Dr Reza Shaker
Principles of Deglutition: A Multidisciplinary Text for Swallowing and its Disorders
Hardcover: 1017 pages
Publisher: Springer; 2013 edition (Sept. 20 2012)
In a recent (2013) medical textbook from Dr. Reza Shaker (Principles of Deglutition), he mentions a condition that he baptized "Cricopharyngismus", consisting in an abnormal relaxation response of the Upper esophageal sphincter (UES) to esophageal gas distension, but with a normal deglutive relaxation in the majority of cases.
It seems that some cases may be related to achalasia of the Lower esophageal sphincter (LES). Achalasia means "failure of muscle to relax", and it seems to be a condition that should be investigated in non-burpers. Cricopharyngismus in Achalasic patients seems have the potential to have serious outcomes, such as marked esophageal distention, tracheal and airway obstruction.
As for Cricopharyngismus in non-achalasic patients, the situation seems to be less dramatic (the inability to burp does not seem to be an achalasia per se, since the UES has the ability to relax during deglution - the defect seems to be in the belching reflex only). He then goes and describes the symptoms of chest pain and a long-standing inability to belch.
definitive diagnosis can be made by UES manometry.
As for the treatment, at the time there does not seem to be any brilliant solution for the condition. Dr. Reza goes:
"Treatment is problematic at this time. Passage of a nasoesophageal tube can vent the trapped gas and relieve the pain acutely, but this is an unacceptable chronic solution for patients. Helpful dietary and lifestyle modifications include avoidance of carbonated beverages and assuming a recumbent position in the immediate postprandial period (to decrease the frequency of the transient lower esophageal sphincter relaxations responsible for most gastroesophageal gas reflux)."
links of some scientific papers referenced by Dr. Reza Shaker in that matter:
- Dysfunction of belching reflex - non-achalasic
- Dysfunction of belching reflex - achalasic patients