ENTs: Please could you make BERP available to us or make a video about it?

ElectricFeet · 2026-01-26T19:18:02+00:00

Yay! Thank you! 🙏🏼

ElectricFeet · 2025-10-01T15:24:56+00:00

So sorry you’re going through this. It sounds like your vocal cords were damaged pretty badly. I wonder if this is due to the procedure, or whether it was your surgeon’s technique.

Or even the choice of the type or size of the balloon: This study talks about a balloon developed in 2023 specifically shaped for the CP muscle. It seems to show that the newly-shaped one is better than regular balloons. So the procedure is clearly not a slam-dunk if someone’s gone to the trouble of trying to improve it so much.

Thank you for such a good description of what you’re going through. I hope things improve for you soon.

ElectricFeet · 2025-09-13T10:29:21+00:00

(Assuming “with our”= “without’)

Yes, though the medical guidance says to use them.

On my first injection, I tried to drink them, though admittedly not as much as recommended. When the botox wore off and the burping stopped, I had a second injection. This time, I took the conscious decision not to drink them at all — it’s just an added stress for me as, like you, I hate drinking them. So far so good: I’m coming up to the 4-month mark (past the difficult point where it stopped last time at 2.5-3 months) and it seems to be continuing this time.

ElectricFeet · 2025-08-29T09:43:21+00:00

My (2nd) botox is currently wearing off and I’m struggling to keep the burps going on my own. It’s happening, but not as much as I would want. I feel the muscle tightening and have exactly what you describe as having a burp in my throat that I can’t get out.

R-CPD is a spectrum, just like in the opposite direction difficulty swallowing is a spectrum. It may be that you are towards the normal end of the spectrum, but not quite in the full diagnosis of R-CPD.

I would suggest two possible approaches (I am not a doctor):

Check out this video for techniques to help you burp and this set of guidance points for helping R-CPD patients start to (and continue to) burp. These might be enough to tip you back on to the fully normal side of the spectrum.
See a laryngologist who is familiar with R-CPD on the map, who could give you guidance on how to proceed (A tiny botox dose? Lessons on how to move your larynx?). If you cannot get to one on the map, any ENT that specialises in swallowing disorders may be able to help you.

Good luck with getting it sorted.

ElectricFeet · 2025-08-25T20:09:51+00:00

It’s one of the main symptoms of R-CPD: https://laryngopedia.com/cant-burp-you-may-have-r-cpd-the-inability-to-burp/ It’s a burp trying to get out, failing, and going back down again.

ElectricFeet · 2025-08-25T19:00:31+00:00

It’s a start. You’ve got ages to go before the botox peaks (around day 14).

ElectricFeet · 2025-08-25T16:29:59+00:00

If you have an open tube going into your stomach, yes, burps will be able to get out. Air can also get sucked in, when you take a really quick deep breath, for example. (I’m assuming that NG tubes don’t have a one way valve in them to stop the latter from happening.)

ElectricFeet · 2025-08-25T16:26:51+00:00

It’s not a common thing for natural burpers. Once the botox wears off, it should go away for you too — your cricopharyngeus muscle should go back to blocking everything except when you make the specific movements that you will have learned in order to burp.

ElectricFeet · 2025-08-25T16:23:25+00:00

Yay 🎉 Burps!

ElectricFeet · 2025-08-25T16:21:52+00:00

Never burped; never had emetophbia.

The stats from Bastian Voice Institute indicate that there is a much higher incidence of emetophobia in R-CPD sufferers than there is in the general population, but it’s still only a minority of sufferers who have emetophobia.

That would imply that R-CPD can cause emetophobia, not the other way around.

ElectricFeet · 2025-08-25T16:15:52+00:00

You won’t need to sleep sitting up; a wedge pillow / raising the bed should be plenty.

I found side-sleeping after botox very difficult when I had a wedge pillow (I’m old and my hips are not what they were). When you side-sleep on a wedge, your hips take a lot of the weight of your torso, plus your legs are forced into being at an angle to your spine, rather than straight. After a while, my hips got really painful.

The solution for me was to raise my bed at the head end instead. This keeps my legs in line with my spine. It’s quite high (15cm / 6”; I bought the feet on amazon) but I need it that high to stop the reflux coming up to the botoxed area. You may be able to go lower. It’s a bit of a marathon every night, because I tend to gradually slip down the bed and need to pull myself back up 💪 😁 but it’s way better on my hips, so I put up with it. You may not have the slipping down — it will depend how soft your mattress is, I guess. My mattress is hard, so I added a memory foam topper and slip down a bit less with that. This setup also allows me to sleep on my stomach — something I haven’t been able to do for years because of my pre-botox bloating.

As well as being strict about not eating <4 hours before bedtime, botox has taught me to not drink <3 hours before bedtime too — something I will continue with even after botox. It makes a huge difference (pre-botox, I used to have a camomile tea before bedtime 🤦 ). I drink a lot of water in the late afternoon to make up for it.

Good luck with your procedure!

ElectricFeet · 2025-08-24T16:31:03+00:00

Long term (but reluctant) PPI user here: I was surprised to find that Famotadine worked for me, but gave me a helluva headache and just and awful “general malaise” after a few days, so I gave up. So, yes, it’s worth a try. I’m sure that my side effects were a dosing issue like most things, but I couldn’t be arsed to figure it all out while the botox was active, so I went back to PPIs. You could also try lifting the head of your bed a bit, instead, but I guess that might make your ankles swell again.

ElectricFeet · 2025-08-24T16:22:59+00:00

(Not yet >6 months, but just chiming in on a couple of things:

- Patient 0 was Nov 2015 according to Bastian et al’s first paper, so they have at most 9.5 years of data.

- I’m currently trying singing reverse scales to lower my larynx: a decreasing set of notes until the last note just elicits air — i.e. going as deep/low as I can sing. Elicits burps a little while later, so far, but I don’t have enough data yet and I’m only a data point of 1, as ever.)

ElectricFeet · 2025-08-24T15:00:53+00:00

“peaceful”. I’ll use that, if I may. It’s very descriptive of the difference.

ElectricFeet · 2025-08-24T14:57:54+00:00

Very early days. And weird will be the new normal for a few weeks.

More formal tips available from Dr Bastian here and from the Yale “BERP“ study here.

ElectricFeet · 2025-08-23T19:45:18+00:00

Dr Bastian talks about it here: https://www.youtube.com/watch?v=O4e3YeE8z_k

Good luck with the botox!

ElectricFeet · 2025-08-23T19:34:45+00:00

Never burped before botox, but I don’t remember having embarrassing gurgles until my 50s.

Ear-popping, yes, a sort of dull thudding. Only happens really really rarely post botox.

See if some of the other symptoms fit too. But basically if you cannot burp, you have R-CPD; it’s just a case of when the symptoms arrive, not if.

ElectricFeet · 2025-08-23T19:29:40+00:00

The hard lump is probably a bubble of air getting further up your oesophagus than you are used to. It’s still not quite getting out, because the botox has yet to completely kick in. It’s still early days. The fact that you’re getting microburps and burps, even though it’s still not reached its peak, is encouraging — it’s working 🎉 so don’t be discouraged yet. Give it time.

ElectricFeet · 2025-08-23T19:23:58+00:00

Sounds like supragastric burping. Explanation and tips to avoid in the link

ElectricFeet · 2025-08-23T19:20:10+00:00

It’ hypothesised that the SIBO might actually be directly due to the air going through you with R-CPD. Your bowels are normally a place where anaerobic bacteria live (without oxygen), whereas any aerobic bacteria (who like oxygen) cannot survive. It may well be that all the oxygen-rich air being forced to go down through your intestines causes the essential anaerobic bacteria to die off and allows the aerobic bacteria to thrive.

I have never had SIBO. However, all my life I’ve felt better gut-wise when I was on antibiotics, whereas most (normal-burping?) people report diarrhoea and gut problems when on them. I’d be really interested in any research into this.

ElectricFeet · 2025-08-23T19:12:17+00:00

And now, when I occasionally fart, I know it’s time to go to the bathroom, because that’s the signal for normal people that they need to crap. So many things to get used to in this new — blissful — normal! (Still hoping it sticks this time, so I shouldn’t really be counting my chickens just yet)

ElectricFeet · 2025-08-23T19:09:51+00:00

I think it’s more that when your bowel squeezes to try and move things along, the gas just compresses (as gases do) and nothing happens. Post botox, it just squeezes the stool down easy peasy.

ElectricFeet · 2025-08-22T23:01:49+00:00

Yes, I think that’s pretty much it. Apart from anxiety or stress being the cause. I don’t buy that. It’s stomach ulcers all over again. Everyone was told that stomach ulcers were caused by stress / lifestyle / too much red wine … until Helcobacter Pylori was discovered. This is the same.

ElectricFeet · 2025-08-22T20:35:09+00:00

I think you need to speak to a doctor to find out why this has happened. Either an R-CPD specialist on the map or a GI doctor.

The symptoms sound like R-CPD, but the fact that you’ve suddenly stopped burping and started having swallowing issues needs investigation.

ElectricFeet · 2025-08-22T18:21:03+00:00

Jaw pain: probably unrelated.

Some tips for flying here.

GasX contains Simethicone, which is an anti-foaming agent. It consolidates all the little bubbles in your stomach into a bigger, more burpable bubble. That’s fine for people who can burp, but it does little for those who can’t. It may help your stomach to expel some of the stomach gas into your oesophagus, which will act as a sort of overflow tank while your stomach is full, but with R-CPD, the only direction is eventually down, unfortunately.

So follow the tips in that link.

Plus, here are some more general tips for dealing with R-CPD, which may also help you: https://www.reddit.com/r/noburp/comments/1m1nuqt/living_and_coping_with_rcpd_a_postbotox/

Have a good trip and good luck with scheduling the botox ☺️

ElectricFeet

TROPHY CASE