Initially described by Dr. Bastian (and his first R-CPD patient, on Reddit: no-burp https://www.reddit.com/r/noburp/), inability to belch can cause the severe symptoms of socially-awkward gurgling noises, bloating, and excessive flatulence, etc. BVI clinicians Bastian and Smithson (Wingo) published a report of the first 51 such patients, all treated successfully with Botox injection into the upper esophageal sphincter. (See https://journals.sagepub.com/doi/10.1177/2473974X19834553) Drs. Bastian and Hoesli have now published the first known report of a surgical solution to this problem: cricopharyngeus myotomy. For more information, see https://journals.sagepub.com/doi/full/10.1177/2473974X20917644.