Early-Life and Psychosocial Factors in Adults with Symptoms Consistent with Retrograde Cricopharyngeus Dysfunction.

Background

Retrograde cricopharyngeus dysfunction (RCPD) is a recently described upper esophageal sphincter motility disorder caused by the inability of the cricopharyngeus muscle to relax, prohibiting belching. While clinical features and treatment have been reported, early-life experiences remain unclear. This study aimed to explore childhood experiences, comorbidities, and family history in adults reporting symptoms consistent with RCPD.

Methods

This cross-sectional survey included adults recruited through an online community focused on RCPD who reported cardinal symptoms consistent with RCPD. The survey collected and descriptively analyzed demographics, symptom profile, family history, neonatal and childhood experiences, psychological factors, and physician visits.

Results

Of 225 respondents, 207 met inclusion criteria (mean age 32 years; 69% female). Nearly all experienced abdominal bloating (98%), gurgling noises (98%), flatulence (90%), and inability to belch (100%). Painful hiccupping, a newer described symptom, was reported by 80%. Symptoms began before age 25 in 97%, and 29% reported a first-degree relative affected. Common early-life experiences included emetophobia (39%), anxiety (38%), and difficulty being burped as an infant (20%). No statistically significant crude differences were detected in symptom severity, frequency, gender, or age of onset by presence of experiences. Only 36% felt that any physician understood their condition, and 18% reported their gastroenterologist improved their symptoms.

Conclusions

Psychological early-life experiences and family history were common, but exploratory analyses did not detect statistically significant differences in symptom burden by their presence. These findings provide a foundation for future studies investigating the disorder's pathophysiology. Limited physician recognition highlights the need for greater clinical awareness of this emerging esophageal motility disorder.