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Botox for burping? Doctors use injections to treat ‘no-burp syndrome’

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Botox for burping? Doctors use injections to treat ‘no-burp syndrome’

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Burping is often considered a “faux pas,” as it can be embarrassing and off-putting, especially in social situations. 

But for some, the inability to belch can be an issue that can cause discomfort. There is even a medical name for the condition: retrograde cricopharyngeal dysfunction (R-CPD), also known as “no burp syndrome.”

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The cricopharyngeus is the main muscle of the upper esophageal sphincter, the top gate of the food pipe. With no burp syndrome, this muscle does not relax, which interferes with the burping process, according to Neil Chheda, MD, associate professor and vice chair in the department of otolaryngology and chief of the division of laryngology at UF Health in Gainesville, Florida.

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“Both men and women can be affected, and risk factors for developing this condition are not known,” Chheda told Fox News Digital.

The inability to belch is a medical condition called retrograde cricopharyngeal dysfunction (R-CPD), also known as “no burp syndrome.” (iStock)

It may not seem like an inability to burp is a big deal, but it can bring severe challenges, the doctor said. 

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“Those who can’t burp may report quality of life issues, such as bloating, a gurgling noise, and discomfort with certain foods and drinks, such as carbonated beverages,” Chheda said.

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Priya Krishna, MD, an otolaryngologist in the department of head and neck surgery at Loma Linda University in California, agreed that no burp syndrome can cause “significant psychological distress” in the affected person.

“It actually severely impacts the life of an individual, making social situations embarrassing because the gurgling can be loud and the flatulence excessive,” she told Fox News Digital.

“Those who can’t burp may report quality of life issues, such as bloating, a gurgling noise, and discomfort with certain foods and drinks.”

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If over-the-counter options, prescription medications and lifestyle tweaks don’t solve the burping issues, patients can turn to Botox for a potential remedy, medical experts say.

Whether it’s injected into the face for a cosmetic procedure or elsewhere in the body for a functional reason, Botox works by preventing a motor nerve from releasing the chemical transmitter that signals a muscle to contract, explained Dr. Chheda with UF Health. 

Botox works by preventing a motor nerve from releasing the chemical transmitter that signals a muscle to contract. (iStock)

“When Botox is injected into the cricopharyngeus, the muscle can’t contract, and thereby relaxes and permits the venting of the esophagus.”  

As a result, this can help a patient burp.

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Dr. Krishna of Loma Linda University told Fox News Digital that a Botox injection can be a very safe procedure as long as it is injected into the correct and intended muscle.

“That means having a surgeon familiar with the anatomy — as all otolaryngologists are — injecting the cricopharyngeus muscle,” she said.

While it may not seem like an inability to burp is a big deal, it can bring severe challenges, a doctor said.  (iStock)

The remedy was discovered by Robert Bastian, MD, an otolaryngologist (ear, nose and throat doctor) and director of Bastian Voice Institute in Downers Grove, Illinois.

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“I have subspecialized in laryngology (the ‘T’ of ENT), which means voice, swallowing, upper airway, sensory neuropathic cough and inability to burp, or R-CPD,” he told Fox News Digital. “So I describe myself as a ‘laryngologist.’”

Bastian said he pioneered the procedure that involves injecting Botox into the cricopharyngeal muscle, which enables it to loosen and permits burping. 

What to expect from the procedure

There are two methods of using Botox to induce burping, according to Bastian. 

The first is a brief procedure under general anesthesia in an outpatient operating room. 

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“A simple ‘scope’ procedure allows one to see the sphincter, at the junction between the low throat and opening of esophagus,” the doctor told Fox News Digital. “A tiny needle is then inserted into the muscle to inject Botox.”

“Both men and women can be affected, and risk factors for developing this condition are not known,” a doctor told Fox News Digital. (iStock)

Because of the anesthesia, someone must drive the patient home after the procedure.

The second method is to inject the muscle while the patient is sitting in a chair in a doctor’s office. 

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“A needle is passed into the muscle from the side of the neck. Surface landmarks and three-dimensional visualization are used by the surgeon, and an EMG device monitors and verifies muscle placement,” Bastian described. 

The patient can drive to and from the procedure since only local anesthesia is used.

A Botox injection can be a very safe procedure as long as it is injected into the correct and intended muscle, one doctor stated. (iStock)

Bastian said it has been rewarding to pioneer the Botox method. 

“It has been a great privilege to be the one to ‘discover’ and codify the diagnosis and help spread the information to other doctors … and above all, it has been an honor to work with lovely patients who have suffered so much and for so long with this terrible disorder,” he told Fox News Digital.

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A patient of Bastian spoke about the effectiveness of the procedure, saying it has allowed them to burp, that “any gurgling is gone,” and that “bloating has diminished almost entirely,” the doctor shared.

The patient also noted that getting the procedure has “drastically” improved their day-to-day life.

Fox News Digital reached out to the manufacturer of Botox and the U.S. Food and Drug Administration (FDA) requesting comment.

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Natural Ozempic? 6 GLP-1 Foods That Work Just Like the Shot

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Natural Ozempic? 6 GLP-1 Foods That Work Just Like the Shot


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Simple daily habit could help people with type 2 diabetes manage blood sugar

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Simple daily habit could help people with type 2 diabetes manage blood sugar

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Sitting next to a window may help people with type 2 diabetes control their insulin levels, according to new research.

The study, published in Cell Metabolism, found that exposure to natural light — even indoors next to a window — changes how the body processes glucose and uses energy.

People in Western societies spend 80% to 90% of their time under artificial lights, which are much dimmer and less dynamic than sunlight, the researchers noted. Natural daylight is a powerful cue for the body’s internal clock, also known as the circadian rhythm.

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The body’s internal clock influences many processes, including digestion, hormone release and metabolism, according to research. When it gets out of sync, it can worsen insulin resistance and blood sugar control, which are two of the main issues caused by type 2 diabetes.

Typical lighting in homes and offices is much dimmer and lacks the biological signals provided by natural daylight. (iStock)

To test the effects of daylight on blood sugar, scientists recruited 13 adults with type 2 diabetes. Each person spent two separate 4.5-day periods in a controlled office setting, according to a press release.

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In one period, they worked in front of large windows with natural daylight streaming in. In the other period, participants worked in the same room with the windows covered and were exposed only to typical indoor lighting.

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Daylight isn’t a replacement for medication or traditional management strategies like diet and exercise, the researchers noted.

Everyone ate similar meals, followed the same schedule and continued their usual diabetes medications in both conditions.

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While average blood sugar levels didn’t differ drastically between the two conditions, people spent more time in the healthy glucose range when they were exposed to natural daylight — their blood sugar fluctuated less and stayed within a desirable range for a greater portion of the day.

Participants who were exposed to daylight burned more fat and fewer carbohydrates, a metabolic pattern linked to better blood sugar regulation. (iStock)

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Exposure to natural light also affected metabolism. In daylight, participants burned more fat and fewer carbohydrates for energy.

Muscle biopsies and laboratory tests further showed that the genes responsible for the body’s cellular clocks were more synchronized under natural light conditions, the study revealed.

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Better alignment of these genes can improve nutrient processing and how cells respond to insulin, the researchers concluded.

Sitting near windows or spending more time outdoors could support diabetes management alongside standard treatments, researchers say. (iStock)

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However, daylight isn’t a replacement for medication or traditional management strategies like diet and exercise, according to the team.

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The study did have some limitations, including that the group of patients was small. The researchers cautioned that larger studies are needed to confirm these results and determine how much natural light exposure is optimal.

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“This study also highlights the often unnoticed impact of the built environment on our health, and raises further concerns about the prevalence of office environments with poor (natural) daylight access,” the researchers noted.

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Frequent heartburn may be a warning sign of a more dangerous condition, doctor says

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Frequent heartburn may be a warning sign of a more dangerous condition, doctor says

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For most people, heartburn is an occasional annoyance and source of temporary discomfort. But for some, chronic heartburn can lead to more dangerous conditions — potentially even pre-cancerous ones.

About 10% of people with chronic gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer, according to medical experts.

Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer, but most will not.

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When acid reflux becomes dangerous

“Your stomach is designed to handle acid. Your esophagus is not,” Dr. Daryl Gioffre, a Florida-based gut health specialist and certified nutritionist, told Fox News Digital.

About 10% of people with chronic acid reflux will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer. (iStock)

“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”

In most people, the lower esophageal sphincter — which Gioffre refers to as the “acid gate” — keeps acid in the stomach, which is lined with thick mucus and specialized cells designed to protect it.

“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”

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“But when the gate gets weak, it relaxes or stays slightly open, and acid slips back up the wrong way,” he said. This “gate” can weaken with magnesium deficiency, high stress, alcohol, poor sleep, dehydration and late-night snacking, all of which can disrupt healthy digestion.

When acid hits the esophagus, it irritates tissue that was never designed to withstand it, according to the doctor.

“Every time acid comes back up the wrong way, it injures the lining like a slow chemical burn,” said Gioffre, who is also the author of “Get Off Your Acid” and “Get Off Your Sugar.” Over time, that irritation erodes the lining, drives inflammation and can change the cells.

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“These new cells are no longer normal esophageal cells — they begin to shift into cells that look more like stomach lining, because those cells can tolerate the acid,” the doctor said. “That change is called metaplasia, or Barrett’s esophagus.”

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Once the cells start changing, the risk of further mutation goes up. If that process continues, Gioffre warned, it can progress to dysplasia, which is the stage right before esophageal cancer.

Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer. (iStock)

“So the real danger is not the heartburn you feel,” he summarized. “It is the repeated acid exposure forcing the esophagus to adapt in ways it was never designed to. Fixing reflux at the root stops this entire cascade before those cellular changes begin.”

Men at higher risk

Men generally have a higher risk because they burn through magnesium faster, tend to carry more visceral fat pushing upward on the stomach, eat heavier meals and snack late at night, Gioffre cautioned. These activities all weaken the acid gate and shut down healthy digestion. 

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“Eating within three hours of lying down almost guarantees the stomach does not empty, and that is one of the biggest drivers of nighttime reflux,” he said. “On top of that, men often ignore symptoms, or mask them with PPIs and antacids instead of fixing the root cause.”

All of these factors contribute to a “perfect storm” for chronic inflammation and long-term damage, according to Gioffre.

Warning signs

There are certain red flags that indicate when acid reflux has gone beyond an occasional annoyance and has progressed to constant and chronic. 

“If that burn becomes more frequent or more intense, or starts showing up even when you have not eaten, your body is waving a giant warning flag,” Gioffre said.

Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach. (iStock)

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Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach, according to the doctor. 

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“Ulcers in your throat, or even in your mouth, are another sign that the acid is doing real damage,” he warned. 

“Another major warning sign is when reflux goes from something you notice occasionally to something you feel every day or every night, or when PPIs and antacids stop helping,” Gioffre said. “That usually means the lining is irritated and eroded, and may already be changing on a cellular level.”

Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, the doctor said. (iStock)

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Unexplained weight loss, vomiting blood and black stools are all serious symptoms that demand immediate attention, the doctor added.

“The bottom line: When reflux becomes consistent, chronic and starts impacting swallowing, your voice, or the tissues in your mouth or throat, it is no longer just a nuisance,” Gioffre told Fox News Digital. “That is the point where the esophagus may be moving toward a precancerous state, and men especially cannot afford to wait on it.”

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3 key ways to prevent reflux

Gioffre shared the following essential steps to preventing acid reflux and improving digestive health.

No. 1: Follow the 3-hour rule

“Stop eating three hours before bed,” the doctor recommends. “When you eat late, the stomach does not empty, pressure builds and the acid gate relaxes, guaranteeing that acid travels upward into your esophagus while you sleep.”

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Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, he warned. “This one rule alone can dramatically lower acid reflux and cancer risk.”

No. 2: Strengthen the acid gate

When stomach acid is low, the lower esophageal sphincter loses its tone, allowing acid to travel upward instead of staying in the stomach, Gioffre said.

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“The fastest way to tighten that gate is to build your mineral reserves, especially magnesium,” he said.

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The best way to do this is to load up on magnesium-rich foods like avocado, spinach, pumpkin seeds, chia seeds, quinoa and almonds, and consider adding a clean magnesium supplement.

No. 3: Remove or neutralize daily triggers

The fastest way to protect your esophagus, according to Gioffre, is to eliminate or neutralize the foods and habits that weaken the acid gate and push acid the wrong way.

For people who can’t fully eliminate these triggers, certain habits can help neutralize their impact by reducing acid strength and pressure before it reaches the esophagus.

The doctor recommends cutting back on alcohol and caffeine, both of which relax the acid gate and increase the risk of acid reflux. (iStock)

“Drinking most of your water earlier in the day helps, because pounding water at night stretches the stomach and relaxes the acid gate, making it much easier for acid to flow the wrong way once you lie down,” he said.

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He also recommends cutting back on alcohol and caffeine, both of which relax the acid gate instantly.

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Some other major triggers that fuel the reflux cycle include chocolate, spicy foods, garlic, onions, sugar, ultraprocessed foods and heavy nighttime meals, according to the doctor. 

“These foods and habits weaken the lower esophageal sphincter, drive up inflammation and push pressure upward,” he said. “That’s exactly how a little heartburn turns into chronic reflux, and slowly causes the kind of damage that puts the esophagus at risk for cancer.”

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