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What is regurgitation?
Regurgitation occurs when food, liquid, or stomach acids comes back up from the stomach and into the mouth. Unlike vomiting, there’s no nausea and no stomach pain or cramping. You may not even realize it’s happening until you feel or taste it in your mouth.
What is coming back up can include undigested food and drink along with stomach acid and yellowish-greenish liquid called bile.
It can be from eating too much or too fast, from being pregnant, or being obese. But it is often caused by gastroesophageal reflux disease (GERD) or peptic ulcer disease. Other causes include gastritis, gastroparesis, irritable bowel syndrome, and multiple sclerosis.
Recurrent (repetitive) regurgitation can also cause the same symptoms as these other diseases because the acid or bile can irritate the lining of your stomach, esophagus, and throat.
Is regurgitation serious?
"Although regurgitation is unpleasant, it is rarely dangerous." —Dr. Chandra Manuelpillai
- Burning in the upper abdomen
- Throat or chest irritation
- Retching or nausea
- Acid reflux coming into the mouth (heartburn) or regurgitation
Gastroesophageal reflux disease or GERD occurs when the sphincter muscle between your food pipe (esophagus) and your stomach does not completely close. This can cause stomach acid to flow upward through your esophagus, resulting in a burning sensation sometimes known as heartburn.
Regurgitation occurs in approximately 80% of people with GERD. Acid reflux may occasionally occur due to foods you eat, such as spicy foods, and can also occur more regularly in pregnant people or may be a side effect of certain medications. While some people occasionally get acid reflux and many of the symptoms overlap with indigestion, people who experience these symptoms frequently may be diagnosed with GERD.
If you have GERD, you may need to modify your diet and may need to take medication to control the symptoms and prevent damage from frequent regurgitation of stomach acid.
2. Gastric distention
- Feeling uncomfortably full
Gastric distention mainly occurs when you eat or drink too much or too fast. Symptoms can get worse when you eat spicy, fried, or greasy foods or drink alcohol or carbonated beverages. It can also happen if you eat or drink before going to sleep, and if you have too much stress, take certain medications, or are overweight or pregnant.
Unfortunately, if it’s from overeating, you just have to wait until you feel better. Resting or light activity such as taking a walk may help. Or try an over-the-counter medication, including:
- Bismuth subsalicylate (Pepto-Bismol or Kaopectate) for upset stomach
- Anti-gas medicine such as simethicone (Gas-X)
- Antacids such as Tums (calcium carbonate) or Milk of Magnesia (magnesium hydroxide) or Maalox.
3. Peptic ulcer
- Burning upper abdominal pain that gets worse after eating
- Loss of appetite and/or nausea
- Bloating or belching
Peptic ulcers, also called stomach ulcers, can form anywhere on the lining of the stomach or your small intestines. They are sores or breaks in the stomach lining caused by inflammation.
This is usually caused by:
- Infection with the bacteria, H pylori
- Medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or aspirin
- Alcohol overuse
Just as with a cut or other injury, your body needs time to heal. But it’s difficult for your stomach because every time you eat, you release acid to digest the food. This can re-injure the stomach lining.
Your doctor may prescribe medications that decrease acid production, protecting the stomach lining, and/or treat H pylori infection, if present. You should also avoid alcohol, smoking, and foods and medications that can cause irritation and inflammation.
4. Overweight or pregnant
- Feeling full sooner than normal or after eating less than usual
Being overweight or pregnant can cause regurgitation. Normally, the sphincter (a ring of muscle) prevents stomach contents from going backwards into the esophagus (the tube connecting your mouth with your stomach).
But increased pressure in the abdomen (from excess weight or the developing baby) forces food back up through the sphincter and into your mouth.
Eating or drinking too much or too fast can cause symptoms. Eating certain foods or beverages (such as spicy, fried, or greasy foods, or alcohol or carbonated drinks) or lying down or going to sleep immediately after eating or drinking can worsen symptoms.
Treatment includes eating smaller, more frequent meals, avoiding foods that trigger symptoms, staying upright after eating, and not wearing tight-fitting clothing.
5. Abnormal anatomy
- Feeling as if food gets stuck in the esophagus
- Feeling like food sits in the stomach
- Feeling like food moves from the stomach back into the esophagus
Certain anatomical issues can interfere with your normal swallowing and digestion. These include esophageal stricture, hiatal hernia, or motility disorder.
- Esophageal stricture is an abnormal narrowing of the esophagus, which may be from a genetic birth defect, cancer, or inflammation or scarring from acid reflux. It is treated with a procedure to dilate (widen) the esophagus.
- A hiatal hernia is when part of your stomach is pushed into the chest cavity. Depending on the size of the hernia and the severity of symptoms, treatment can include weight loss, medications, or surgery.
- Motility disorders (problems with the gastrointestinal tract) can lead to delays in gastric emptying. This can then cause food to stay in the stomach too long and eventually come back up into the esophagus. These are usually treated with diet changes and medications.
6. Rumination syndrome
- Difficulty swallowing
- Feeling as if food gets stuck in the esophagus
Rumination syndrome is a rare cause of regurgitation. It is more common in infants and those with developmental disabilities. It can be thought of as a chronic cause of regurgitation. Symptoms occur daily and with almost every meal. It is caused by involuntary muscle contractions moving food backward.
Treatment depends on the cause. The treatment of infants often focuses on teaching parents proper feeding positions and avoiding distractions during feeding. People with developmental disabilities may use behavior therapy such as diaphragmatic breathing and biofeedback.
Although there is no medication to treat rumination syndrome, a proton pump inhibitor such as omeprazole (Prilosec) can be taken to protect the lining of the esophagus from stomach acid.
Other possible causes
There are other conditions that may cause regurgitation, but they’re rare or the regurgitation is not a typical symptom of the disease. These include multiple sclerosis and Parkinson’s disease.
Are regurgitation and GERD the same thing?
"Recurrent regurgitation may result in a burning sensation in the center of the chest from repeated exposure to stomach contents, including acid and bile. While symptoms can become very similar to gastroesophageal reflux (GERD), they are not the same thing." —Dr. Manuelpillai
When to call the doctor
"If symptoms are frequent, it is very important to discuss them with your doctor. Although it’s rarely a sign of something more serious, it can be a sign of diseases such as Parkinson’s and multiple sclerosis. Particularly if the symptoms of regurgitation are associated with difficulty swallowing, spasms, tremors, rigidity, numbness, or weakness."—Dr. Manuelpillai
- If the symptoms are frequent or interfere with daily life.
- If you develop other concerning symptoms such as tremors, rigidity, or a heavy sensation in your arms or legs, it could be a sign of Parkinson’s. If you experience blurry or double vision, numbness/tingling, or spasms, these may be early signs of multiple sclerosis.
Should I go to the ER for regurgitation?
Generally, you should not need to go to the emergency department for regurgitation. But if you are also having these symptoms, it could mean it’s a more serious problem:
- If you are unable to swallow liquid, food, or your own saliva, it may be a sign of an esophageal obstruction. It needs to be treated or it can cause tissue damage.
- If you are vomiting and unable to keep any food or fluid down.
- If you develop chest pain, difficulty breathing, or dizziness.
There are some things you can do to prevent regurgitation:
- Eat slowly and chew your food thoroughly.
- Eat smaller, more frequent meals.
- Avoid lying down after eating.
- Lose weight if you’re overweight.
- Wear loose pants and avoid belts. Tight-fitting clothes around the abdomen can put pressure on the stomach, which may cause regurgitation.
- Avoid certain foods and drinks (spicy, greasy foods, and carbonated and alcoholic drinks).
- Take antacids (such as TUMS) or proton-pump inhibitor such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and pantoprazole (Protonix). These medications should not be used regularly.
Other treatment options
- If you are having frequent symptoms or are regularly taking over-the-counter medications, discuss your symptoms with your doctor so they can rule out other underlying issues and treat them separately.
- Prescription medications for GERD
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