Here's What Regurgitation Is—and Why You'd Experience It

Regurgitation is when the contents from your esophagus (the tube that brings food from your mouth to your stomach) or stomach come back up into your throat or mouth.

Your lower esophageal sphincter (located between the esophagus and stomach) protects stomach contents from being regurgitated. When it relaxes or weakens, regurgitation may occur.

Regurgitation is a symptom of several conditions, but the most common causes are gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). About 80% of people with GERD will experience regurgitation.

Regurgitation usually isn't harmful. Chronic regurgitation can sometimes result in complications like esophageal inflammation, erosion of tooth enamel, chronic cough, and asthma.

Regurgitation Symptoms

Regurgitation has unmistakable symptoms. The hallmark symptom of regurgitation is the sensation of your stomach contents coming back up and into your throat or mouth. You might taste the recently eaten food or stomach acid, which is usually sour or bitter.

If GER or GERD causes your regurgitation, you may also experience other symptoms of these conditions, including:

• Heartburn, which is a burning feeling in the center of your chest
• Chest pain
• Coughing
• Hoarseness
• Nausea
• Trouble swallowing
• Painful swallowing
  

Regurgitation vs. Vomiting vs. Acid Reflux

It's easy to get regurgitations mixed up with vomiting or acid reflux. While they share similarities, all three are separate sensations.

Regurgitation differs from vomiting because it doesn't usually involve serious nausea or strong, involuntary contractions of your abdominal muscles like vomiting does. In regurgitation, the movement of gastric (stomach) contents to your throat and mouth happens more passively. Vomiting also often happens when you are ill, and regurgitation isn't usually connected to an illness.

Acid reflux is another term for GER. Acid reflux occurs when the contents of your stomach come back up into your esophagus. In regurgitation, the stomach contents go a little higher—up to your throat and mouth. Regurgitation might also involve content from your esophagus, not just your stomach.

Regurgitation and acid reflux can both be symptoms of GERD (chronic GER). People often experience regurgitation along with acid reflux, but the symptoms don't always occur together.

What Causes Regurgitation?

Regurgitation occurs when the lower esophageal sphincter becomes less effective at stopping your stomach contents from being released back up to your throat and mouth. Lower esophageal sphincter dysfunction can be associated with a number of conditions. Here are the most common ones:

Gastroesophageal Reflux (GER)

GER is one of the two most common causes of regurgitation. It is when acid reflux and regurgitation occur from time to time rather than chronically. Many people occasionally experience GER. You might refer to it as indigestion, acid indigestion, heartburn, reflux, or acid reflux.

Gastroesophageal Reflux Disease (GERD)

GERD is the other most common cause of regurgitation. It is when your GER symptoms, such as heartburn, reflux, and regurgitation, happen repeatedly over the long term. Symptoms are also usually more severe.

About 20% of people in the United States experience GERD, and it's more likely to occur if you are overweight, pregnant, a smoker, or are taking medications that have acid reflux as a side effect.

Reflux Esophagitis

Reflux esophagitis is characterized by chronic inflammation of the esophagus. It's often a complication of GERD. One of its main symptoms is acid regurgitation, which may include sour, burning sensations in the throat and mouth.

Other symptoms include heartburn within about an hour of eating, the sense that you have a lump in your throat, trouble swallowing, and increased saliva.

Rumination Disorder

Rumination disorder is when you regurgitate food back into your mouth or throat without any effort or specific cause. The regurgitation usually occurs about 15 minutes after you eat. Both adults and children may experience this.

While the cause is not known, rumination disorder is believed to be a behavioral habit. It is sometimes classified as an eating disorder.

Reflux in Infants

It's common for babies to experience reflux, and one symptom of that is regurgitation. When a baby regurgitates, it is usually referred to as spitting up.

It occurs because babies' lower esophageal sphincter muscle isn't always fully developed. As they age, the lower esophageal sphincter muscle strengthens, and regurgitation stops. Most babies stop spitting up by about 12 months old.

When To See a Healthcare Provider

Experiencing regurgitation from time to time is not a problem. If you experience it frequently, and if your symptoms aren't going away with over-the-counter (OTC) GER medications or lifestyle changes, you should visit your healthcare provider.

You should also see a healthcare provider immediately if you are experiencing other concerning symptoms, such as:

• Chest pressure and pain
• Vomiting
• Trouble swallowing
• Loss of appetite
• Weight loss without a clear cause
• Blood in your vomit or stool
• The presence of blood when you regurgitate

People over 60 and those with iron deficiency or a family history of gastric cancer should see a healthcare provider if they don't have any symptoms other than regurgitation.

Diagnosis

Diagnosing the cause of regurgitation typically starts with your healthcare provider discussing your symptoms and reviewing your medical history. Tests are also sometimes necessary to understand what's causing your symptoms.

An upper gastrointestinal (GI) endoscopy is where an endoscope (a tube with a camera on the end) is inserted into your upper GI tract to view your esophagus and stomach. Esophageal pH monitoring checks how much stomach acid has entered your esophagus.

Treatment

If you are experiencing regurgitation, it's important not to panic. Most episodes of regurgitation are brief and will pass. If you are experiencing an acidic taste in your mouth or symptoms of heartburn, try an over-the counter (OTC) antacid, which should help with your symptoms quickly.

Although antacids can be helpful for occasional regurgitation and acid reflux, they shouldn't be taken daily or to treat more serious cases. If regurgitation and acid reflux are severe or chronic, you should visit your healthcare provider for other mediation options.

GERD treatment may include H2 blockers or proton pump inhibitors (PPIs). Both lower the levels of acid your stomach makes. Both can be purchased over the counter or prescribed by your healthcare provider.

Treatment for GER and GERD may also involve lifestyle changes, such as maintaining your optimal weight, eating a balanced diet, elevating your head during sleep, and avoiding or stopping smoking.

When GERD symptoms don't improve with medications and lifestyle changes, other medical procedures may be recommended, including:

• Fundoplication, a surgical procedure where the top of your stomach is sewn to the end of your esophagus
• Bariatric surgery, weight loss surgery to reduce symptoms
• Endoscopy procedures, where the top of your stomach is sewn to your lower esophageal sphincter or where radiofrequency energy is delivered to your lower esophageal sphincter
  

Other causes of regurgitation might need different treatment. For rumination disorder, practice diaphragmatic breathing after a meal or when you feel the start of regurgitation. Sit in a chair with one hand on your belly, feeling your diaphragm (the large muscle under your lungs) tighten and your belly expand as you take deep breaths in.

How To Prevent Regurgitation

The good news is that, in many cases, you can prevent regurgitation with some simple lifestyle changes. These may include the following:

• Maintain the weight you and your healthcare team determine is optimal for you
• Sleep with your head elevated about 6-8 inches off the bed
• Avoid or stop smoking
• Eat smaller meals
• Avoid eating about three hours before bed
• Avoid foods that trigger GERD, such as acidic, high-fat, and spicy foods, as well as coffee and alcohol
  

Complications

Infrequent and mild bouts of regurgitation aren't serious and won't lead to complications. If you have chronic regurgitations, such as with GERD, and you don't treat your symptoms, some complications can occur over time.

Chronic regurgitation with GERD can cause the following complications to your esophagus:

• Esophagitis, inflammation of the esophagus
• Esophageal stricture, narrowing of the esophagus
• Barrett's esophagus, where tissue similar to the tissue lining your intestines begins to line your esophagus; some people with Barrett's esophagus can develop esophageal adenocarcinoma, a kind of cancer

Repeated regurgitation with GERD can also cause the following complications unrelated to your esophagus:

• Asthma
• Chronic coughing
• Hoarse throat
• Tooth enamel erosion
• Laryngitis, inflammation of your voice box that can lead to a temporary loss of voice
  

A Quick Review

Regurgitation occurs when gastric content moves from your stomach or esophagus into your throat and mouth. Regurgitation is often caused by GER or GERD, conditions usually called acid reflux.

While the sensation and taste of regurgitation can be unsettling, infrequent regurgitation is not typically a cause for alarm. It's important to visit a healthcare provider if regurgitation becomes a chronic condition or if you have any other serious symptoms, such as trouble swallowing or blood in your regurgitated content.