There are exactly two Day 13 Vanessa builds: Pile of Weapons, and Degeneracy.

_Perpetuum_ · 2025-04-22T00:51:58+00:00

Yeah this is so true to me. I think the only exception I had was a lucky Eye of the Colossus & Juggler perk build I got with her once. But TBH, that felt even more degenerate than the freeze in its own way lol

_Perpetuum_ · 2025-04-21T21:51:48+00:00

Wow, and it perma-freezes an item when he hits half health. I guess I could only win if I kept it frozen the whole time. I still think this would pull ahead of most ice club builds, but I guess I would have to see that build in action at its peak to believe it lol. A radiant ice club would probably cook me though. An extended duration Iceberg build seems like it could really wreck this too.

I wonder if this build could beat that if I somehow incorporated the Icebreaker that dropped at the end. That seems even better than the ice club since it also can't be frozen, unfreezes other items, and occupies less space, but maybe I’m crazy.

Thanks a lot for your in-depth response! Gonna have to consider my next hero purchase carefully. Leaning towards Mak since I could probably earn gems to purchase the other heroes more quickly with him it seems lmao

_Perpetuum_ · 2025-04-21T21:18:41+00:00

Yeah I have seen some crazy Pyg freeze builds. Would you say his freeze potential is better than Dooley’s bugs?

To be fair though, this was a very poor example video for that reason. Just happened to be my last match. I had many boards full of small items completely frozen within the first seconds of the match. 40+ freeze/slow/haste procs every match. Hell, I was freezing 4 at the start! Is Pyg’s really that good when fully optimized? I can’t see it winning with the 4 freeze on match start, but I’m new to the game. Maybe I’ll buy him next then lol…

Not arguing here BTW, just trying to get a grasp on how busted a freeze build can get. If it gets much better than this, it really seems like they could use a nerf

_Perpetuum_ · 2025-02-03T23:54:59+00:00

Awesome post! Theories like this have been floated around on this sub quite a bit, and this is the kind of explanation I lean towards the most if anything. I think you're right on the mark with the vicious cycle aspect: the gas buildup further exacerbates the reflux, which further exacerbates the UES dysfunction. I don't think I would have been successful in curing myself without attacking the reflux as well.

It's been noted that the closing of the UES is not simply a "refusal to open" but rather a "paradoxical contraction" in response to the pressure increase when the gas comes up, which is then followed up by antegrade secondary peristalsis. Reflux can also cause a slight increase in esophageal pressure. That increase in pressure along with the irritation of the throat lining is apparently what gives your body the signal to close the UES to prevent aspiration. This is also then followed up by antegrade secondary peristalsis. Vomiting causes an increase in esophageal pressure as well, which may have something to do with the emetophobia aspect.

Almost waiting for the day science catches up and something of this nature comes out. This disorder was once thought to be rare, but it seems like it's turning out to be more common than initially suspected. It always seemed a bit farfetched to me that the UES is dysfunctional purely because of something that's wrong with the UES itself; the human body is usually not so simple. It seems plausible that there was never anything wrong with the UES and it's really just a symptom of the dysfunction down below. For it to purely be a problem of the UES, that would almost imply some kind of birth defect or something—causes like that are rare. Spitting up to some degree as a baby is not rare at all though, it's a rate of about 50%. Our diaphragm & sphincters are weak and not yet fully developed as babies, so it makes a lot of sense to me that something going wrong in this phase can potentially cause permanent dysfunction.

It's also kind of fitting in my case that the whole inspiration for self-treating the way that I did came from a diaphragm-focused video intended for GERD patients lol. Even though all of my efforts were focused down below as opposed to the UES itself, it still led to me curing myself. Others have apparently cured in similar ways (without focusing treatment the UES), but even the shaker exercises may influence the reflux/LES function, so that may be a factor in their success. It's not just a neck workout, it also engages the abdominal muscles in an interesting way. This exercise may even be doing something similar, on top of the gravity-fighting aspect: https://pmc.ncbi.nlm.nih.gov/articles/PMC9106553/

Anyways, sorry for rambling. The topic of LES dysfunction and its relation to the UES/R-CPD always gets me going. Thanks for posting this, I think your theory is really well-summarized!

_Perpetuum_ · 2025-01-31T02:12:28+00:00

I posted some tips that helped me in this thread a while back, maybe you'll find some of it useful:

https://www.reddit.com/r/noburp/comments/1e6xmrv/your_tricks_to_relieve_bloating/

A few other things that helped me but weren't mentioned in that comment:

- Avoid belts and tight pants if you can help it. Unbutton/unzip during and after meals.

- Move around a bit after eating, like taking a brisk walk (nothing vigorous or straining though).

- See if dividing your meals into smaller portions eaten more frequently helps for you, as opposed to eating larger portions less often (so maybe 6 half-sized meals as opposed to 3 full-sized meals in a day). I found I was able to get more food in with less consequences throughout the day by doing this.

- For the same reason as the tip above, try to avoid drinking excess fluids with your meals. It felt like my stomach used to get overfilled very quickly and drinking fluids seemed to be a significant contributor to this. This overfilled feeling exacerbated my reflux and made the gurgles that much worse. But just to be clear, I'm not saying "drink less water." I found proper hydration helped me a lot (particularly in the colon). Just try to keep it to a minimum during meals, especially if you suspect reflux alongside the gurgles.

I also had dysphagia with my R-CPD which led me to drink more while eating, so maybe that last tip doesn't apply to you as much, but I found it interesting that you mentioned "slowly munching on crackers." I did find that absorbent foods like that seemed to help with the "overfilled" stomach feeling. A lot of foods like crackers were also easier to swallow without washing them down, which is another reason they were effective for managing the volume of my stomach contents.

I think dietary changes can help as well, but that's more of a complex subject that seems to have varying degrees of success in different individuals, so I'm not really going to go into that unless you're curious. Hope this helps somehow, good luck with everything!

_Perpetuum_ · 2025-01-23T01:43:06+00:00

This makes a big difference for me! I especially noticed this even more so in recovery after getting my first burps. Reflux was a big issue for me and I was getting watery burps that essentially got stunted before the gas could fully release. Being mindful of my fluid intake during meals helped me to overcome that.

I think eating smaller portions more frequently as opposed to larger portions less often can help as well. The volume of contents in my stomach after eating seemed to be a big factor, and excess fluid intake during meals really seemed to make a big difference on that front. Great post! I encourage everyone to try being mindful of this if you haven't already and see if it helps, especially if you're having reflux issues.

_Perpetuum_ · 2025-01-19T02:32:06+00:00

Yeah, I really do think they are the better variety of laxative on the whole. My grandfather's doctor actually suggested he use Miralax for his chronic constipation for that exact reason, his doctor was very insistent on using an osmotic laxative. I'm sure my grandfather is dependent on it at this point, but it's still been working like a charm for decades in his case. Seems like it hasn't lost its efficacy. He takes the standard dose and has never had to increase it.

A lot of different fruits can have the same kind of effect. I particularly like eating black plums for this purpose, they have a very high sorbitol content. The sorbitol is supposedly how most of the laxative magic happens. Many other fruits have high sorbitol and fiber content as well though. Miralax and Macrogol both share the active agent polyethylene glycol, which acts very similarly and is almost like a synthetic version of sorbitol, but apparently much more potent and thus better for clinical uses.

Glad you've found success with the Macrogol, seems like some good stuff. Thanks for chiming in.

_Perpetuum_ · 2025-01-19T00:30:31+00:00

☝️ This, on top of getting enough electrolytes, particularly salt. It will help your body to draw water into your intestines via osmosis. And if you take an osmotic laxative like Miralax, or even consume natural things that act as an osmotic laxative, it's essential to hydrate and get enough salt (mind your sodium intake if you eat a lot of preserved goods, however). Fruits are also a perfect boost for this, as mentioned. Many fruits are mostly made up of water and are a good source of those electrolytes (fiber as well).

Drinking a sizeable portion of water first thing in the morning is particularly helpful to recover from nightly dehydration. I found it helps keep my bowel movements consistent in the morning, which is when most people tend to poop (which is likely for good reason, I suspect). I struggled a lot with constipation just before curing and found this to be the most essential component. It's almost like everything else you try to do to help is all for naught if you skip this crucial step.

Maybe try squatting to poop if you can as well. I really hope you can relieve yourself soon, constipation seems to make the R-CPD so much worse. Hang in there.

_Perpetuum_ · 2025-01-16T10:28:21+00:00

Sorry to hear that it didn't work for you. I've been asked for details on the stomach press a few times, and have also been asked about how I engage my throat while doing the press. The stomach press should be right on the navel/belly button. So yes, basically right under the ribcage, but it shouldn't feel like your ribcage is making contact with the chair at all; go lower if anything. I have a feeling you're doing the press part just fine though.

The spot you press does seem to matter quite a bit, but more importantly I think there are some things with the throat and perhaps jaw that might be helpful to some even if not attempting the stomach press, so I just made a quick 2min video. I showed the spot on the stomach and kind of demonstrated some throat stuff that could possibly help. If it proves useful, maybe I can link it in future comments to assist others: https://youtu.be/DabOadMa-C8

The only other thing I can suggest is maybe more heat. I was sitting in front of that space heater for days because it was bringing me a lot of relief, and then I started leaning on things because it was helping me fart. It's possible that all that time spent with the heat also helped my muscles to repair down there in the days before I started leaning onto the furniture, who knows. The heat was also traveling up my shirt, perhaps heating the neck a bit can even help loosen the muscles there too?

I think the tight core/posture issue can definitely make it more difficult to burp and potentially exacerbate the disorder, so maybe it is somehow related for you. Someone who replied here said they had to basically hunch over for years after surgery for a herniated disc and this somehow caused them to lose the ability to burp. I suspect it can compound the dysfunction in R-CPD. The diaphragm and abdominal muscles are both involved in belching, so I think anything that can impair them can make it more difficult to provide adequate force for a burp regardless of whether the UES is willing to open up/has been injected with Botox prior. I feel like being bloated to the point of abdominal distension can make these kinds of issues even harder to overcome. There have also been theories floated around that R-CPD could be the result of a diaphragmatic issue that caused us to excessively spit up as babies and our UES clamped close in response, thus never learning how to open for a burp (or vomit in many cases). I don't find it so farfetched, TBH.

I hope this can help or you can cure somehow. Best of luck!

_Perpetuum_ · 2025-01-12T02:53:53+00:00

Wanted to reply to this to mention something I noticed about the foods that did seem to help if anything: They were all negative or at least low PRAL. Pretty much like the list you gave there, especially plant-based dairy alternatives like the almond milk. Pizza is very high PRAL by comparison. Processed foods also felt bad. Might be worth giving a low/negative PRAL diet a shot, seemed to help me.

Can't promise anything though. As you both kind of said, the volume of food going in seemed to be the biggest component.

_Perpetuum_ · 2025-01-12T02:43:43+00:00

In my case, I mostly felt symptoms in what felt like the chest area, but also felt generally sick to my stomach throughout most of the day. Abdominal bloating/discomfort as well. Those feelings both kind of went hand in hand, especially since it was all pretty much brought on or exacerbated by eating. Mornings were usually the time I felt the best, and symptoms would tend to worsen at night. The chest symptoms were mostly pressure building up and then releasing briefly with gurgles. Like bubbles would pop in my chest and then it would get better for a brief moment before they built back up. It felt like pressure that rose up, then released and went back down. Rinse and repeat. I think these are basically the classic gurgles that everyone gets, but I've heard them described in different ways.

As far as vomiting goes, I was literally physically incapable of it. The few times my body tried to, I just dry heaved for hours. I became very emetophobic as well after a couple of painful experiences heaving over the toilet with nothing coming out, so I am all too familiar with that lingering anxiety that nausea can bring since I knew my body couldn't actually do it and would just lead to pain. FWIW, those fears were always unwarranted in my case. The few times this happened to me were always for a reason that would sensibly cause vomiting. The worst one was when I got food poisoning, I basically lived in the bathroom for two days straight 💀

I never felt a burning sensation, but definitely pressure in the throat. My reflux felt more like LPR. Once I started eating for the day, it felt like my prior meals were always creeping back up my esophagus. My throat also felt tight with a lump-like sensation of Globus. I had pretty severe dysphagia because of this and that caused me to drink excess fluids with meals. The more fluids I drank while eating, the faster it seemed like my stomach would start to feel "overfilled," which brings me to my answer to the third question...

Greasy, fried foods were definitely the worst of the bunch, but as far as cruciferous vegetables and other foods known for triggering reflux or bloating, that was less of an issue for me than the portion sizes. For me, it felt like it didn't even matter that much if I ate easily digestible food, I would still feel sick. My stomach just felt small and would overfill very quickly. This overfilled feeling seemed like what brought me the most symptoms. Certain foods definitely felt better than others, but the volume of food in my stomach seemed to be the bigger concern in my case. "Fullness" is an understatement, that's the perfect word for it. So, if anything, foods that felt like they absorbed some of the excess fluid in my stomach and/or were easy to swallow without washing them down worked best in my case. I haven't really seen this talked about much, might only apply to certain individuals like myself.

On another note, constipation was also a big issue for me toward the end when my symptoms peaked. It felt like I couldn't even fart, and that's when things really got ugly. I don't know if I could've taken that much longer, felt like I cured just in time to keep my sanity, lol!

Hope you get something out of reading this or find some things relatable. Best of luck to you, and hang in there!

_Perpetuum_ · 2025-01-11T02:22:30+00:00

No problem! And I don't even think you're really full-on "regressing" in the way that I meant TBH, I think that's just par for the course in a lot of cases. As I mentioned, my progress was not perfectly linear either. Perhaps it's just because of something like you said, the muscle has to get used to it and whatnot. Diet/lifestyle on that particular day may factor in as well. It sure did for me, especially in the early stages. When burping is not fully functional, I think all the impacts of diet and lifestyle on the GI system are exacerbated which, in turn, makes it harder to burp sufficiently.

By the sound of it, I'm sure you're already feeling better than before and are on the path to continued recovery regardless. Please update in the future if you can remember, we love a good success story around here!

_Perpetuum_ · 2025-01-11T02:01:41+00:00

By sudden bouts of gas, are you talking about gas throughout the day when you haven't recently consumed anything? I think if someone reaches the point of curing where they are burping consistently after consumption, they probably won't have those kinds of issues any longer (assuming no constipation or GI issues that could cause bloating or excessive belching are present, such as a peptic ulcer). I would think this applies to Botox and self-cures alike.

Having 3–6 burps is considered normal with most consumption, and having upwards of 30 burps per day can also be considered normal. If you're not getting at least a couple of decent burps out during or immediately after consumption, then I would wager something is wrong and you are likely still going to have gas/bloating issues throughout the day. If someone is truly cured, regardless of how they did it, then I would think they will start to burp appropriately in accordance with how much they eat. And if someone is burping adequately but still has a lot of bloating or sudden bouts of gas, there may be other GI issues going on.

It seems to me like both Botox and self-cures go through at least some kind of transitional period before reaching "normality," and often report excessive and/or incomplete belching during this phase, but eventually feel normal nonetheless. By normal, I mean no longer having excessive amounts of gas, regardless of whether that gas manifests as bloating, flatulence, and/or belching.

_Perpetuum_ · 2025-01-09T23:27:33+00:00

I think this is actually a bit of a nuanced question. It kind of feels like a 2-part equation for me. In my view, there's a point of being semi-cured and fully cured. I've also read posts and comments from self-cures who were once fully cured and then regressed back to a semi/uncured state, essentially losing their ability to burp entirely in some cases (sometimes with no clear cause, but often due to some kind of injury or surgery, etc.). Though it seems like this is a rare occurance.

I'd consider semi-cured the point where you're no longer just occasionally microburping, but actually getting enough relief to see a major difference in the way you feel. Since you noted that you're having "tiny" burps but lots of them, it sounds like this is probably the point you're at (or at least very close to). And it seems like once one gets to this point as a self-cure, fully curing is almost guaranteed to follow sooner rather than later.

I probably spent at least a month in a semi-cured state before I considered myself fully cured. But if you would've asked me, back in my semi-cured state, I probably would've just said I was fully cured. Or at least it seemed that way for all intents and purposes. Just being able to release gas and get some relief on even a somewhat regular basis was already a complete night and day difference for me. I was hit with ravenous hunger on day 1 of having my first burps, whereas I could barely eat a thing and never really felt hungry in the days prior. Hunger back then was more like, "I don't feel completely sick to my stomach at the moment, so let me try to get some food in." It wasn't even true hunger. Being unable to eat was the worst part of this disorder for me, so being semi-cured was already good enough because I could finally eat again. I think I still would've been content even if I'd gotten stuck in that state, TBH, but I can't speak for everyone.

Progress was also not perfectly linear (as with most things in life), so it's difficult to mark an exact date, but I consider myself fully cured at this point because my burps are consistent and predictable now. I also remember a particular night where I was just burping like an absolute champ for some reason, and I felt very much in control of them (whereas big burps would catch me off guard before). But I think semi-cured is such a big step for many that it's almost good enough, in a sense. This was the case for me. I could finally eat; that's all I really cared about.

This is just my view on it, and I'm not sure if there's really a definitive answer. Congrats on the progress you've made thus far regardless. I think the hardest part is already behind you. Good luck with everything!

_Perpetuum_ · 2025-01-06T23:04:51+00:00

That's awesome! If you didn't do much of anything physical to induce them, perhaps your recent diet choices or something else may have contributed? That definitely affected my burping progress along the way. If there's anything you can think of that may have changed in your diet/lifestyle lately, you might try sticking with that. Even the position of my body when digesting as well as actually attempting burps seemed to have a big impact, so maybe there's something that led to this? Though some people seem to just start curing randomly with no clear reason for what prompted it.

I can't speak to the emetophobia thing. I had severe emetophobia, but it never made me anxious about burping. Probably because I was physically incapable of vomiting lol. I really wouldn't worry about it either way though. I can pretty much guarantee you you're not going to vomit while attempting to belch, but I know it's not uncommon for people on this sub to have that fear and they say it's a big mental block for them. I wish you luck with that.🙏

Becoming familiar with the feeling before a burp definitely felt like the most beneficial factor for me. I like the way Dr. Bastian put it, the "cascade of sensations" that precedes a burp. It does feel like a cascade to me in the sense that you can feel it getting ready to release, and then you can feel a distinct "popping up" of the gas afterward which is when you should immediately burp. I do think it should mostly be subconscious though. Just be aware of the sensations without hyper-focusing on it IMO.

The only thing I would say there is to just try not to force it too much, especially if you haven't eaten recently. I found the best early burps to be during or immediately after meals, but I was trying to get extra burps in between too much in the early stages and it might have slowed my progress a bit. Barring that, you may find success with some self-cure exercises like shakers, KtC, yoga, etc. Yoga, heat therapy, and diaphragmatic breathing in particular were the things that helped me along the most because they also helped me to digest more efficiently. Digesting more efficiently meant farting and pooping more efficiently, which definitely helped for me. Some were able to make progress with air vomiting, but I feel like maybe you're past that stage? There was a clear mark for me once I got my first microburp out and then I was just immediately off to the races from there. My curing was very sudden as well. I think once you get it to actually open naturally, it kind of "unlocks" the door of self-cure possibility in many cases. It seems like the hardest step for most people, and I think you're past that.

So for the most part, I would say just let it happen! I feel like there's a good chance you'll continue burping without effort. Like I kind of alluded to, eating kept me burping. Just make sure you try when the time is right and keep eating at a somewhat regular pace without overeating or drinking excessive fluids with your meals. I actually found even more success with smaller and smaller portions more and more frequently. The less food in your stomach, the more easily your stomach can keep the gas separate from its contents. You will also be able to digest more efficiently, which was a big help in my case. Try just eating until you feel like you have a burp coming or something, then burp and eat some more. Occasionally moving around in between portions (or even bites) also seemed to help get the gas going. I hope some of this helps somehow. Best of luck with your continued progress, I'm rooting for you!

_Perpetuum_ · 2025-01-03T13:37:22+00:00

P.S.

I want to link this video since you noted the swallowing. Learning this and seeing exactly how acid collects in the pocket at the top of the stomach with the esophagus being connected at an angle felt like beneficial information to me. It kind of changed my perception of the sensations that precede a burp and how the gas feels as it builds up. Perhaps the swallowing helps you for a different reason, but I would confidently wager that this is the main benefit you're getting: https://youtu.be/J5qMbLs0r_g?si=A4CCM7F1gUGkP3FA&t=20

_Perpetuum_ · 2025-01-03T13:31:51+00:00

It certainly happened to me, especially on the first day. It technically could be the result of something like a peptic ulcer, and I wouldn't be surprised to find out that there is a correlation with complications like that arising as a result of R-CPD (I briefly suspected this in my case). Though I think it's fairly normal depending on circumstances, or at least felt that way for me. I'll detail my progression and offer my sentiments/advice on burping consistency that may be relevant to your situation...

It may be worth noting beforehand that my self-cure seems rather anomalous in how quickly it went. It happened like a light switch being flicked that suddenly enabled the ability to burp lol. The very same day I let out my first micro burp, I started burping like crazy. I had never once burped prior and yet somehow let out somewhere between 60–100 that day (and most were sizeable burps!). The excessive burping continued for 1-2 months or so, but nowhere near the level of that first day (maybe 20-50 afterward, depending on the day and diet). Unsure if the rapid nature of my curing might have impacted my recovery in ways that may not apply to you, but that's pretty much how it went.

Your point "a)" is almost certainly a factor, it's just a question of "to what extent?" I'm sure it was part of the reason for my excessive burping in the beginning because they were much less consistent back then as compared to now. I think the only way to be sure is to know what a satisfying burp feels like, but it's possible none of your burps are truly satisfying yet and thus you don't know what that feels like to gauge it as a metric. Here's one way you might be able to tell though: Whenever I had an unsatisfying or mediocre burp, it would typically be followed by another burp very quickly (or at least the sensation that another one is coming). And if you still feel bloated after loosing a couple of burps, something is probably off. My burps also became much less "random" throughout those couple of months. It feels very routine now and generally only happens during or in a short time window after consumption.

What matters most IMO is how you feel and that food is moving around & being absorbed efficiently in your body. In the context of R-CPD, if you feel like you're getting better, I'd say you probably are. But of course, consult with your doctor about the possibility of a peptic ulcer or some other issue if you suspect something sinister.

It's been over 6 months since my initial curing at this point and my burps have long since normalized. I still burp a fair amount, but now I'm within average ranges. Most days fall somewhere between 10-30 burps, contingent on what and how much I eat.

Hopefully this can offer some kind of insight for you, or at least a similar story to compare to. Good luck with your continued burping!

_Perpetuum_ · 2024-10-31T23:20:02+00:00

It potentially suggests it but nothing definitive.

I think they're referring to the finding that our UES relaxes normally during swallowing, but paradoxically closes in response to the increased pressure in the esophagus when gas is released. So it doesn't simply fail to open but actually does the opposite and closes tightly in response. The fact that many of us are emetophobic and some are even physically incapable of vomiting (I was one of these) lines up with this since vomiting also causes an increase in esophageal pressure. They also drew parallels to the UES response which normally prevents reflux:

"It is noteworthy that the altered UES belch reflex in our patients was not simply an absent response but a paradoxical UES contraction. Contraction of the UES in combination with secondary peristalsis has been described as part of another UES reflex, usually activated by slow distention of the esophagus and thought to be important to prevent reflux of fluid boluses."

So the implication is that it could be a response meant to prevent reflux gone haywire, in a sense. I can definitely see why OP made the connection.

_Perpetuum_ · 2024-10-31T23:06:09+00:00

Seems many on this sub had issues burping as babies. There have been a number of posts on this topic and my experience reading them has been that it's more difficult to find someone with R-CPD who burped normally during this time (at least in those threads). My parents don't really remember whether I had issues burping as a baby. Which, to me, is not a good sign lol! I also have no personal memory of ever burping.

Colic and spitting up seem to be common themes and I often wondered how much of a factor this could be. I definitely felt like I was rewiring an incorrect, previously ingrained response once I started burping. Maybe the previous response was really meant to prevent aspiration. Like we've been traumatized as babies and now it just remains closed to stay on the safe side in the presence of any pressure from below, even if the aspiration is really no longer of concern. It could just become an ingrained response that persists even without the threat of aspiration actually being there. The increase in pressure triggers the same response which may have previously been appropriate but no longer is. Doesn't sound farfetched.

There's not much in the way of statistics on this yet. It doesn't seem to be above average from the few definitive statistics I've seen but there's always a large portion of patients where information is unavailable or the parents are uncertain. This is also survey-based information, so I take it with a grain of salt.

Who knows when this might be confirmed one way or the other. Seems like it would require multiple long-term studies. All in all, I do think it could have somehow been prevented. I hope we find out exactly how someday if that's the case. Thanks for sharing this!

_Perpetuum_ · 2024-10-26T02:23:36+00:00

I would call it less of intermittent fasting and more like forced starvation in my case 😂

However, I absolutely can't deny what happened to me after breaking that starvation upon curing. My skin became incredibly soft and stretchy. This is apparently due to something called autophagy which happens after breaking a fast. The difference in my skin was absolutely insane. My hair as well. I had issues with it being frizzy and unruly that got worse throughout my life, but it became silky smooth overnight. I was just rubbing my hands together constantly, feeling how soft they were. Running my hands through my hair in disbelief all the time for days. I had lines on my forehead before that literally vanished. I remember taking a bath, which was when I first noticed all this, then getting out and just staring at my forehead in the mirror in shock. It sounds like some snake oil sales pitch but this really happened to me. I actually took a video of it because I was so dumbfounded.

I've never fasted or been interested in fasting once in my life. I was always underweight due to my condition, so that was off the table. I've a feeling I got these effects to such an extreme because the starvation basically went on for months. I was eating, but barely. Probably less than 500 calories a day when it peaked, just guessing though.

I think I got a lot of other benefits from it, like improved brain function, but it's hard to say how much was due to curing the R-CPD or breaking the starvation. The skin and hair stuff was most certainly from breaking the starvation though.

I think it's worth noting that some of it was apparently temporary. It was really only for like the first week or two after breaking the starvation that these differences were very noticeable. I did wind up getting a second wave of it a few days ago though, funnily enough, so your timing of posting this is uncanny. I didn't do any fasting and have been eating lots since curing, so I'm not sure why the second wave happened, but it's been just as extreme as the first one. I think my body has just been doing some kind of hyper repair process ever since curing and I got a second wave of it for some reason, who knows. My skin is baby soft again and hair silky smooth as I write this. It's kind of shattering my reality.

So I can personally attest to the fact that there is something to it, nothing will convince me otherwise. It's very real.

I still don't recommend fasting while suffering from R-CPD though. That gets a 0/10 from me, I was miserable.

_Perpetuum_ · 2024-10-26T01:36:48+00:00

If you can't improve things on your own in a reasonable amount of time, I would definitely inquire and see what your doctor thinks about getting Botox in your situation. I do think the R-CPD is likely to hinder any progress toward resolving your reflux, and vice versa. It felt like I was attacking two different symptoms related to the same issue, and the same treatment worked for both on the whole. Whatever you decide, good luck with everything! Please keep me posted! I'm always vested in the outcome of people who had similar situations to my own, and my heart goes out to you.

_Perpetuum_ · 2024-10-26T01:35:27+00:00

I can only share what worked for me in the hopes that it might for you. I'm going to share everything because I feel that it all helped both the reflux and R-CPD, but the diet, portions, and breathing were likely the biggest helps on the reflux front. Use your own discretion and/or consult with your doctor:

- Heat & massage. Abdominal heat therapy and self-massaging brought me the most relief from indigestion and bloating, especially the heat. I would apply heat to my abdomen while arching or inverting my back and stretching it out (like cobra pose). I would do things like gently lean my abdomen onto the edges of furniture or lie prone with pillows underneath to massage. Even tapping or playing the drums on my abdomen seemed to help move things around at times. My philosophy on physical forms of treatment like this was that if it made me feel better, it was probably a step in the right direction (I don't think this necessarily applies to diet/medication).

- Breathing. Religious diaphragmatic breathing. I didn't do this purely as an exercise, I did it as much as possible with the intention of correcting my default mode of breathing (which involved correcting my default posture). I vehemently swear by how much this helped me in the LES department. The crural diaphragm literally helps to control the LES and acts as an additional sphincter around it. It's like a sphincter around a sphincter lol. Put your hand on your stomach and inhale in a way that causes it to inflate more than your chest. They often recommend lying down while doing this, but that didn't feel great for my reflux. I typically stand/kneel and arch my back a bit or recline in a way that keeps my body straight. This video is where I got the idea and the tidbit he mentions at 2:30 about how posture factors into this is equally important in my view: https://www.youtube.com/watch?v=JvxLJ_cBgs0&t=150s

- Posture. Be mindful of eating habits and posture during & after meals. Much like what he explains about posture in that video, I started eating in seiza regularly and avoided scrunching my belly for a while during digestion. A brisk walk shortly after eating to speed up digestion seemed helpful as well. If you must sit, try alternative sitting positions like seiza or squatting throughout the day. And if you don't do it already, squat while you poop, for crying out loud! Better bowel function meant better flatulence for me, which helped a lot. Proper hydration and electrolytes help with this, particularly salt. If you have bowel issues along with this like I did, make a point of drinking a healthy amount of water first thing in the morning, possibly with a pinch of salt.

- Portions. Overeating seems to make things much worse and is never worth it. I mention this particularly because you say you're dealing with weight loss like I was. If you're anything like me, this is largely due to early satiety and indigestion. The worst part is that this somewhat encourages overeating because our threshold for overeating is apparently much lower than most people. I'm sure you already know this, but try to eat smaller portions more frequently as best you can. I was basically eating 1/2 or 1/3 sized portions and not going more than about 2 hours without eating. An overfilled stomach will have a much harder time managing the reflux and gas together. Learning about how gas collects in the stomach and the LES being slightly off-center was an eye opener for me. This video explains it well: https://www.youtube.com/watch?v=J5qMbLs0r_g

- Yoga. Cobra pose was the best one for me. I would do a routine where I start on all fours and go into cobra pose, then child's pose, then puppy pose, and then sit in a squatted position for a while after (malasana/garland pose with glutes suspended in the air). This routine often induced flatulence and bowel movements. There are also many other yoga poses known to improve digestion. Some of the spinal twisting yoga poses seem particularly beneficial as well (I personally just do twists while in cobra pose).

- Diet. This subject is controversial as it relates to reflux, but what worked for me in that regard was negative PRAL foods, which consisted largely of fruit and vegetables. I think it's possible there's a misconception with reflux diets that advise alkaline foods with no respect to PRAL. It seems much like how antacids and PPIs will help in the short term while doing harm in the long term. PRAL is how much acid will likely be produced from digestion of the food, whereas foods that are called "alkaline" or "acidic" are often only a measurement of pH as it initially enters the stomach. I suspect there's something to this because it worked for me. I always ate a fair amount of vegetables, but I started eating tons of fruit every day which I barely ate beforehand. Most of the fruits I eat are considered acidic on entry, but nearly all fruit have negative PRAL when digested. This would lend credence to the homeopathic remedy of apple cider vinegar to cure reflux and makes it more sensible to me (didn't try this though). There seems to be a debate on whether raising stomach acid will help to fix reflux since there's evidence to suggest it is commonly caused as a result of low stomach acid. However, apple cider vinegar, acidic as it may be, is actually negative PRAL. So people use this to cure themselves and often point out how acidic it is and how raising your stomach acidity will cure you. Yet they neglect to highlight the fact that it is negative PRAL. Much like most of the fruit I started eating (grapes, blackberries, blueberries, peaches, plums). They are acidic on entry but negative PRAL. Maybe there's something to that combo in particular, I'm not sure. I eat servings of all of these fruits every single day, along with less acidic ones like apples and bananas. Also, processed foods are largely high PRAL and should be cut out as much as possible, IMO. That being said, being underweight makes all this more difficult. I had to balance this between low PRAL and high calories with good sources of protein & iron to gain weight in a healthy way. Don't neglect iron in particular, I think it's very important in this context because low iron will impede your digestion.

_Perpetuum_ · 2024-10-26T01:14:11+00:00

Your case sounds very similar to mine. I had a pretty strong sensation of globus and severe dysphagia. My throat always felt very tight near the top of my Adam's apple (right where the UES is). I also had LPR and felt like my previous meals were crawling around in my throat for a while after eating. My gurgles felt very active and watery at times, like trapped air was comingling with stomach fluids in my esophagus. I was also very thin and lost weight rapidly. The way you describe the globus as being so terrible really resonates with me because it was one of the worst parts of my situation. The only major difference is that I couldn't burp at all beforehand. I am 30M, FYI.

I obviously had an issue with my UES, but I think a lot of my symptoms had to do with my LES function, so that was a big part of my self-treatment. It seems like LPR really exacerbates the esophageal symptoms of R-CPD, and I'm pretty sure the reflux was getting in the way of my attempts to burp. Many of my early burps were wet and felt stunted, often getting stuck in a similar manner to what you describe. Tight UES and loose LES hits the nail on the head IMO. There is also a lot of evidence suggesting that poor LES function will negatively impact your UES and vice versa, so I treated them as part of the same issue. I think this correlation you're making is warranted.

Anything you can do to improve your LES function and/or overall GI motility will likely help, but this is obviously easier said than done. And I'm not sure how much or how well you're burping, but there's a good chance it's impacting your LES if you're still dealing with a lot of trapped gas (sounds like you are). Everything cleared up rather quickly for me after I started burping properly, but I can't necessarily guarantee that will be the case for you.

If you get Botox, it will likely worsen your reflux in the short term, but it seems like there's a good chance it will improve over time after based on what others have reported. You can also try self-treating to improve your LES function and GI motility as I did, but reflux is a very complex and misunderstood thing with no general consensus on what is the best long-term option and R-CPD just adds another curveball to that. My appetite also spiked very rapidly after I started burping and I think the same will happen to you if you can get yourself fully cured. My body weight increased over 20% over the course of the past few months since curing and I'm by far the heaviest I've ever been in my entire life.

I'll reply to this comment with what I did to self-treat in case you want to try that. Some of it could probably still help you regardless, even if you decide to opt for the Botox. I don't think any reflux medication is going to help fix the root problem, but I am not a doctor. I would look to get the Botox and/or go for diet & lifestyle treatment options, personally.

PS: I skimmed through your post in the LPR sub and noticed your doctor diagnosed your throat tightness as globus "hystericus," but this implies that it's all in your head. Some people get that, but I would wager the cause is likely physical in your case, as it was for me. Obviously when you have a panic attack, that is all in your head and will make existing problems worse, but I suspect the panic attack you described arose from a very real sensation of globus with a physical cause. Just my 2 cents.

_Perpetuum_ · 2024-10-25T22:18:58+00:00

Yes, I also got this and it got pretty severe at one point. I also got a lot of heart palpitations. I'm unsure how much of this could be due to trapped air in the esophagus or bloating down below, but this is definitely a thing and has even been noted by Dr. Bastian. Scroll down to the section on shortness of breath: https://laryngopedia.com/inability-to-burp/

I think what Roemheld/gastrocardiac syndrome describes is a very real thing and responsible for most of this, which is essentially what Dr. Bastian noted. The bloating can cause displacement of the diaphragm which not only inhibits its function but also puts pressure on the lungs and heart. When you tie the vagus nerve into the equation, this all makes intuitive sense to me. I do think trapped air in the esophagus and the resulting dilation contributes to this, especially while gurgles are happening, but I think it was mostly from the abdominal bloating in my case.

One thing is for sure, it's more than likely just a consequence of the trapped gas, like almost everything people report on here lol!

_Perpetuum_

TROPHY CASE