Hello again, I'm Dr. Robert Bastian of Laryngopedia and Bastian Voice Institute.
My subject is flatulence. I'm talking about a kind of flatulence that is
sort of extreme—well out of proportion to anyone you know,
and really disrupting your, your life your social life in particular.
So in people who have extraordinary flatulence, there is a list of potential explanations. There
are: lactose intolerance, irritable bowel syndrome, giardia, you know, just a lot of things that cause
a lot of flatulence, malabsorption. But I'm looking for people who have flatulence—or I'm looking to
help people who have a lot of flatulence—as one of a number of GI symptoms. So, you have several
symptoms, but you're searching on flatulence; that's your sort of entry point to the disorder.
But in fact you have a list of issues. You have: you can't burp; you have gurgling noises that are,
that are embarrassing socially; you have bloating, abdominal bloating, even distension; you have
sometimes chest pressure or even low neck pressure; and then flatulence as a part of it usually the
flatulence being worse after meals towards the end of the day and even into and through the
night. Well what specific diagnosis? Not taking away from any of the other possibilities, but
I'm imagining there are people out there who have done all kinds of work-up cultures and
scopes and x-rays and everything and they still don't have an answer to their flatulence.
Well I'm here to just offer another potential diagnosis for you to consider
with your doctor's input. It is flatulence that occurs as one component of a larger
syndrome called R-CPD or Retrograde Cricopharyngis Dysfunction.
It's really a disorder of the upper esophageal sphincter, sphincter being a circular muscle
contracted virtually all the time; while you sleep, while you read, while you're watching this video,
it's sitting there contracted, this one, the one at the lower esophagus, all the way down to the
anus. They're all a series of sphincters that are contracted at the moment that you swallow saliva,
food or liquid, the sphincter lets go for about one second, and then it clamps shut on the back side.
Well, there are people whose upper esophageal sphincter or crycrpharangeus muscle won't let
go in the retrograde direction. It won't let go to let you burp or sometimes to vomit. Well, in
those people, since you can't burp the air up and out like everyone does, people burp more than they
realize, it's a very important function that we all have to have. So that air has to go somewhere.
And because it's building up and you can't burp it out, sometimes people swallow excessively, and so
now they're swallowing more air. And so, they just fill, they inflate themselves with all this air.
Well eventually that air makes its way out the other end. So if you are a person who
has been searching—you've been seeing doctors, getting tests for flatulence, that being your
primary purchase point. In other words, that's the issue that bothers you the most. But you also say,
"Yeah, I can't burp and I get gurgling noises and I get bloated, nausea after eating, painful hiccups..."
There are a lot of different symptoms. Then what I would do, is, I would go to YouTube and just type in
the two search terms "can't burp." Up will come a video that explains the syndrome in detail,
and you'll hear about the flatulence embedded as one issue of several in this terrible disorder.
So, if the search for relief for flatulence has risen to the top for you, it might lead you
into a disorder that you could possibly have, if you think "Yes I match that whole syndrome!"
then consult your physician and say, "Is this possible that I have this condition?"
You can also go to the internet, into your browser type two words, "bastian belch" and up comes my first
article. It's peer-reviewed, it's open source, so it's not behind a paywall. You can read it just
like medical professionals can. You'll see an x-ray photo in that article that shows
this huge amount of air in the stomach, in the transverse colon, and in the descending colon.
And so in a picture it just it shows you why people with rcpd have such flatulence.
I've had people say it's crazy flatulence. "I can blow the roof off the house." One young woman said,
"It's like I swallowed a leaf blower." So it can be—doesn't have to be that extreme—but it can be
quite extreme. So take the information, arm yourself with information on the internet, take that journal
article into your physician, and say, "Could we explore this?" And of course, if you're in the
midwest or run out of all other options, just contact us and we'll try to give you some guidance
about the strategy for finding a physician near you who might help you with it. Well thank you for
listening to this video, and all the best in your search for relief!