Anderson Jennifer, Hu Huixin, Bakhsh Zainab, Liu Louis
St Michaels Hospital, University of Toronto, Toronto, Ontario, Canada.
University Health Network, University of Toronto Canada, Toronto, Ontario, Canada.
Laryngoscope. 2025 Feb;135(2):758-762. doi: 10.1002/lary.31811. Epub 2024 Oct 1.
Self-diagnosis of retrograde cricopharyngeus dysfunction (RCPD) or abelchia has been increasing over the past 5 years with patients seeking treatment for lifelong symptoms of inability to burp, neck gurgling, bloating, and flatulence. There is a distinct paucity of objective data in diagnosis and underlying pathophysiology of this disorder.
The purpose of this study was to prospectively evaluate patients with abelchia using standardized investigations to explore possible underlying mechanisms.
Patients presenting with clinical scenario consistent with RCPD were recruited into the study after informed consent. All patients underwent standardized investigations: Self reporting questionnaires EAT-10, VHI-10, and RSI scores, as well as esophagogastroscopy, barium swallow, and high-resolution esophageal manometry (HRM), were performed.
RCPD patients demonstrated a minor increase in the mean EAT-10 (5.2 ± 1.2) and normal RSI/VHI-10 scores. Barium swallow revealed 53% (CI 38%-64%) were abnormal with reflux with hiatus hernia (37%) and dysmotility (16%) as most common findings. HRM showed that 67% (CI 54%-78%) were abnormal. Ineffective motility was found in 41%, a further 23% showed a complete absence of peristalsis, whereas 33% were normal.
RCPD is a clinical condition of lifelong inability to belch and associated symptoms. The underlying pathophysiology is poorly understood. This study demonstrates that a significant number of RCPD patients have abnormal esophageal neural network with high proportion of abnormal or absent esophageal peristalsis.
3 Laryngoscope, 135:758-762, 2025.
在过去5年中，逆行性环咽肌功能障碍（RCPD）或嗳气困难的自我诊断呈上升趋势，患者因终身无法打嗝、颈部有咕噜声、腹胀和肠胃胀气等症状前来寻求治疗。关于这种疾病的诊断和潜在病理生理学，客观数据明显匮乏。
本研究的目的是通过标准化调查对嗳气困难患者进行前瞻性评估，以探索可能的潜在机制。
在获得知情同意后，将临床表现符合RCPD的患者纳入研究。所有患者均接受标准化调查：进行自我报告问卷EAT - 10、VHI - 10和RSI评分，以及食管胃镜检查、吞钡检查和高分辨率食管测压（HRM）。
RCPD患者的平均EAT - 10略有升高（5.2±1.2），RSI/VHI - 10评分正常。吞钡检查显示53%（置信区间38% - 64%）异常，最常见的发现是伴有食管裂孔疝的反流（37%）和运动功能障碍（16%）。HRM显示67%（置信区间54% - 78%）异常。41%发现运动功能无效，另有23%显示完全无蠕动，而33%正常。
RCPD是一种终身无法打嗝及伴有相关症状的临床病症。其潜在的病理生理学尚不清楚。本研究表明，大量RCPD患者存在食管神经网络异常，食管蠕动异常或缺失的比例较高。
3 《喉镜》，135:758 - 762，2025年。
