In the video posted on Reddit this summerLucy Rosenthal's face is first focused and uncertain, she stares into the camera, and then…
She makes a short, croaking burp.
Then there's wide-eyed surprise, followed by uncontrollable laughter. “I got it!” says a Denver woman after burping for the second time in her life.
“It really blows my mind that I’m completely implementing a new bodily function at 26 years old,” Rosenthal later told KFF Health News while working remotely, because as good as the burps were, they were now uncontrollable. “Sorry, sorry. Oh, my God. It was a burp. Did you hear that?”
Rosenthal is among more than 1,000 people who have had the procedure to help them burp since 2019, when an Illinois doctor first reported the steps interventions in a medical journal.
Failure to burp can cause bloating, pain, rumbling in the neck and chest, and excessive gas as the trapped air seeks an alternative escape route. One Reddit user described a gurgling sound like “an alien is trying to escape from me” and a heart attack-like pain that goes away with a fart.
The procedure has become widespread primarily due to increasingly loud noises in bowels of redditThe subreddit for people with or interested in the condition has grown to around 31,000 members, making it one of the platform's largest groups.
Since 2019, this condition has had official name: Retrograde cricopharyngeal dysfunction, also known as “abellchia” or “no burp syndrome.” The syndrome is caused by a malfunction of the muscle that acts as the pylorus of the esophagus, a muscular tube about 10 inches long that moves food between the throat and the stomach.
The procedure to correct this problem involves the doctor injecting 50 to 100 units of Botox, which is twice as much as is usually used for smooth out wrinkles on the forehead – into the superior cricopharyngeal muscle.
Michael KingThe doctor who treated Rosenthal said he had not heard of the disorder until 2020, when the teenager, armed with a list of scientific papers found on Reddit, asked him to perform the procedure.
It wasn't an exaggeration. King, a laryngologist at Peak ENT and Voice Center, has injected Botox into the same muscle to treat people who have difficulty swallowing after a stroke.
Now he's among doctors from Norway to Thailand listed on the subreddit, r/bezrygivanieas offering the procedure. Other doctors, commentators noted, sometimes laughed at them or made them feel like they were being melodramatic.
To be fair, it should be said that doctors and researchers I don't understand why The same muscle that allows food to move down prevents air from moving up.
“It's very strange,” King said.
Doctors also not sure Why do many patients continue to burp long after Botox wears off after several months? Robert Bastianlaryngologist from Chicago, gave the condition a name and invented the procedure. He estimates that he and his colleagues treated about 1,800 people, charging a fee about 4000 dollars cotton.
“We hear that in Southern California it's $25,000, in Seattle it's $16,000, in New York it's $25,000,” Bastian said.
He said that because insurance companies viewed Botox costs as a “red flag,” his patients now pay $650 to cover the cost of the drug so it can be excluded from insurance claims.
The pioneering patient is Daryl Moody, an auto mechanic who has worked at the same Houston Toyota dealership for half his life. The 34-year-old said that by 2015, he had become “desperate” for relief. The bloating and gurgling weren’t just a painful shadow of his day; they were interfering with his new hobby: skydiving.
“I haven't done anything fun or interesting in my life,” he said.
That was until he tried skydiving. But as he gained altitude on the way up, his belly bulged like a bag of chips in mid-air.
“I went to 10 doctors,” he said. “No one seemed to believe me that this problem even existed.”
Then he came across Video on YouTube Bastian describes how Botox injections can fix some throat problems. Moody asked if Bastian could try it to cure his burping problem. Bastian agreed.
He said Moody's insurance company deemed it “experimental and unnecessary,” so he had to pay about $2,700 out of pocket.
“This will honestly change everything,” he wrote on his Facebook page in December 2015 about his trip to Illinois.
A year after his surgery, Moody helped break a national record by being part of the largest group of people to skydive together while wearing the wing suits that turn people into flying squirrels. He has jumped nearly 400 times.
People have been struggling with this question for at least several thousand years. Two thousand years ago, the Roman philosopher Pliny the Elder described a man named Pomponius who couldn't burp. And 840 years ago, Johannes de Howilla included a tasty morsel In the poem he writes: “Pomponius' smoking face found no relief in belching.”
It took several more centuries for clinical examples to emerge. In the 1980s some case reports In the United States, people were described as unable to burp and had no memory of vomiting. One woman, doctors wrote, “was unable to voluntarily burp with her childhood friends when it was a popular game.”
The patients were in severe pain, although doctors could not find any abnormalities in their anatomy. But doctors confirmed with the method it's called manometry that patients' upper esophageal sphincters simply won't relax—not after a meal of a sandwich, a glass of milk, and a candy bar, not after doctors use a catheter to inject several ounces of air under the stubborn valve.
Andre SmootA gastroenterologist at the University of Amsterdam in the Netherlands said he read the reports when they came out.
“But we had never seen this disease, so we didn't believe it existed in real life,” he said.
Smout's doubts persisted until he and his colleagues studied a small group patients a few years ago. Researchers gave eight patients with burping difficulties a “burp challenge” in the form of carbonated water and used pressure sensors to watch their throats move. Sure enough, the air remained trapped. A Botox injection solved their problems by enabling them to burp, or, to use the academic term, burp.
“We had to admit that this really exists,” Smout said.
This summer he wrote in Current Opinion in Gastroenterology that the syndrome “may not be as rare as previously thought.” He credits Reddit with bringing its existence to the attention of patients and health care providers.
But he questions how often a treatment can cause a placebo effect. He points to studies that have shown that in conditions such as irritable bowel syndrome, 40% or more of patients treated with a placebo feel their symptoms are improvingThere is also growing awareness of “cyberchondria,” where people desperately search the internet for answers to their ailments, putting themselves at risk unnecessary treatment or further disaster.
In Denver, Rosenthal, a new burper, is open to the idea that the placebo effect may be at work for her. But even if it is, she feels much better.
“I felt nauseous all the time, and that went away a lot after I had the procedure,” she said. So did the bloating and stomach pain. She can drink a beer at happy hour and not feel sick.
She's glad her insurance covered the procedure, and she's coping with the burping. However, she can't burp the alphabet.
“Not yet,” she said.