Regurgitation: Causes, Symptoms, Treatment, Diagnosis

Regurgitation is rising up, of the mixture of gastric juices and sometimes undigested food back up in the esophagus into the mouth.

Regurgitation is a common condition in babies in the first year of life. In adults, it is a common symptom of acid reflux and GERD.

The cause of regurgitation varies depending on whether it’s occurring in a baby or an adult.

In adults regurgitation can occur if there is:

• Acid reflux, a condition which is characterized by reflux, heartburn, and bad breath. It occurs after eating large meals, eating certain food, or lying down soon after eating. GERD, a condition that is caused due to multiple acid refluxes. Both acid reflux and regurgitation lead to regurgitation of stomach acid and food.
• Rumination syndrome, a rare condition in which there is frequent regurgitation of undigested food. In this condition, regurgitation happens frequently right after eating.
• Bulimia can also lead to regurgitation. It is a type of eating disorder that is characterized by bingeing on food.
• Other conditions such as blockages, pregnancy, smoking, eating disorders, and certain medications can also lead to regurgitation.
• In babies, regurgitation is very common.
• Functional infant regurgitation is a type of regurgitation which is not accompanied by other symptoms. In this condition, there are frequent, more than one regurgitation during the first year of life.
• GERD can also affect children but is less common as it is in adults.

The symptoms occur depending on the cause.

In adults, regurgitation mostly occurs due to acid reflux and GERD. The regurgitation symptoms include:

• Trouble swallowing
• Heartburn and chest pain
• A sensation as if there is a lump present in the throat
• Bitter and sour taste in the mouth
• Regurgitation of stomach acid and food.

In the case of rumination syndrome the symptoms are:

• Bad breath
• Nausea
• Weight loss
• Frequent regurgitation after eating
• Fullness in the belly

In the babies, due to functional infant regurgitation, the symptoms are:

• Frequent regurgitation, which occurs twice daily
• Regurgitation in the first year of life
• Regurgitation for at least 3 weeks

If regurgitation is a symptom of GERD it may be accompanied by:

• Blood or bile in regurgitation
• Problems in breathing
• Excessive crying
• feeding problem

Regurgitation in the adults is diagnosed by X-ray, upper endoscopy, and esophageal imaging.

These tests help the doctor determine the extent of the damage to the esophagus and any complication due to GERD.

For rumination syndrome, additional testing which includes the EGD test and gastric emptying test might be required. These tests look for the blockages if present which might be a cause of frequent regurgitation.

24-hour impedance-pH monitoring is also an effective way to diagnose rumination syndrome.⁽¹⁾

In babies, regurgitation is a normal side effect of feeding in the early years. The test can be the same which are used to detect regurgitation in the adults which are:

• Upper GI endoscopy and biopsy
• Upper GI series
• Esophageal pH measurements

These tests are only used in moderate to severe cases of GERD as they can be invasive for an infant.

The treatment involves the use of certain medications that can treat the condition. The medicines include:

• Antacids, which can help relieve GERD symptoms
• H2 blockers, which can help reduce stomach acid production
• PPIs. Which can reduce long term stomach acid production
• The doctor might also prescribe prokinetics and antibiotics to increase stomach emptying and reduce the risk of regurgitation.

In babies with regurgitation, there are no treatments or surgery options. In case the baby has the regurgitation due to GERD symptoms, the pediatrician might recommend the medications used in adults.

Lifestyle changes are another option to reduce the occurrence of regurgitation. They include:

• Keeping a healthy weight
• Quitting smoking
• Limiting caffeine and alcohol consumption
• Taking smaller meals and chewing food thoroughly
• While lying down at night, keeping the head up with an extra pillow
• In some cases, psychotherapy would be required.

To reduce the symptoms of regurgitation in a baby, a doctor might suggest a few changes during feeding, which are:

• Feeding the baby in a quiet location where there is no disturbance
• Avoiding overfeeding as it may increase the chances of regurgitation
• Thickening the formula or milk with one tablespoon cereal per ounce of liquid, which can be easy to digest.
• If the child is experiencing regurgitation which is making it difficult to keep the food down, consult a doctor.