained Dr. Chheda d ‘UF Health.

“When Botox is injected into the cricopharyngeus, the muscle cannot contract and thus relaxes and allows evacuation of the esophagus.”

As a result, it can help the patient burp.

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Dr. Krishna of Loma Linda University told Fox News Digital that a Botox injection can be a very safe procedure as long as it is injected into the correct, intended muscle.

“This means that a surgeon who is familiar with the anatomy — as all otolaryngologists are — injects the cricopharyngeus muscle,” she said.

The remedy was discovered by Robert Bastian, MD, an otolaryngologist (ear, nose, and throat doctor) and director of the Bastian Voice Institute in Downers Grove, Illinois.

“I subspecialized in laryngology (the ‘T’ in ENT), which stands for voice, swallowing, upper airway, sensory neuropathic cough and inability to burp, or R-CPD,” he told Fox News Digital. “So I describe myself as a ‘laryngologist’.”

Bastian said he pioneered the procedure that involves injecting Botox into the cricopharyngeus muscle, allowing it to relax and allow burping.

What to expect from the procedure

There are two methods for using Botox to induce burping, according to Bastian.

The first is a brief procedure under general anesthesia in an outpatient operating room.

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“A simple ‘scope’ procedure allows you to see the sphincter, at the junction between the bottom of the throat and the opening to the esophagus,” the doctor told Fox News Digital. “A small needle is then inserted into the muscle to inject Botox.”

Due to the anesthesia, someone must drive the patient home after the procedure.

The second method involves injecting the muscle while the patient is seated in a chair in a doctor’s office.

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“A needle is inserted into the muscle from the side of the neck. The surgeon uses surface landmarks and three-dimensional visualization, and an EMG machine monitors and verifies the placement of the muscle,” Bastian described.

The patient can drive to and from the procedure since only local anesthesia is used.

Bastian said it has been rewarding to pioneer the Botox method.

“It has been a great privilege to be the one who ‘discovered’ and codified the diagnosis and helped disseminate the information to other doctors…and most importantly, it has been an honor to work with lovely patients who have suffered so much and for so many things for a long time with this terrible disorder,” he told Fox News Digital.

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One patient of Bastian’s spoke about the effectiveness of the procedure, saying it allowed him to burp, “all the gurgling is gone” and “the bloating is almost entirely gone,” the doctor shared.

The patient also noted that this procedure “dramatically” improved his daily life.

Fox News Digital has contacted the Botox manufacturer and the U.S. Food and Drug Administration (FDA) for comment.