Author(s)
Spencer Johnson
Nancy Jiang
Affiliation(s)
Department of Otolaryngology – Head & Neck surgery, School of Medicine, Stanford University, Stanford, CA
Abstract:
Background: Since launching in March 2014, users have contributed thousands of posts to r/NoBurp, an online Reddit community where patients discuss their experiences with retrograde cricopharyngeus dysfunction (R-CPD). This study performed large language model analysis of r/NoBurp, characterizing common themes, symptoms, and management strategies.
Methods: All r/NoBurp posts from 2014-2025 were extracted, de-duplicated, and analyzed with GPT-5 reasoning mode using prompts for: theme identification, descriptive analysis, temporal trends, common symptoms, and sentiment analysis. Python3 was used for further analysis, and a 5% random sample was human-adjudicated to estimate precision/recall. This study used publicly-available data, and was deemed IRB exempt.
Results: We identified 17,523 unique posts. Common themes include symptoms & physical sensations (68% of posts), botox treatments (43.5%), access & diagnosis barriers (26.2%), self-management strategies (19.7%), and psychological impacts (16.3%). Commonly-endorsed concerns include abdominal pressure/bloating (55.6%), gurgling noises (36.9%), reflux/heartburn (22.3%), social inhibition and embarrassment (12.6%), and excessive flatulence (12.0%). Botox was the most common treatment, mentioned in 83.6% of 8,659 posts discussing management strategies. Some experienced improved burping, while others voiced frustration with limited efficacy or short duration of relief. Botox side effects included pain, reflux, and choking. Other interventions included esophageal dilation and cricopharyngeal myotomy. Frequently used medications included proton pump inhibitors, gas relief medications, and natural supplements like ginger and probiotics.
Conclusions: r/NoBurp offers a comprehensive overview of patient experiences with R-CPD, including symptoms, treatment responses, and access barriers. These insights support better counseling, timelier specialty referral, and targeted treatment approach studies.