There’s no medical term for it, but one doctor has pioneered inability to belch as a condition and is working to help no-burpers

Can you burp? Not even on command – just, for instance, have you burped at all in 2019?

While belching is characterized as a day-to-day bodily function, for an unknown number of people, it’s a relief they never experience.

Instead, a big meal or carbonated beverage sets off a chain of gastric unpleasantries: bloating, searing pain in the esophagus, and excessive flatulence. And of course, the gurgling, a sound reminiscent of croaking frogs that seems to come from the throat.

There’s no medical term for people who can’t burp, and the amount of scientific studies on the missing body function can be counted on one hand. But after years of being ignored by the medical establishment, the no-burpers have now taken things into their own hands.

In March, Robert Bastian, an ear, nose and throat doctor at Bastian Voice Institute, published the first known research article to recognize the lack of burping as a condition, and to advocate for the use of Botox to treat these patients. For the last four years, his office had been stormed by people who learned online that he had successfully helped one person burp and demanded the same procedure.

The first patient, a man from Dallas, contacted Bastian in 2015 in a desperate search for help after finding his website about illness and injury to the larynx. Bastian often deals with disorders of the sphincters – the muscle rings that open and close in the esophagus – and floated a treatment idea: a Botox injection. “I was simply using deductive reasoning based on what he told me because I had never encountered it before,” Bastian said.

The man replied that he wanted to travel immediately to Bastian’s office in the suburbs of Chicago to try the treatment. Bastian told the patient travel wouldn’t be necessary because so many doctors were licensed to provide the injections across the country, but the man, traveled for the injection anyway.

He managed to burp right away, then wrote about his experience on r/noburp, a community on the social media website Reddit, without Bastian’s knowledge. Since then, more than 170 people have gone to Bastian for the injection.

For many no-burpers, the r/noburp community is where users find both hope and solace. There, people suggest vocal exercises such as those done by singers to train people to burp, or offer tips on medicine that provides relief. Users swap stories of doctors who don’t take them seriously, and about getting treatment from the doctors who do. Posts such as I spent spring break burping! Back to a no burp now or Here’s how i learned to Burp (Ongoing Burp-Log), include temporary tweaks that seem to help.

No-burpers, such as 26-year-old Canadian engineer-in-training @i-like-tea, usually find the community while searching online for an explanation about why they gurgle after drinking soda, or feel bloated for a full day after one meal.

@i-like-tea, who chose to use her Reddit name so people wouldn’t know her real-life identity, always knew she couldn’t burp. It wasn’t until her early 20s, when she started drinking and going out, that she realized it could be connected to the pain and bloating that often interrupted boozy nights. She would gurgle and feel like her stomach was a balloon that had been tied up at the top.

It was a significant enough problem that she brought it up with a doctor, who told her it was a problem only she had. Then she found r/noburp.

“It’s been uplifting, to know I’m not the only one that deals with this, that there are cures or ways to deal with it to make it less uncomfortable and just to be able to commiserate with this community of people that I didn’t even realize existed,” she said.

It's been uplifting to just to be able to commiserate with this community of people that I didn't even realize existed @i-like-tea

As traffic picked up in the forum last year, @i-like-tea decided to conduct a comprehensive survey incorporating topics and issues raised in the group. There were 789 respondents.

Of those surveyed, 88% said they experienced bloating, 87.5% experienced gurgling and 80% experienced excessive flatulence. After that, the remaining symptoms only applied to 54% of the group or less. Only 19.9% of those surveyed, for instance, said they had experienced a “cough-burp”.

The group was also surveyed on what they felt triggered their symptoms and on the methods they had used to relieve discomfort and pain, including a suggestion to “vomit air” in a bathroom and to eat smaller, more frequent meals.

As for @i-like-tea’s own burp journey, every couple of months she’ll “squeak out” a burp, up from the usual pattern of a couple times per year. She is doing this by being more mindful when she gets the gurgles.

She has also been approached by a doctor who saw her survey while trying to figure out why one of his patients couldn’t burp. He is hoping to use her research to fuel his own study. “It is promising that they [r/noburp] are able to get recognition for a condition that nobody else cared about,” she said.

@i-like-tea also warned that self-diagnosis can be dangerous, which is why she is reluctant to spend too much time searching online for information about no-burp. At the same time, she was surprised by how severely people in the survey said not burping was affecting their lives.

“I do think a lot of people will self-diagnose themselves with things and then address it in ways that aren’t prudent,” she said. “But also, a lot of the survey responses I’ve got are people saying this is ruining my life.”

Dr Bastian said he has treated patients who made extreme life adjustments because of the condition – one woman who would eat at work, then leave her office and lie down in her car because of the pain she would experience. A university student he spoke with said he wouldn’t eat for the first six hours of each day because he didn’t want to get gurgles in class.

Bastian’s article focused on the first 51 people who had the Botox injection, since more than six months had elapsed since they had the injection when he was preparing the paper. Patients came from 20 states and three foreign countries. All 51 people were able to belch after the injection, though 11 lost the ability between eight and 20 weeks after the injection. Four of that group returned for another injection.

There are now four more doctors r/noburp trusts to provide the procedure in the UK, Canada and the US, but Bastian hopes it will one day be much more.

Ever since that first patient, he has been inundated with messages from no-burpers.

The article published in March is a formalized version of an email text he sends to no-burpers looking for more information. He deliberately published it in an open-source publication so it wouldn’t be stuck behind a paywall. Because he is busy treating patients with other disorders, he hopes by putting his initial work out, other doctors will do the treatment themselves or do more research into why people can’t burp.

Bastian sees his experience with the no-burpers as a reminder to the medical community that anecdote can be a powerful basis to develop science. He repeatedly emphasized that he encourages everyone to use the information they find in concert with their doctor, but defended how the internet can help people become better-informed patients.

Bastian said: “It [the internet] is a bad thing if you’re talking about actual diagnosis and treatment, but to serve as a way to alert and to give people a concept or to expand their consciousness or to give them another question to ask their physician is a very good thing.”