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 obese. Or, though less likely, from serious medical conditions like multiple sclerosis.
It is important to figure out whether you have regurgitation or some other cause of an “upset stomach” such as gastroesophageal reflux disease (GERD), peptic ulcer disease, gastritis, gastroparesis, or irritable bowel syndrome. It can be confusing as there are many similar symptoms.
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.
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1. Gastric distention
Although regurgitation is unpleasant, it is rarely dangerous. —Dr. Chandra Manuelpillai
- 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.
2. 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.
3. 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.
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4. Rumination syndrome
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
- 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.
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.
I think I may have Rumination syndrome; the food that comes up to my mouth tastes just the same; no acid or whatever and happens with almost everything that I eat. I never had this problem last year but now it has been part of my daily life. I've never thought much of it, seeing it to be like animals that chew cud in order to digest the food better. Perhaps my body just want extra time to digest by bringing it back up? However, sometimes like today, my stomach feels so uncomfortably bloated with more frequent burping of food. This feeling reminded me of a recent event when I drank too much milk tea. I felt so awful in my stomach that breathing seemed a little more difficult so I went to lie down. About 10 minutes later, I bent over to the nearest dustbin and released a milk tea waterfall along with my past 2 meals/tea-breaks in shreds--all in colour and shape. As I picked up the immediately-filled bin, I gauge that I vomited at least 1.5 litres of goo. A doctor has ever suggested to me before if I had IBS (Irritable Bowl Syndrome) too, thus I had thought at first this vomiting case was perhaps due to the milk being out just slightly too long. After reading this article, I figured that Rumination syndrome could be the case too. However, I do not have difficult swallowing; the food feels like it sits in my stomach, not my throat; I don't have any eating disorders; I usually sit straight and I don't lie down after eating. Any medical opinions? Does this mean I am unhealthy? How bad is it? How can I reduce the symptoms or make it better?
I am not the medical type of person and my parents have never even used the term, but I have been having this issue since the age of consciousness of my behaviours. After reading this article, I think my problem is " rumination syndrome." Although it doesn't trouble me, except for the fact that I feel different because I don't see this happen to other people. My issue is that anytime I eat, even if I take drugs, I vomit them with their original taste in my mouth like when I put food in my mouth. And it has been like this for a very long time up until now. THIS IS MY STORY.