Regurgitation

Regurgitation is when stomach contents — including digestive juices and sometimes newly chewed food — flow back up into your mouth.

People with regurgitation often describe:

• Food coming back up in their throats
• Burping up food
• Having a sour taste in their mouths
• A sensation of fluids moving up and down in their chests

What is regurgitation a symptom of?

Regurgitation is a symptom of:

• Acid reflux
• GERD (chronic acid reflux)
• Rumination syndrome (a disorder in which a person chews up regurgitated food and either spits it out or swallows it again)

What causes regurgitation?

Causes can vary depending on whether acid regurgitation occurs in babies or adults.

Regurgitation in babies

It’s common for babies to have regurgitation. This is because they consume a liquid diet and spend much of their time lying down. Most of the time, regurgitation happens on its own and isn’t caused by another condition. But babies with GERD are more likely to have frequent or more severe regurgitation.

However, not all spit-up is harmless. Forceful or projectile regurgitation — especially when paired with poor weight gain, back arching or unusual irritability — warrants prompt evaluation by a pediatrician. These symptoms can signal a more serious condition, like pyloric stenosis.

Regurgitation in adults

The most common causes of regurgitation in adults include:

• Acid reflux
• GERD
• Rumination syndrome

Other possible causes include:

• Certain medications: Some drugs can irritate the lining of your esophagus, including NSAIDs (nonsteroidal anti-inflammatory drugs), oral bisphosphonates, anticholinergics, calcium channel blockers and tricyclic antidepressants.
• Blockages in your esophagus: These obstructions may be due to scar tissue, narrowing or tumors.
• Eating disorders: Things like bulimia nervosa and other disordered eating conditions often contribute to regurgitation.
• Smoking: Smoking weakens your esophageal sphincter (the valve that keeps gastric contents in your stomach), allowing digestive juices to flow back up.
• Pregnancy: Early pregnancy hormones can relax your esophageal sphincter (a ring of muscle fibers that keeps swallowed food down), which may cause regurgitation.

How is regurgitation treated?

Treatment for regurgitation depends on the underlying cause and the severity of your symptoms. Your healthcare provider might recommend:

• Medications
• Lifestyle changes
• Surgery

Medications

Medications that may help reduce regurgitation and other acid reflux/GERD symptoms include:

• Antacids, like calcium carbonate (Tums^®), which treat heartburn and indigestion
• H2 blockers, like famotidine (Pepcid^®), which quickly suppress the production of stomach acid
• Proton pump inhibitors (PPIs), like omeprazole (Prilosec^®), which reduce the amount of acid your stomach makes

PPIs take longer to work than H2 blockers but last longer, making them helpful for chronic acid reflux.

Lifestyle changes

Certain lifestyle changes can also help reduce regurgitation. These may include:

• Limiting caffeine and alcohol
• Quitting smoking
• Maintaining a weight that’s healthy for you
• Sitting upright for at least two to three hours after eating
• Propping your head up while sleeping

To help manage regurgitation in your baby, avoid overfeeding and try:

• Feeding your baby in a quiet environment
• Thickening milk or formula with cereal, if recommended by your pediatrician

Surgery

If you have frequent discomfort from acid regurgitation, your healthcare provider may recommend a procedure called fundoplication. This surgery tightens and reinforces the muscles at the bottom of your esophagus to reduce regurgitation and other reflux symptoms.

Depending on your situation, a surgeon may do a Nissen fundoplication or a TIF procedure (transoral incisionless fundoplication).

What are the possible complications or risks of not treating regurgitation?

Conditions related to regurgitation — like acid reflux, GERD and rumination syndrome — can lead to complications if left untreated. These may include:

• Esophagitis (inflammation of your esophageal tissue)
• Esophageal stricture (narrowing of your esophagus)
• Malnutrition
• Abdominal pain
• Dehydration
• Barrett’s esophagus (precancerous changes in the esophagus that can raise the risk of esophageal cancer over time)

Barrett’s esophagus can increase the risk of esophageal cancer if it isn’t monitored or treated. But most people with GERD don’t develop Barrett’s esophagus.

Can regurgitation be prevented?

You may be able to reduce regurgitation by:

• Eating slowly
• Limiting foods and drinks that trigger acid reflux, like caffeine, alcohol, citrus fruits and tomato sauce
• Quitting smoking
• Waiting at least two to three hours before lying down after eating
• Taking over-the-counter medications like antacids, H2 blockers or proton pump inhibitors

When should I call my doctor?

Occasional regurgitation is normal. But if you have frequent regurgitation — with or without other symptoms — let your healthcare provider know. You may have an underlying condition that needs treatment.

Seek immediate medical care if you have difficulty swallowing, unexplained weight loss, severe chest pain or if you vomit blood.

What is the difference between reflux and regurgitation?

Acid reflux is the backward flow of stomach contents into your esophagus. Regurgitation happens when that material reaches your mouth or throat.

Regurgitation vs. vomiting: What’s the difference?

Regurgitation can look a lot like vomit, but it’s not the same thing. Regurgitation is passive, while vomiting is forceful. For example:

• Regurgitation happens when stomach contents rise into your mouth without nausea or abdominal contractions. It often looks like newly chewed food.
• Vomiting is the forceful emptying of stomach contents through your mouth. It’s often accompanied by nausea and retching. Vomit doesn’t look like newly chewed food because it’s already been digested.