For 52 years, a Singapore man named Daryl lived without a reflex most humans never notice — the ability to burp — while his body quietly accumulated the consequences of that absence. What medicine repeatedly misread as acid reflux or irritable bowel syndrome was in fact retrograde cricopharyngeus dysfunction, a condition so recently named that many doctors had never encountered it. It took a Reddit forum, a research paper, and a specialist at Singapore General Hospital to close the distance between a man's suffering and its cause — and ultimately, a Botox injection to give him something he had
Botox injection cures 52-year 'no-burp' condition, offering relief to rare disorder sufferers
Patient experienced decades of daily discomfort, bloating, excessive flatulence, and self-induced vomiting to relieve trapped gas before receiving effective treatment.
I never knew that when I burp, I could smell the food
Mark
So this man couldn't burp his entire life until age 52. That's not just uncomfortable—what was the actual medical consequence?
Mimi
Gas built up in his stomach with nowhere to go. He felt constantly bloated, had excessive flatulence, and when it got bad enough, he'd force himself to vomit just to release the trapped air. He was doing this regularly at work.
Luke
But here's what I want to know—how many people actually have this? The article says it could affect up to 22 percent of the population, but then says exact prevalence remains unknown. That's a huge range. Is it actually common or actually rare?
Mimi
That's the tension, isn't it. It's formally identified only since 2019, so we don't have good data yet. But the fact that Daryl saw multiple specialists over years and none of them knew what RCPD was suggests it's underdiagnosed, even if the actual number of sufferers is high.
Mark
And the Botox treatment—does it actually cure him, or is he dependent on injections forever?
Mimi
The injections last three months, so he'd need to return for more. But the doctor asks patients to practice burping during that window, hoping the reflex will eventually redevelop naturally. So it's not necessarily permanent, but it's also not just symptom management.
Luke
That's important. The headline says Botox "cures" him, but six months in, we don't actually know if he's cured or if he's going to need another injection soon. We're only seeing the honeymoon period.
Mimi
Fair point. What we know is that after six months, he's burping comfortably without pain or bloating. Whether that lasts depends on whether his brain relearns the reflex.
Mark
Why did it take him so long to find the right diagnosis? He saw doctors for years.
Mimi
RCPD wasn't formally identified until around 2019. Before that, it didn't exist in medical literature. Daryl's symptoms looked like GERD or IBS to the doctors he saw, so that's what they treated him for. He only found out about RCPD by reading Reddit and then finding a research paper by the one specialist in Singapore who studies it.
Luke
So this is partly a story about a rare condition, but it's also a story about how a condition can be invisible until someone names it. Once Leong published his paper, Daryl could find him. Without that paper, Daryl might still be massaging his stomach with medicated oil every night.
Mimi
Exactly. The treatment existed—Leong had been doing Botox injections in Australia—but the diagnosis didn't exist in Singapore until he started researching and publishing on it.
El Pulso
- For decades, trapped gas with nowhere to go turned ordinary meals into ordeals, forcing Daryl to lock himself in bathroom stalls and induce vomiting just to relieve the pressure.
- Years of medical consultations, endoscopies, and misdiagnoses left him cycling through ineffective treatments while the real condition remained unnamed in every clinic he visited.
- A chance encounter with a Reddit post introduced him to RCPD — 'no-burp syndrome' — a condition formally identified only around 2019 and still largely unknown to many practitioners.
- Daryl tracked down the one specialist in Singapore who had published research on the condition, secured a referral, and finally received a confirmed diagnosis on his first visit.
- A Botox injection into his esophageal sphincter muscle relaxed it enough to allow burping, with effects lasting roughly three months and requiring practice to potentially restore the reflex permanently.
- Six months after treatment, Daryl drinks lattes without fear, burps without pain, and describes the experience — with quiet wonder — as liberating after a lifetime of pressure.
For 52 years, a Singapore man named Daryl lived without a reflex most humans never notice — the ability to burp — while his body quietly accumulated the consequences of that absence. What medicine repeatedly misread as acid reflux or irritable bowel syndrome was in fact retrograde cricopharyngeus dysfunction, a condition so recently named that many doctors had never encountered it. It took a Reddit forum, a research paper, and a specialist at Singapore General Hospital to close the distance between a man's suffering and its cause — and ultimately, a Botox injection to give him something he had never once experienced in half a century of living.
Daryl was 52 years old when he burped for the first time. The cybersecurity executive had spent five decades unable to perform something so automatic that most people never think about it — and for much of that time, he didn't realize anything was wrong.
In his mid-40s, the consequences caught up with him. Trapped air accumulated relentlessly, leaving him bloated and in pain. His body rerouted the gas downward, causing waves of embarrassing flatulence. Carbonated drinks and gas-producing foods became impossible. When the pressure grew unbearable, he would retreat to a bathroom stall and force himself to vomit to release the trapped air — audibly enough that colleagues could hear him through the office walls.
Beginning in 2018, Daryl sought answers from gastroenterologists and general practitioners across both private and public hospitals. He underwent endoscopies and colonoscopies. Doctors diagnosed him with GERD, then IBS. Medications did nothing. Each night he massaged his stomach with medicated oil and kept searching for an explanation that fit.
Two years before his breakthrough, a Reddit forum introduced him to a term he had never heard: retrograde cricopharyngeus dysfunction, or RCPD. He raised it with a gastroenterologist in private practice. The doctor had never heard of it. Another year passed. Then Daryl found a research paper on RCPD authored by ENT specialist Leong Zhou Hao at Singapore General Hospital. He obtained a referral and made an appointment.
Leong confirmed the diagnosis at once. RCPD — informally called no-burp syndrome — was only formally identified around 2019. In healthy individuals, the brain senses gas stretching the esophagus and triggers a sphincter muscle to relax, producing a burp. In people with RCPD, that reflex simply never develops. Medical literature suggests the condition may affect up to 22 percent of the population, with roughly 13 percent experiencing severe symptoms.
The treatment is Botox injected directly into the esophageal sphincter, relaxing the muscle and allowing burping. Effects last about three months, requiring repeat procedures, though Leong encourages patients to practice the reflex in hopes it will eventually redevelop naturally. In March 2026, Daryl underwent the procedure under general anaesthesia.
Six months later, he burps freely — without pain, without bloating. He discovered for the first time the smell of food hours after eating it, carried up with each burp. He drinks lattes now without a second thought. His wife, he noted with a laugh, was the happiest person after his treatment. After 52 years, the pressure cooker finally had a valve.
Daryl was 52 years old when he burped for the first time in his life. The cybersecurity executive, who asked not to be identified by his full name, had spent five decades unable to do something most people take for granted—something so automatic that they never think about it at all.
For most of his life, Daryl did not realize his condition was unusual. The inability to burp seemed like just another quirk of his body. But in his mid-40s, everything changed. The trapped air began to accumulate, pressing against his insides with relentless pressure. He felt bloated constantly. His body, desperate to expel the gas somewhere, sent it downward instead, creating waves of embarrassing flatulence. He developed pain. His digestion became unpredictable. Certain foods became impossible—anything carbonated, anything that produced gas in his stomach, turned him into what he described as a pressure cooker with no release valve. When the discomfort became unbearable, he would lock himself in a bathroom stall and force himself to gag, triggering his body to vomit up the trapped air. His colleagues could hear him retching through the office walls.
Daryl spent years chasing answers. Starting in 2018, he saw gastroenterologists and general practitioners at both private and public hospitals. He underwent endoscopies and colonoscopies. Doctors told him he had GERD—gastroesophageal reflux disease, where stomach acid backs up into the food pipe. Others said IBS, irritable bowel syndrome. The medications they prescribed did nothing. The tests found nothing serious, nothing that looked like cancer or a blockage, so the medical system moved on. Daryl kept massaging his stomach with medicated oil each night, kept inducing vomiting when the pressure became too much, kept searching for an explanation that made sense.
Two years before his breakthrough, Daryl found a Reddit forum where someone mentioned a condition he had never heard of: retrograde cricopharyngeus dysfunction, or RCPD. The term meant nothing to him at first, but he recognized himself in the description. He brought it up to a gastroenterologist in private practice. The doctor had never heard of it. Another year passed. His bloating worsened. The nightly ritual with the medicated oil continued. Then, browsing the internet again, Daryl found a research paper on RCPD written by an ear, nose and throat specialist named Leong Zhou Hao at Singapore General Hospital. He felt something shift. This was the person who could help him. He went to a polyclinic, got a referral letter, and made an appointment.
Leong confirmed the diagnosis immediately. RCPD, also called no-burp syndrome, is a relatively rare and underdiagnosed condition, formally identified only around 2019. The mechanism is straightforward: humans swallow air constantly while eating, drinking, and talking. Two sphincter muscles—one at the top of the food passage, one at the bottom—normally stay closed. When we eat, they relax to let food through. When food produces gas, that gas travels back up the oesophagus, stretching it. The brain senses this stretch and triggers the sphincter muscle to relax, allowing a burp. In people with RCPD, this reflex simply never developed. Medical literature suggests the condition could affect up to 22 percent of the population, with about 13 percent experiencing severe symptoms, though exact prevalence remains unknown.
The treatment is Botox—botulinum toxin injected directly into the sphincter muscle in the oesophagus. The toxin relaxes the muscle, forcibly allowing the patient to burp. Leong had performed the procedure while working in Australia. Each injection lasts about three months, requiring repeat treatments, but he encourages patients to practice burping in hopes the reflex will eventually redevelop on its own. In March 2026, after an endoscopy confirmed no blockage, Daryl underwent the procedure under general anaesthesia so Leong could treat the site directly.
Six months later, Daryl burps without pain or bloating. He discovered something he had never experienced before: the smell of food hours after eating it, released with each burp. He calls it liberating, life-changing. He drinks lattes now without fear. His wife, he noted with a laugh, was the happiest person after his treatment—for obvious reasons. After 52 years, the pressure cooker finally had a valve.
Citas Notables
I could not eat certain foods or have gassy drinks without turning into a pressure cooker. When it happened, I would get relief by self-inducing vomiting to expel the excess air.— Daryl, describing his symptoms before treatment
It was liberating. I would even say it was life-changing. Now I am happy that I can go back to drinking a latte without any issues.— Daryl, six months after receiving Botox injections
Quieres la nota completa?
Lee el original en The Straits Times ↗