Unexplainable

Everyone does it. Why can’t I?

February 9, 2026

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  • The central medical mystery discussed is the inability to burp, a condition known as Retrograde Cricopharyngeus Dysfunction (RCPD), which causes significant gastrointestinal distress including bloating and nausea. 
  • RCPD was only formally named in medical literature in 2019, despite being easily recognizable, and the medical system often misdiagnoses sufferers, sometimes suggesting drastic procedures like colon removal. 
  • A potential, sometimes permanent, cure for RCPD involves injecting Botox into the upper esophageal sphincter muscle to relax it, allowing patients to learn the previously inaccessible burping reflex. 

Segments

Introduction and Medical Mystery Setup
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(00:01:16)
  • Key Takeaway: The host reveals her lifelong inability to burp, which causes significant physical discomfort.
  • Summary: The episode introduces guest Noel King and immediately pivots to the host’s personal medical mystery: the inability to burp. This condition leads to symptoms like nausea, bloating, and painful internal pressure. The host confirms she has this condition, which she has never disclosed to her long-time friend.
Symptoms and Condition Reveal
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(00:02:47)
  • Key Takeaway: Symptoms of the inability to burp include digestive issues and unique, often frog-like, auditory emissions.
  • Summary: Audio clips reveal sufferers experience nausea, severe bloating, and trapped air in the intestines, sometimes feeling like torture. The host plays audio of the unique sounds made by those with the condition, often compared to a frog or dinosaur sound. The root cause is revealed to be the inability to burp, stemming from the upper esophageal sphincter muscle not relaxing properly.
Medical System Blindness to RCPD
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(00:07:00)
  • Key Takeaway: The medical system has historically overlooked RCPD, leading to severe misdiagnoses and unnecessary invasive procedures.
  • Summary: A major mystery is why the medical system ignored this condition until it was named in 2019, despite clear patient descriptions. One patient, Dory Gray, was advised by two separate surgeons to consider removing her colon before the true cause was suspected. The condition is often misdirected to GI doctors, but the affected muscle is at the border of GI and ENT specialties, making it an ‘orphan area.’
Dr. Bastian and Botox Solution
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(00:09:37)
  • Key Takeaway: Laryngologist Dr. Robert Bastian recognized the pattern and proposed using Botox to paralyze the tight muscle.
  • Summary: Dr. Robert Bastian, a laryngologist, is introduced as a solution-oriented doctor who values patient observation. He received an email from a skydiving enthusiast who couldn’t burp, leading him to suggest injecting Botox into the upper esophageal sphincter. Botox is used elsewhere to freeze muscles, and the theory is that paralyzing this sphincter will force the muscle to relax, enabling burping.
Community Recognition and Diagnosis
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(00:14:41)
  • Key Takeaway: Online communities like Reddit’s r/NoBurp accurately self-diagnosed the condition with nearly 100% accuracy before medical recognition.
  • Summary: The Texan patient posted his experience online, leading to a thriving no-burper community that recognized the symptom cluster: inability to burp, bloating, gurgling, and sometimes painful hiccups or emetophobia. Dr. Bastian found that patients self-diagnosing as no-burpers online were correct almost every time, contrasting sharply with the zero diagnostic rate from extensive traditional testing. The official name for the syndrome is Retrograde Cricopharyngeus Dysfunction (RCPD).
Host’s Botox Experience and Results
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(00:25:51)
  • Key Takeaway: The host underwent Botox injections, initially experiencing exuberant burping that is now transitioning into learned control.
  • Summary: The host details her procedure, which required general anesthesia and precise injection into the cricopharyngeus muscle. In the first few days, she experienced no change, but around 48 hours post-surgery, she began burping, often mid-sentence, surprising her friends. Dr. Bastian emphasized that patients must consciously practice burping during the Botox window to make the learning permanent, as the effect wears off in about three months.
Post-Procedure Learning and Future
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(00:31:29)
  • Key Takeaway: Learning to burp post-Botox involves finding specific voluntary postures that invite the reflex, suggesting burping requires learned input.
  • Summary: The host discovered that specific physical postures, like turning her head while backing a car up, helped trigger the burp reflex. Dr. Bastian theorizes that non-burpers never learned the correct voluntary input needed to invite the burp reflex. The host is now nearing the end of the Botox window and hopes her practice has successfully taught her body how to burp permanently.