Symptoms
Bringing up undigested food or liquid into the mouth.
Sour or bitter taste in the mouth.
Feeling of a lump in the throat.
Heartburn (burning sensation in the chest).
Difficulty swallowing (dysphagia) in some cases.
Coughing or wheezing, especially at night.
Causes
Infants: Overfeeding, immature esophageal sphincter.
Adults:
Gastroesophageal reflux disease (GERD).
Hiatal hernia.
Esophageal strictures or webs.
Achalasia (failure of the lower esophageal sphincter to relax).
Esophagitis (inflammation of the esophagus).
Rumination syndrome (a behavioral disorder).
Gastroparesis (delayed stomach emptying).
Zenker's diverticulum (a pouch in the esophagus).
Medications.
Pregnancy.
Medicine Used
The medication will depend on the underlying cause:
Antacids: Neutralize stomach acid.
H2 Blockers: Reduce acid production (e.g., ranitidine, famotidine).
Proton Pump Inhibitors (PPIs): Block acid production more effectively than H2 blockers (e.g., omeprazole, lansoprazole).
Prokinetics: Help to empty the stomach faster (e.g., metoclopramide, domperidone). (Use is more limited due to side effects)
Sucralfate: Coats and protects the esophagus.
Antispasmodics: If muscle spasms are a suspected cause.
Is Communicable
Regurgitation itself is not communicable. However, if it's a symptom of an underlying infectious disease (rare), that underlying disease may be communicable.
Precautions
Eat smaller, more frequent meals.
Avoid lying down immediately after eating.
Elevate the head of your bed while sleeping.
Avoid trigger foods (e.g., fatty foods, spicy foods, chocolate, caffeine, alcohol).
Maintain a healthy weight.
Quit smoking.
Avoid tight-fitting clothing.
Consult a doctor for persistent or worsening symptoms.
How long does an outbreak last?
Regurgitation is not an outbreak. It's a symptom. The duration of regurgitation depends on the underlying cause. Acute episodes due to overeating might last a few hours. Chronic conditions like GERD can cause ongoing regurgitation unless managed with medication and lifestyle changes.
How is it diagnosed?
Medical History and Physical Exam: Doctor will ask about symptoms, diet, and medical history.
Upper Endoscopy: A thin, flexible tube with a camera is inserted into the esophagus and stomach to visualize the lining.
Esophageal pH Monitoring: Measures the amount of acid refluxing into the esophagus.
Esophageal Manometry: Measures the pressure and function of the esophagus muscles.
Barium Swallow: X-ray of the esophagus after drinking barium, which helps visualize the structure.
Gastric Emptying Study: Assesses how quickly the stomach empties.
Timeline of Symptoms
The timeline of symptoms is highly variable and depends on the underlying cause.
Infrequent episodes: Related to overeating or specific foods, may resolve within hours.
GERD: Symptoms may be daily or weekly, fluctuating in severity.
Achalasia or strictures: Symptoms are typically chronic and progressive.
Rumination Syndrome: Occurs shortly after eating.
Important Considerations
Persistent regurgitation can lead to complications such as esophagitis, Barrett's esophagus (a precancerous condition), and aspiration pneumonia.
Regurgitation in infants should be evaluated by a pediatrician, especially if accompanied by poor weight gain or breathing difficulties.
Self-treating with over-the-counter medications may mask underlying conditions. See a doctor for proper diagnosis and treatment.
Regurgitation needs to be differentiated from vomiting; the treatment approaches can differ significantly.