r/noburp

Hello! I received my Botox exactly one year ago today, and I'm still burping every day. I'm very amused by the concept of a Burp Day, and to celebrate, I thought I'd come on and see if anyone has any questions about the procedure. Nothing is off limits—pre-treatment symptoms, the initial consult, the procedure, cost, learning to burp, side effects. I'll answer everything to the best of my ability. I know how scary the prospect of Botox can be, especially with all the unknowns, so I'd like to help with that where I can.

My take as a Chemist, not a Doctor, note I maybe wrong.

This covers, chemistry, physics and fluid mechanics etc of what I see is happening based on scientific principle’s and my background as a chartered chemist specialising in pressurised gas and liquid for over 25 years.

I touch upon why I think some symptoms occur - flying, scuba diving, exercise.

I touch upon relief mechanisms to temporarily help - pre-Botox.

I touch upon my experience…misdiagnosis, ineffective treatments.

I got my English corrected by AI.

SYMPTOMS INCLUDE…

Based on the medical literature, clinical findings, and chemistry / physics / mechanical principles associated with the inability to burp (R-CPD) and subsequent gastrointestinal gas retention, the comprehensive list of symptoms includes:

Primary Functional Deficit:

Complete inability to belch or burp.
Difficulty or inability to vomit (or doing so only with extreme difficulty/strain).

Upper GI and Thoracic Symptoms:

Loud gurgling/croaking noises:
Socially awkward, involuntary sounds originating from the chest and lower neck as trapped air strains against a closed upper esophageal sphincter.

Chest pain and retrosternal discomfort:
Pressure trapped in the esophagus and upper stomach mimicking cardiac pain.

Nausea and throat tightness:
A persistent feeling of fullness, pressure, or a "lump" in the throat, especially severe after eating or drinking.

Abdominal and Lower GI Symptoms:

Severe abdominal bloating and distension: Pronounced swelling of the abdomen that progressively worsens throughout the day (often described by patients as looking several months pregnant by evening).

Cramping and abdominal pain:
Sharp or dull colicky pain caused by stretching of the intestinal walls and mucosal ischemia.

Excessive flatulence:
The body's forced compensatory mechanism to vent the large volume of trapped air that travels down the entire gastrointestinal tract.

Constipation-like symptoms & obstruction:
Difficulty passing stool due to compressible gas pockets acting as hydraulic shock absorbers, stalled transit, and secondary stool hardening.

Compression of surrounding organs and stricture-like effects:
Massive gas-driven distension creates an internal mass effect, physically compressing adjacent abdominal and thoracic organs (such as the diaphragm, stomach, small bowel, and inferior vena cava).
This external organ compression can restrict diaphragmatic excursion (causing shortness of breath), impair venous return, and create functional "strictures" or bottlenecks where compressed loops of the bowel pinch or kink against one another under intense pressure.

Acute/Mechanical Complications (Advanced Progression):
Intense, acute colicky spasms:
Resulting from the bowel attempting to force contents past functional gas blocks.

Vomiting and reflex autonomic distress:
Triggered by extreme backward pressure.

Volvulus / Bowel Twisting:
Extreme rotational torsion (such as a 540-degree colonic volvulus) caused by massive distension, buoyancy, and mechanical torque - explained below.

Psychosocial Impacts:
Social inhibition and anxiety:
Resulting from embarrassing, loud gurgling noises, uncontrollable flatulence, and severe visible bloating.

Also pressure changes.

External Pressure Changes and Pain (Boyle's Law):

The Chemistry and Physics (Boyle's Law):
According to Boyle’s Law, the volume of a given mass of gas is inversely proportional to its pressure (P_1V_1 = P_2V_2).
When external environmental pressure drops, trapped gas inside a fixed, closed system (such as a patient with R-CPD whose upper esophageal sphincter and GI tract are trapped) must expand.

Flying on a Plane / Climbing Mountains (Altitude):
As an aircraft ascends or a person climbs a mountain, atmospheric pressure decreases significantly.
For a healthy person, this minor gas expansion is easily relieved by burping or passing gas.
For someone with R-CPD or an unvented system, that trapped internal gas expands dramatically inside the stomach and intestines, causing abdominal distension, intense pressure, and acute pain.

Scuba Diving:
During descent in scuba diving, ambient surrounding pressure increases, compressing gas spaces; however, upon ascent, external pressure rapidly drops.
If gas is trapped in the GI tract and cannot escape upward or downward due to functional blockages, ascending even a few feet causes the trapped gas to violently expand, leading to severe, debilitating gastrointestinal barotrauma ("stomach cramps" or "gut squeeze").

Exercise:
During intense physical exertion, internal intra-abdominal pressure naturally rises due to the contraction of abdominal wall and core muscles. When combined with unvented gas and a compromised venting route, this muscular compression squeezes the already pressurised, gas-distended loops of the bowel, exacerbating wall stretch, triggering mechanoreceptors, and causing sharp cramping pain.

BUT WHY…

Henry's Law:
In a healthy individual, excess gas is routinely released upwards via belching.

Because a patient with R-CPD cannot open the upper esophageal sphincter to vent gas, air accumulates continuously in the stomach and esophagus.

As gas volume climbs and becomes trapped, the internal partial pressure of gas inside the stomach increases significantly.

According to Henry’s Law (which states that the amount of gas dissolved in a liquid is directly proportional to the partial pressure of that gas above it), this escalating pressure forces a higher concentration of gases (like carbon dioxide and air) to remain dissolved in solution within the liquid chyme and gastric contents.

As this pressurised chyme moves downward into the intestines and colon, any subsequent minor drops in local pressure or changes in environment cause that supersaturated solution to rapidly "outgas"—releasing micro-bubbles of gas directly inside the lower GI tract.
This compounds the volume of gas already trapped downstream.

Why Trapped Gas Eventually Leads to Severe Pains:

Intestinal Wall Stretching and Mechanoreceptor Activation:
The wall of the colon is densely lined with stretch-sensitive mechanoreceptors (tension receptors).
When unvented gas accumulates and distends the lumen, it forcefully stretches the smooth muscle fibers beyond their physiological limits, triggering pain signals sent directly to the central nervous system via visceral afferent nerves.

Ischemia and Wall Tension:
Driven by Laplace’s Law, as the radius of the bowel increases due to gas distension, the wall tension escalates exponentially.
This severe tension can compress the tiny micro-vessels (capillaries) supplying blood to the intestinal wall, causing localised ischemia (reduced blood flow and oxygen deprivation), which is acutely painful.

Spasms and Colic:
The enteric nervous system perceives the abnormal over-distension as an obstruction emergency, triggering violent, uncoordinated, and high-pressure muscle spasms (colic) as the bowel desperately tries to force the gas and contents past a blocked or non-functional exit route.

The intersection of the colon's normal physiology, fluid dynamics / chemistry / physics, and the physical properties of gas explains how trapped gas severely exacerbates constipation and mechanical obstruction:

The Colon's Water Extraction Role:
A primary function of the large intestine is to absorb water and electrolytes, compacting liquid waste into solid feces.
Under normal conditions, a proper fluid-to-solid gradient allows gas bubbles produced by digestion to coalesce, migrate, and naturally "break out" of the fecal stream to be expelled.

The Compressibility Problem (The "Slurry Pump" Effect):
While liquids and solids are incompressible (meaning muscle squeezes directly transfer force to push them forward), gas is highly compressible.

When peristalsis attempts to squeeze a gas-filled segment, the muscle energy is wasted compressing the air pocket rather than propelling contents, acting like a hydraulic system with an air bubble.

Disrupted Transit and Stool Hardening:
Compressible gas pockets act as dead zones that absorb mechanical pushing forces, stalling the transit of waste.

Because transit slows down and stalls, the stool lingers longer in the colon, allowing it to excessively absorb water and turn into hard, unyielding masses.

The Mechanical Deadlock:
As gas accumulates and distends the bowel, it becomes trapped between segments of over-dehydrated stool.

The gas cannot easily "break out" because it is buffered by compacted blocks of feces, and the stool cannot move because the compressible gas pockets absorb all the mechanical force—ultimately, worst case, leading to severe distension, functional obstruction, and predisposing the bowel to twisting (volvulus).

Upward Venting Relieves Downstream Pressure:

Releasing gas upward (via natural burping, air vomiting or a functional venting route like an open NG tube) acts as the primary pressure-relief valve for the entire gastrointestinal tract.

By venting gas at the top, it prevents the progressive accumulation and downstream force of air that would otherwise travel into the colon, causing severe distension, high pressure, and mechanical complications like a volvulus.

Air Vomiting:

The Phenomenon:
When extreme pressure accumulates in the upper GI tract due to an inability to burp, patients often resort to "air vomiting" (either artificially by putting fingers down their throat or involuntarily triggered by extreme physiological pressure).

The Mechanism:
This involves a forceful retching or regurgitation reflex where the body attempts to relieve the catastrophic internal pressure by expelling a massive rush of trapped air.

Why The Role of a NG Tube helps in Pressure Relief:

A nasogastric (NG) tube placed in the stomach or upper gastrointestinal tract acts as an artificial venting mechanism, allowing continuous pressure release for patients who cannot burp.

Depressurizing the System:
By leaving the NG tube open to the atmosphere (open drainage), trapped gas can continuously escape before it builds up, preventing the gastrointestinal tract from turning into a closed, pressurised system.

Allowing the System to "Reset":
Unclamping or leaving the cap off the NG tube reduces gaseous distension, relieves acute abdominal pain, and allows the bowel walls, fluid dynamics, and pressure gradients to decompress and normalise.

Restoring Normal Bowel Function and Motility:

When an NG tube is left open / or air vomiting takes place etc both functioning to vent trapped gas, it removes the mechanical obstruction of compressed air.

This depressurisation relieves the "shock-absorber" effect on peristalsis, allowing (helping) normal, coordinated muscle contractions to resume, smooth out propulsion, and successfully move stool and fluids forward to restore regular bowel movements.

And here is an overview of the chemistry, physics, and mechanical principles regarding how I see trapped gas causes, worst case, the colon to twist (volvulus) in a patient with an inability to burp (R-CPD):

Creation of a Closed or Pressurised System:
An inability to burp creates a mechanical failure where gas entering normally through eating, drinking, or swallowing cannot escape upward.

When a nasogastric (NG) tube—an alternative venting route—is closed, clamped, or capped, the gastrointestinal tract becomes a sealed, pressurised system.

Gas Volume and Pressure (The Ideal Gas Law):
As gas continuously accumulates inside this closed system without an exit route, the fundamental chemistry and physics described by the Ideal Gas Law (PV=nRT) dictate that pressure, volume, or both must increase, causing the bowel to expand.

Distension and Wall Stress (Laplace's Law):
The accumulation of gas causes physical distension and volume expansion of the bowel.

According to Laplace's Law (Hoop Stress), as the radius of the colon increases, the internal wall stress increases exponentially, leading to a thinning of the bowel wall and a loss of structural stability.

Structural Lengthening and Redundancy:
Chronic or acute distension does not only expand the diameter of the colon; it also elongates it and creates redundancy, which are established surgical precursors to bowel twisting.

Buoyancy and Rotational Torque:
Gas-filled structures have a lower density, making distended segments more buoyant and mobile, behaving much like a gas-filled balloon.

Uneven gas distribution across a partially fixed and partially mobile colon generates uneven internal air distribution, creating "rotational torque" and structural instability similar to how an unbalanced submarine tilts and rotates.

Final Mechanical Torsion:
Worst case - Driven by this internal increasing gas pressure, wall stress, and rotational torque, an unstable, elongated bowel undergoes extreme rotational torsion, resulting in a severe clinical events such as a 540-degree colonic volvulus.

My experience - not personally, but those that know know………

Mis-Diagnosis (as experienced from Doctors not knowing about this disorder) include………….

Hirschsprungs
Tummy migraines
Cyclical vomiting syndrome
Floppy colon
DNA disorder
Aerophagia
Pseudo obstruction
Food allergies
SIBO and IBS
Gastroparesis
Dysmotility disorder
Functional constipation
Colon architecture issue
Neuromuscular disorder
Myopathy

Treatments, investigations etc…….., which don’t show anything….. don’t improve anything………..can included……………………

Laxatives (2020 and 2021)
Ultrasound (2020)
“Rear end” Tube placed for decompression (2020 and 2021)
Two biopsies for Hirschsprung’s disease (2020 and 2022)
Anti-spasm tablets for stomach (2020 and 2021)
Painkillers (2020 and 2021)
Piresteen Washouts (2020 and 2021)
Numerous x-rays (2019 to present)
FODMAP diet (2020 and 2021 and 2022)
Gluten / wheat diet. (2020 and 2021 and 2022)
Greens / onions / dairy / fish / wheat diet. (2020 and 2021 and 2022)
Standard Bloods (2020 and 2021 and 2022)
Genetic Bloods for REN2 (2022)
Small Intestine Bacterial Overgrowth (SIBO) antibiotics - Rifaximin for almost 200 days, including 60 consecutive days (2021 and 2022)
Numerous Barium swallow / enema x-rays (2021 to 2024)
Multiple colonoscopies (2021 and 2022)
Multiple laparoscopies (2021 and 2022)
G-Tube placed into intestine (did nothing) (2021)
Colostomy stoma placed for decompression (did nothing) (2021)
Anal manometry (2022)
Colon manometry (2022)
Gastric Emptying (2022)
pH impedance (2022)
Upper and lower colon biopsies (again) (2022)

Then, eventually got the Carbonate burp test, which was positive…(2022)

Eventually got diagnosed with an inability to burp.

Colon distended for months needlessly…..

Then his colon twisted and he given an ileostomy stoma in April 2023…….medical instructions not being followed, his Naso Gastric was being clamped closed - stopping the gas from escaping………..gas was trapped inside colon, pressure increased and twisted colon 540 degrees…..he ended up needing 5 hours of life saving and life changing surgery and got an ileostomy stoma in April 2023…….

You guys, I’m 36 years old and I’ve been dealing with this my entire life. It’s gotten significantly worse in the last few years. I’ve had an EGD, been told it’s acid reflux etc etc. no one believes me that I can’t burp ( except my family and best friend who have seen me air vomit a million times). Googled my symptoms for the first time in a while and found Retrograde Cricopharyngeus Dysfunction (R-CPD/No Burp Syndrome). I actually almost cried because maybe there is some hope.

My first question, what kind of specialist should I be referred to for this? I live in Northern CA (about an hour north of sac) and have anthem blue cross insurance. If anyone has a specific specialist in this area that they know of that performs the Botox procedure I would love a recommendation.

My GP retired recently and I haven’t met my new one yet so I want to make sure I go in with all the information of what I need her to do in case she isn’t familiar with this. ENT? Gastro again even though they never figured this out? Any guidance would be appreciated!

I know the recovery is individual and different for everyone but I’d like to hear your experiences. How was it for you right after the botox, when did you go to hang out with friends, to gigs, events etc.? Or did you need to stay at home because being a bit unwell? And when did you manage to do sports (especially sports which include running or jumping)?

Oh my goodness, THANK YOU to whoever made this subreddit! Because omg, I have never been more happy to be seen in my entire life, I truly thought I was alone in this.

Like many people on here, I've never had the ability to burp naturally. I have done it a handful of times throughout my life (And I do literally mean handful, like less than 5 in my 28 years of life) and never intentionally. I have always had a tremendous fear of vomiting so I had thought that maybe my burping inability stemmed from that. However, it really worsened about 3 years ago when I had a very bad episode of "the gurgles" which led to me having a my first ever PANIC ATTACK! Yay! (Actually not yay, it was miserable.) Ever since that incident, I became hyper aware of my bloating and even lost a significant amount of weight because I just completely lost my appetite didn't want to be sick.

It's gotten a little better since then, less panic attacks and more familiarity with the feeling, but I have visited multiple doctors, done laryngoscopies and other GI tests to no avail. Fast forward to today, 3 years later, still dealing with this issue on a near daily basis. Until I find this specific video talking about this very undiagnosed dysfunction that we're all very familiar with. And omg... I would've cried if I didn't feel so miserable and gurgle-y! That video then led me to do some research and find Dr. Bastian's website and this subreddit. After being looked down on and brushed aside by doctors, friends, and even family, I truly cannot express the sheer joy I feel to realize that I'm not the only person in the world experiencing this issue.

I'm gonna be using these resources on here to check for participating ENT's to properly diagnose and maybe even perform this procedure if possible. But just, the sincerest thank you to all of you for making me feel not so alone in this gurgle-y world!

Hi, for those who have gotten the Botox via operation (not injected from outside), how much time would you say you need to recover at a minimum? I work for myself so i will not get paid anything and would like to take the least amount of time possible. I work from home but do a good amount of talking in my job.

In the last couple of years, I've started having all kinds of mystery problems, pains, and discomforts — stabbing abdominal pains, shortness of breath, weird sensations behind my solar plexus, chest and neck pressure, along with constant bloating, gurgles, flatulence, constipation, etc. The works! None of the barrage of medical tests I had found anything that could explain any of these symptoms (though they did find a hiatal hernia).

At some point, having learned years prior that my inability to burp had a name, the dots connected and I realised that R-CPD could be the explanation for, if not all, at least some of these symptoms.

And so, tomorrow morning, I'll be receiving 75 units of Botox under general anaesthetic! It was surprisingly smooth to arrange treatment for this in Paris. I haven't checked with the doctor yet if they'd be happy with me sharing online that they perform this procedure, but if you're looking for treatment in France, please reach out and I'll give you their details.

I'll be sure to come back and update you with my progress. In the meantime, if anyone has any tips or advice, they'd be very welcome.

I have my botox procedure tomorrow! Mayhaps this is a dumb question, but when will I be able to comfortably smoke weed again? I can go however long I need to, I’m mostly asking other smokers when they started again after botox. Thank you!

29, went my whole life not being able to burp.. thought I was broken and the only one with this complex and accepted it.. I accidentally discovered the gag to throw up —> lets you burp and was so stoked! It took a lot of work and was kinda painful but did that when I really needed relief, for a couple months..

Then in July I discovered this sub, and a post by a kind gentleman detailing how to stick your middle finger down your throat and be able to burp.

I’ve been doing that daily, multiple times a day now for 5 weeks now and it’s working really well.. but it’s inconvenient having to wash my hands and go to the bathroom to do this every time.. if irc he said he naturally after doing that for a few days the burps just started coming out on their own.. but that still hasn’t happened for me..

Any advice? I have ibs so I’m always gassy and letting it out the way normal people do is such a relief to the frog sounds and the farts LMAO.. I can’t do the Botox because I’m actively trying to get pregnant and the Botox isn’t studied enough for my liking to do it just before/during pregnancy so I’m really trying to self fix..

And what can I do about it?

Earlier this year I got an official RCPD diagnosis from Dr Pittman in NYC and opted for the in-office Botox injection.

I had a noticeable improvement after the injection, but not the full benefit of what would typically be expected. After it set in I had one or two true burps at random, and a handful of micro burps, but then mostly nothing. To be fair, those small handful were more than I’d ever really experienced and it was great to see progress! But Dr Pittman recommended a second in-office shot on the opposite side as a follow up.

About 6 weeks after my first shot I got a second, and after that had a few days to set in it was like night and day. I was burping regularly, I could make myself burp, it was great! I was buying cases of sparkling water just to be constantly practicing throughout the day.

But then over time that one wore off too. It’s been a few months since then and I will get the occasional accidental burp (again, that’s more than I could say before the shots) but I’m getting bloated again and running into more and more times where I feel the need to burp but can’t make it happen.

Obviously that’s a bit disheartening. At this point I’m pretty sure the next step would be getting the traditional method injections while being put under. I’m not opposed to doing this, but I just hate the idea of spending the time and money to do so just for it to wear off again…

Has anyone had a similar experience and can offer any advice?

Going to my endoscope appointment tomorrow and I am so nervous. Is it bad?

Hi all.

I find that when I have an abundance of trapped air in my stomach it activates my gag reflect a lot, but it’s not air vomiting. No air comes out when I gag, I just gag/dry heave, and there is no relief.

Any one else have this? Or have any tips? It’s very inconvenient while driving, and if it gets really bad to the point of heaving I have to pull over until it’s passed.

Edit to add: This normally happens when I can feel something that i assume to be air or acid reflux at the back of my throat. It ends up getting kind of stuck there and swallowing helps a little so I just swallow for ages until it goes.

Hi,

I've had symptoms that match RCPD for around 5 years: inability to burp, painful bloating (especially after drinking fizzy drinks/beer), painful hiccups, gurgling noises from throat/chest.

I finally went to my GP recently they assumed it might be a gastro issue, so they ordered stool tests and a coeliac blood test. These all came back normal. So I’m wondering what my next step should be. Should I go back to my GP and see what they have to say or would I be better going straight to a specialist?

I aware of Lucy Hicklin in London and the treatment she provides, and I’m open to going private if that's the most efficient route.

Would love to hear what other people have done in similar positions.

Thanks :)

Has anyone had the slow swallow last longer than the 3 months the Botox is active? Not with every bite anymore it’s gotten easier but I will have to drink water to have the food go down otherwise it just sits in my throat.

hi! I’m 18f and I have this condition. I was diagnosed but luckily have found somewhere near me that treats it. I’m still not sure if I’ll be able to afford the procedure due to the fact they usually make you pay out of pocket(from what I’ve heard.) last time I tried they estimated the surgery to be like 30k🥹 anyways, I’m looking to go to college but I’m kind of scared as to what career path I choose. What if they don’t allow me to lay down when needed or call out when I’m having a flare up? I was thinking about being a nurse of some sort. I want to do something I enjoy but I also want to do something I’ll be comfortable with. So what do you guys do??

I’m officially 1 week post-op from Botox surgery, and I’m starting to worry that I may need another treatment.

I’ve been micro-burping since day 2, but it takes a lot of mind-body manipulation to even get one out, and I’ve only had a few decent sized belches so far. My gurgles, nausea, bloating, and acid reflux have actually been worse than they were before surgery.

The one thing keeping me hopeful is that I’m barely experiencing slow swallow, so I’m wondering if the Botox just hasn’t fully set in yet.

For those who have had success from the surgery, I’d love some insight of your experience!

Hi everyone, I am asking for help, because everyday, I struggle with the feeling of gas trapped in my chest and throat.

I get the typical frog croaking and the struggle to burp, but the thing is... I can burp sometimes. If I drink a lot of water, I can sometimes force a burp out directly after, sometimes I can force it out, but it's really hard. I have been told that typical R-CPD means you cant burp at all? I was just wondering if there was anyone else like me?

I have been dealing with it really bad for almost 2 years now,. Chest pain, ear pain, it feels like somehow air is not able to go out of my throat so it goes into my ears? I know that sounds crazy, but I don't know how else to describe it. My ears pop 24/7, especially my left. It's also not that this was a life long thing, though if I recall, I never burped much before, it was always flatulence. Now I have less flatulence and I have to burp all the time and I can't!

Everyone thought it was GERD and maybe it is also GERD, but GERD medications don't work.

My ENT says he can do the BOTOX, but I'm so afraid that I'm wrong about what this is and that will just mess me up more.

Please help, looking for any advice.

I have had my heart checked several times and my lungs and they are fine, yet I still get a daily fear that something is wrong whenever these symptoms strike. It also makes just existing so much harder.

Please!

Any advice is helpful!

Any remedies or medicines I could try as well?

I understand a lot of people have had RCPD since infancy, basically, I think that’s probably the majority. But, I know that there are people who developed it later on in life for a variety of reasons! I’m interested to hear if there was a specific trigger that caused yours, if it was random, if it developed slowly over time?

For my story, I could burp normally as an infant and young child, until I was around 5 years old. At 5, I started getting really uncomfortable bloating, nausea, vomiting, regurgitation, bile reflux, etc. After a barium swallow, I was diagnosed with intestinal malrotation.

I think the standard practice for children with malrotation these days is to operate and fix it, even if volvulus isn’t present. But, in the late 90s/early 2000s, the doctors here preferred a “watch and wait” approach instead. So that they did.

I had constant nausea, bloating and vomiting for MONTHS. I was super underweight and malnutritioned because I couldn’t keep anything down, and I have vivid memories of being sat on a bench in the playground at school during lunch just feeling SO sick, trying my hardest not to vomit all over the floor, whilst my friends played without me. Truly an awful experience for a 5 year old.

I’ve never had a fear of being sick (I still don’t, it’s unpleasant but I usually feel better after it - and am still occasionally sick every few years. Usually after too much alcohol lol), but I was being sick so often and in such inconvenient places (like the classroom) that I tried to stop myself being sick as much as I could.

My intestinal malrotation didn’t progress to volvulus, and eventually straightened itself out. I’m 31 and still have it without any direct symptoms, since it was never fixed.

I’m certain that my intestinal malrotation caused my RCPD - or rather, my attempts to suppress the nausea and vomiting it caused. Even after my malrotation symptoms went away, I started noticing loud gurgling/croaking in my throat at school, painful abdominal distention after fizzy drinks, random nausea, etc.

That RCPD then lead to a hiatal hernia and GERD diagnosis in my mid-20s, due to the decades of pressure build up.

So, my GI timeline is: intestinal malrotation > RCPD > hiatal hernia.

Anyone else have a similar experience/origin - or a completely different one?