How Botox changed the life of a man who could not burp for 52 years

Medical Mysteries is a series that spotlights rare diseases or unusual conditions.

Daryl has been unable to burp since childhood. He would have to induce vomiting or massage his stomach with medicated oil to help expel gas.

ST PHOTO: NG SOR LUAN

Published Oct 03, 2026, 12:00 PM

Updated Oct 03, 2026, 12:00 PM

Daryl could not burp for 52 years, causing severe bloating, pain, and discomfort, which led to frequent self-induced vomiting and digestive issues.

He was diagnosed with retrograde cricopharyngeus dysfunction (RCPD), a rare condition where the oesophageal sphincter fails to relax to release gas.

Treatment with botox injected into the oesophageal sphincter helped Daryl burp normally, greatly improving his quality of life and relieving his symptoms.

SINGAPORE – Daryl was 52 when he finally learnt how to burp in 2026 .

“All my life, I could not burp ,” the cybersecurity executive, who declined to use his full name, told The Straits Times.

The build-up of gas made him feel terribly bloated and uncomfortable. He also suffered excessive flatulence as his body tried to expel the trapped air elsewhere.

Daryl did not think his inability to belch was a problem until he was in his mid-40s, when he started experiencing bloating, trapped wind, pain and constipation every day.

“I could not eat certain foods or have gassy drinks without turning into a pressure cooker. When it happened, I would get relief by self-inducing vomiting to expel the excess air. My colleagues could hear me gagging in the toilet,” he said.

Daryl thought he had become lactose-intolerant and, because he loves his daily caffeine fix, started drinking kopi-o kosong, or black coffee.

From 2018, Daryl started seeing “a slew of GPs and specialists – at both private and public hospitals”.

“I underwent (procedures) such as an endoscopy and a colonoscopy and was told that they couldn’t really find anything serious. Some told me I had GERD while others said it was IBS (irritable bowel syndrome) ,” he said.

GERD, which stands for gastroesophageal reflux disease, is a chronic digestive condition where stomach acid frequently flows back into the food pipe, or oesophagus, irritating its lining.

IBS is a common, long-term digestive condition that affects the large intestine and how the gut works.

The medication that Daryl was prescribed did not help his condition at all.

“And since tests did not turn up anything serious like cancer, life went on. Whenever I felt gassy or bloated, I continued to induce gagging to rid myself of the gas,” he said, adding that he regularly used medicated oil to massage his stomach to help ease the gas.

It was only two years ago that, while browsing online, Daryl learnt of a condition called retrograde cricopharyngeus dysfunction (RCPD) from a group on online forum Reddit.

“When I consulted a doctor in private practice and told him about RCPD, he said he had never heard of it before. To be fair, he was a gastroenterologist and not a specialist in ear, nose and throat. Again, the medication he prescribed did not work.

“So another year passed, and my bloating got worse,” Daryl said.

Applying medicated oil to his abdomen to relieve the gas became a nightly routine.

Not wanting to give up, Daryl continued his search on the internet, and this time he came across a paper on RCPD, written by ear, nose and throat specialist Leong Zhou Hao from the Singapore General Hospital.

“I told myself: ‘This is the guy. I have finally found him!’ So I went to the polyclinic for a referral letter. After so many years, I needed to reduce my financial ‘damage’,” he said, laughing.

Leong, a consultant in the Department of Otorhinolaryngology at the hospital, confirmed that Daryl has RCPD, also known as “no-burp syndrome”, which is considered a relatively rare and underdiagnosed condition, primarily because it was formally identified only around 2019.

He said humans swallow air while eating, drinking or talking.

Daryl was finally able to belch after SGH otorhinolaryngologist Leong Zhou Hao (right) injected Botox into the sphincter muscle in his oesophagus, relaxing it so that he could burp. ST PHOTO: NG SOR LUAN

Daryl was finally able to belch after SGH otorhinolaryngologist Leong Zhou Hao (right) injected Botox into the sphincter muscle in his oesophagus, relaxing it so that he could burp.

“We have two sphincter muscles along our food passage – one right at the top and one at the bottom – and normally they are closed. When we eat, they are relaxed to let the food down. Many times the food that we eat produces gas, which travels back up the food passage, stretching the oesophagus.

“This stretch is sensed by the brain, which triggers the muscle to relax, causing a burp,” Leong explained.

He added that for some reason the reflex is not developed in some people.

According to medical literature, the exact prevalence of RCPD in the general population remains unknown, but limited preliminary data suggests it could affect up to 22% of people, with about 13% experiencing severe symptoms.

To treat this condition, Leong said botulinum toxin, or commonly known as Botox, is injected into the sphincter muscle in the oesophagus to help relax it and “forcibly allow the patient to burp”.

Leong, who carried out the procedure while he was working in Australia, said the effect of each Botox injection lasts about three months, and the patient needs to return for another jab. But he would ask his patients to “practise burping” in the hope that the reflex would redevelop.

The surgeon carried out an endoscopy to make sure there was no blockage in Daryl’s oesophagus before scheduling the Botox injection into his upper oesophageal sphincter muscle in March.

“I picked to go under general anaesthesia for the procedure so that Dr Leong could treat the site directly and I would be cured of my inability to burp,” Daryl said.

It has been six months since the procedure , and Daryl continues to burp comfortably without feeling pain or bloating in his abdomen.

“I never knew that when I burp, I could smell the food I had eaten a few hours before. It was liberating. I would even say it was life-changing. Now I am happy that I can go back to drinking a latte without any issues.”

Daryl also confessed that the happiest person after his treatment was his wife, “for obvious reasons”, he added, laughing.

Judith Tan is health correspondent at The Straits Times.

ST Medical Mysteries

SGH/Singapore General Hospital

《医学谜案》是一档聚焦罕见疾病或不寻常病症的系列节目。

达里尔从小就无法打嗝。他必须催吐或者用药油按摩腹部才能排出气体。

圣徒照片：吴索銮

发布于2026年10月3日下午12:00

更新于2026年10月3日中午12:00

达里尔52年来无法打嗝，导致严重的腹胀、疼痛和不适，进而引发频繁的自我催吐和消化问题。

他被诊断患有逆行性环咽肌功能障碍（RCPD），这是一种罕见的疾病，患者的食管括约肌无法放松以释放气体。

通过向食管括约肌注射肉毒杆菌毒素进行治疗，达里尔能够正常打嗝，大大改善了他的生活质量，并缓解了他的症状。

新加坡——达里尔在 2026 年 52 岁时终于学会了打嗝。

“我这辈子都打不出嗝，”这位不愿透露全名的网络安全主管告诉《海峡时报》。

体内积聚的气体让他感到极度腹胀和不适。由于身体试图排出滞留的气体，他还出现了严重的胀气。

直到 40 多岁的时候，达里尔才意识到自己无法打嗝是个问题，因为他开始每天都出现腹胀、胀气、疼痛和便秘的症状。

“我不能吃某些食物，也不能喝含气饮料，否则就会像个高压锅一样难受。这种情况发生时，我会通过催吐来排出多余的气体，从而缓解不适。我的同事们都能听到我在厕所里干呕的声音，”他说。

达里尔以为自己得了乳糖不耐受症，而且因为他喜欢每天摄入咖啡因，所以开始喝黑咖啡（kopi-o kosong）。

从 2018 年开始，达里尔开始“在私立医院和公立医院看很多全科医生和专科医生”。

他说：“我做了内窥镜检查和结肠镜检查等检查，医生告诉我他们没发现什么严重的问题。有的医生说我得了胃食管反流病，有的医生说我得了肠易激综合征。”

胃食管反流病（GERD）是一种慢性消化系统疾病，胃酸经常反流到食道，刺激食道内壁。

肠易激综合征是一种常见的长期消化系统疾病，会影响大肠和肠道功能。

医生给达里尔开的药对他的病情一点帮助都没有。

“由于检查结果没有发现癌症之类的严重疾病，生活就继续下去了。每当我感到胀气或腹胀时，我都会通过干呕来排出气体，”他说道，并补充说他经常使用药油按摩腹部以帮助缓解胀气。

就在两年前，达里尔在网上浏览时，从Reddit论坛的一个小组了解到一种叫做逆行性环咽肌功能障碍（RCPD）的疾病。

“当我咨询一位私人执业医生并告诉他我患有RCPD时，他说他以前从未听说过。公平地说，他是一位肠胃科医生，而不是耳鼻喉科专家。而且，他开的药也无效。”

“又过了一年，我的腹胀情况变得更严重了，”达里尔说。

每晚睡前，他都会在腹部涂抹药油来缓解胀气。

达里尔不愿放弃，继续在网上搜索，这次他找到了一篇关于RCPD的论文，作者是新加坡中央医院的耳鼻喉科专家梁周昊。

“我当时想：‘就是他了！我终于找到他了！’于是我去综合诊所开了转诊信。这么多年过去了，我需要减少我的经济‘损失’，”他笑着说。

医院耳鼻喉科顾问梁医生证实，达里尔患有 RCPD，也称为“无嗝综合征”，这是一种相对罕见且诊断不足的疾病，主要是因为它直到 2019 年左右才被正式确认。

他说，人类在吃饭、喝水或说话时会吞咽空气。

在新加坡中央医院耳鼻喉科医生梁周豪（右）为达里尔的食道括约肌注射肉毒杆菌毒素后，达里尔终于能够打嗝了。注射后，括约肌放松，他才能打嗝。（海峡时报照片：黄淑銮）

在新加坡中央医院耳鼻喉科医生梁周浩（右）向达里尔的食道括约肌注射肉毒杆菌毒素后，达里尔终于能够打嗝了。肉毒杆菌毒素使达里尔的食道括约肌放松，从而让他能够打嗝。

“我们的食道上有两块括约肌——一块在上，一块在下——通常情况下它们是关闭的。当我们进食时，它们会放松，让食物通过。很多时候，我们吃的食物会产生气体，这些气体逆流而上，撑开食道。”

“大脑会感知到这种拉伸，从而触发肌肉放松，导致打嗝，”梁解释说。

他还补充说，由于某些原因，有些人没有发育出这种反射。

根据医学文献，RCPD 在普通人群中的确切患病率尚不清楚，但有限的初步数据显示，它可能影响高达 22% 的人，其中约 13% 的人会出现严重症状。

梁医生表示，为了治疗这种情况，会将肉毒杆菌毒素（俗称肉毒杆菌）注射到食道括约肌中，以帮助放松括约肌并“强迫患者打嗝”。

梁医生曾在澳大利亚工作期间进行过这项手术。他表示，每次注射肉毒杆菌的效果大约持续三个月，患者需要再次注射。但他会要求患者“练习打嗝”，希望这种反射能够重新恢复。

外科医生在 3 月份安排给 Daryl 进行上食管括约肌注射肉毒杆菌毒素之前，先进行了内窥镜检查，以确保 Daryl 的食道没有阻塞。

“我选择接受全身麻醉进行手术，这样梁医生就可以直接治疗患处，治好我无法打嗝的毛病，”达里尔说。

手术至今已过去六个月，达里尔仍然能轻松打嗝，腹部没有疼痛或胀气的感觉。

“我以前从不知道，打嗝的时候竟然能闻到几个小时前吃过的食物的味道。这感觉太棒了，简直改变了我的人生。现在我可以毫无顾虑地喝拿铁了，真是太开心了。”

达里尔还坦言，在他接受治疗后最开心的人是他的妻子，“原因显而易见”，他笑着补充道。

Judith Tan是《海峡时报》的健康记者。

ST 医学谜案

新加坡中央医院