Understanding Retrograde Cricopharyngeus Malfunction: Key Points
Retrograde Cricopharyngeal Dysfunction (RCPD) is a recently identified digestive disorder that affects the upper part of the esophagus. First described in 2019, RCPD is still a relatively new condition, with much remaining unknown about its causes and potential complications.
Prevalence and Causes
The exact prevalence of RCPD is not yet clear, but it shares similarities with other conditions affecting the cricopharyngeal muscle, such as cricopharyngeal dysfunction. This muscle plays a crucial role in swallowing, separating the esophagus from the pharynx. When this muscle fails to relax, it can cause difficulties in swallowing, leading to a retrograde or backward flow of food. Conditions like gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) might exacerbate symptoms by causing inflammation or irritation of the upper esophageal area.
Common Symptoms
Symptoms of RCPD can include stomach pain, a feeling of fullness, excessive gas, loud digestive noises, gas or flatulence, abdominal pain or discomfort, a feeling of fullness or pain in the throat or chest, and an inability to burp or belch in some people. In some cases, an inability to vomit may also occur.
Treatment Options
The primary treatment for RCPD is Botox injections, which can paralyze muscles in very small doses. This treatment has shown promising results, with a study of 85 people with RCPD revealing that 88.2% responded positively to Botox treatment. The most common side effect of this treatment is mild and temporary difficulty swallowing, affecting 30.6% of participants.
Traditional treatments for cricopharyngeal dysfunction, such as dilation of the affected area and surgical interventions like cricopharyngeal myotomy, may also be considered for managing RCPD. Additionally, dietary adjustments, such as eating smaller, more frequent meals and avoiding irritants like citrus or spicy foods, can help reduce symptoms.
Diagnosis and Consultation
Because RCPD is a relatively new condition, many doctors may not be familiar with it. Therefore, if a person cannot burp, especially if they have never been able to burp, their symptoms cause pain or distress, or they have other digestive symptoms, it is best to consult a doctor. A gastroenterologist may be particularly helpful in diagnosing and managing RCPD.
As of yet, there are no large studies on the prevalence of RCPD, as it is a recent discovery. Researchers are still working to understand what factors may affect vomiting in RCPD, and no harmful complications have been identified, although intense pain can occur. RCPD can affect both children and adults, but most research to date has focused on adults.
In a study of a 19-year-old with RCPD, it was suggested that his inability to burp as an infant may have contributed to his vomiting. Further research is needed to fully elucidate the causes, prevalence, and optimal management strategies for RCPD.
