The flow of a fluid through a vessel or valve in the body in a direction opposite to normal.
The alimentary tract extends from the mouth to the anus. Food or drink, once ingested, should only travel in one direction.
From the mouth it passes to the throat with voluntary swallowing and then the reflexes coordinate the involuntary processes that transport food or drinks through the esophagus.
From here it passes to the stomach, then to the small intestine and, after passing through the large intestine, eventually the remains are expelled as faeces.
The contractions of the muscles in the wall of the intestine that facilitates the movement of substances inside are known as peristalsis.
Sometimes, the contents of the small intestine, stomach, esophagus or throat can travel in the opposite direction, which is known as antiperistalsis.
If it is expelled by force, then it is known as vomiting. However, in some cases, the violent rash seen with vomiting is not present.
Instead, the contents fade rather passively compared to vomiting and this is known as regurgitation.
What is regurgitation?
Regurgitation is the distribution of undigested or partially digested food or liquids that are expelled less forcefully than with vomiting.
Although the terms regurgitation and vomiting are used interchangeably, regurgitation is synonymous with the most widely used term, “reflux”.
It is usually limited to the content ingested in the last part of the throat, esophagus and stomach. The contents that have passed into the small intestine can not be passed in this passive manner and must be expelled forcefully through the process of vomiting.
Depending on the site from which the contents are distributed, it can be mixed with mucus, water or stomach acid. Sometimes, regurgitated contents can pass through the nose (nasal regurgitation) or can even enter the respiratory tract (tracheal aspiration).
Vomiting occurs when there is irritation of the intestine. It can also be the result of abnormal stimulation of the muscles in the intestine in a way that allows for reverse peristalsis.
Contractions can start from as low as the first third of the small intestine and, therefore, all contents proximal to the origin can be expelled.
Regurgitation is more of a “spill” or “fluidity” phenomenon and is associated with an altered swallowing reflex, weak peristaltic contractions or poor coordination and dysfunction of certain valves, such as the lower esophageal sphincter (LES).
These mechanisms normally ensure that food and drink ingested do not pass through the mouth again.
Regurgitation can occur frequently in babies and is not considered abnormal if the baby is healthy and prosperous.
This usually follows a food and is the result of air trapped inside the intestine pushing up the ingested milk and the immature valves that allow the reflux of the gastric contents.
The typical “sick” feeling known as nausea that typically precedes vomiting is usually absent in regurgitation. The presence of other symptoms depends largely on the cause and the site from which the material is expelled.
When food and liquids in the stomach are regurgitated, as in the case of acid reflux, stomach acid can cause a burning sensation in the chest (heartburn).
It is often accompanied by a sour taste in the mouth. If the content is expelled from a higher place in the intestine, where significant digestion has not occurred, there may be some degree of drowning.
Difficulty swallowing (dysphagia) is a common characteristic that accompanies certain causes of regurgitation.
When normal peristalsis is altered, a person may also complain of pressure in the chest or a feeling of swelling as food is not pushed through the esophagus.
Causes of regurgitation
The causes of regurgitation may not differ significantly from those of vomiting. Many causes overlap and it is not uncommon for regurgitation to be reported as vomiting and vice versa.
Gastroesophageal reflux disease: The most common cause of regurgitation is a lower esophageal sphincter (LES) dysfunction that also explains chronic acid reflux of gastroesophageal reflux disease (GERD).
Reflux or regurgitation is most prominent when lying down, after eating and with activity. In more severe cases, even leaning forward or even belching can cause reflux when gastric contents enter the esophagus and even reach the mouth.
Upper gastrointestinal obstruction: An obstruction can occur in any part of the intestine and may arise as a result of a mass (inside or outside the intestine), stenosis (abnormal narrowing), excessive and prolonged contraction of the intestinal muscle (spasm), or a foreign body.
The site of the blockage may be the laryngopharynx, the esophagus or the stomach. However, a blockage lower than the intestine can contribute to regurgitation, since the contents supported prevent the recently ingested food and drink from passing through the intestine.
Lower esophageal sphincter: Lower esophageal sphincter dysfunction, either increased or decreased tonicity, may contribute to regurgitation.
As discussed above under GERD, the decrease in tonicity allows the gastric contents to empty into the esophagus.
However, in conditions such as achalasia, the muscles that make up the LES remain contracted and restrict the passage of food to the stomach.
Food accumulates in the esophagus as it enters the stomach very slowly. However, if there is a large food intake or a large intestine (complication of achalasia), regurgitation will be a prominent feature.
Neuromuscular disorders: Swallowing and peristalsis is a carefully coordinated process controlled by the nerves and facilitated by the muscles.
If there is any interruption due to disease or dysfunction of nerves or muscles or even both, then regurgitation may be present.
These diseases must affect the nerves and / or muscles of swallowing, including the centers in the brain that are responsible for this mechanism.
Certain medications can also affect the normal activity of the muscles and / or nerves. Some causes may include:
- Miastenia gravis.
- Multiple sclerosis.
- Disorders of the motor neuron.
- Muscular dystrophy.
- Parkinson’s disease
If regurgitation is not present because of a major condition, it can be controlled or eliminated with changes in habit and / or medication.
- Raise the head of the bed by placing a block under the foot of the bed to raise the headboard to about 20 cm.
- Go to bed no less than two hours after eating.
- Avoid eating large amounts of food.
- Avoid alcohol, sodas, spicy foods, fried foods, etc.
- Avoid the cigar.
Your doctor may recommend medications such as antacids. It can also recommend the use of h2 blockers, these decrease the production of acid.