Regurgitation is when the contents of your esophagus or stomach flow back into your throat or mouth. This condition occurs when the lower esophageal sphincter (LES), which separates the esophagus and stomach, fails to prevent stomach contents from returning upwards. While it’s a common issue, persistent regurgitation can indicate underlying conditions that may need treatment.

In this guide, we’ll cover what regurgitation is, what causes it, how to differentiate it from vomiting and acid reflux, and when to seek medical attention.

What Is Regurgitation?

Regurgitation refers to the backward flow of food or stomach contents from the stomach or esophagus back into the mouth or throat. This can occur due to a failure in the lower esophageal sphincter, a muscle responsible for preventing stomach contents from moving upward.

While occasional regurgitation is common, especially after a heavy meal, it can also be a symptom of chronic conditions like gastroesophageal reflux disease (GERD). For individuals with GERD, regurgitation may become frequent and problematic, potentially causing additional symptoms and complications.

What Does Regurgitation Feel Like?

The most noticeable symptom of regurgitation is the sensation of stomach contents coming back up into the throat or mouth. This often includes the taste of food or stomach acid, which may feel sour or bitter.

Symptoms of Regurgitation Include:

  • A sensation of food or liquid coming back into the mouth

  • Sour or bitter taste in the mouth

  • A burning sensation in the throat or chest

  • Difficulty swallowing

  • Hoarseness or sore throat, especially after meals

Regurgitation can occur after eating, and may even happen without warning. In some cases, people experience it without feeling nauseous, which is what sets it apart from vomiting.

Regurgitation vs. Vomiting vs. Acid Reflux

It’s easy to confuse regurgitation with vomiting or acid reflux, but there are key differences between these three.

  • Regurgitation is a passive process where stomach contents come back up without forceful contractions of the abdominal muscles, which typically occurs in vomiting.

  • Vomiting involves a more intense reaction with forceful abdominal contractions and is usually associated with illness or an upset stomach.

  • Acid Reflux occurs when stomach acid enters the esophagus, causing a burning sensation (heartburn), but not necessarily rising all the way into the mouth or throat as regurgitation does.

While regurgitation can occur with acid reflux, the two are different phenomena. Acid reflux only involves the backward flow of acid, while regurgitation can also involve undigested food or liquid from the stomach.

What Causes Regurgitation?

Regurgitation typically occurs when the lower esophageal sphincter (LES) becomes weakened or relaxed, allowing stomach contents to rise into the esophagus or throat. This can happen due to a variety of conditions and factors.

1. Gastroesophageal Reflux (GER)

GER refers to occasional acid reflux and regurgitation that happens from time to time. It’s often caused by overeating or consuming acidic or spicy foods. GER is a common condition, and many people experience it occasionally, often referred to as heartburn.

Unlike GERD, GER doesn’t cause chronic regurgitation or more serious complications. However, frequent GER may indicate a need to adjust lifestyle habits to manage symptoms.

2. Gastroesophageal Reflux Disease (GERD)

GERD is a more severe form of acid reflux where symptoms like heartburn, regurgitation, and discomfort occur regularly. About 20% of the population experiences GERD, which can result in serious complications like esophageal inflammation or damage.

Risk factors for GERD include:

  • Obesity

  • Pregnancy

  • Smoking

  • Medications that cause acid reflux

If you have GERD, you may experience regurgitation frequently, often with a sour taste in your mouth and discomfort in your chest.

3. Reflux Esophagitis

Reflux esophagitis is the inflammation of the esophagus caused by stomach acid. It often accompanies GERD and can cause severe regurgitation. Symptoms include chest pain, a feeling of a lump in the throat, and difficulty swallowing.

Treatment for reflux esophagitis often involves addressing the underlying cause of GERD, such as dietary changes, medications, and lifestyle adjustments.

4. Rumination Disorder

Rumination disorder involves involuntary regurgitation of food into the mouth, often shortly after eating. Unlike GERD, this condition doesn't involve stomach acid but instead results from the mechanical action of regurgitating food without nausea.

Rumination disorder can affect both children and adults, and it’s often considered a behavioral issue. Treatment typically involves psychological interventions and strategies to modify the regurgitation behavior.

5. Reflux in Infants

Reflux, often referred to as spitting up in babies, is common due to their underdeveloped lower esophageal sphincter muscle. In most cases, this issue resolves as the baby grows and the sphincter muscle strengthens. However, if symptoms persist beyond the first year, further investigation may be needed.

When Should You See a Healthcare Provider?

Experiencing occasional regurgitation may not be a major issue, but frequent regurgitation can interfere with your daily life. If you experience regular regurgitation or additional symptoms such as pain, weight loss, or difficulty swallowing, it’s important to seek medical advice.

You should consult a healthcare provider if you experience:

  • Chest pressure or pain

  • Vomiting, especially with blood

  • Difficulty or painful swallowing

  • Unexplained weight loss

  • Blood in your regurgitated content or stool

Diagnostic Testing for Regurgitation

To determine the cause of regurgitation, healthcare providers typically begin by discussing your symptoms and medical history. If further testing is needed, some common diagnostic methods include:

  • Upper GI Endoscopy: This procedure involves inserting a flexible tube with a camera into the esophagus to check for inflammation, ulcers, or other abnormalities.

  • Esophageal pH Monitoring: This test measures the level of acid in your esophagus to assess the frequency of acid reflux.

  • Barium Swallow X-ray: This imaging test helps to observe the movement of food through your esophagus and stomach.

Treatment Options for Regurgitation

The treatment for regurgitation largely depends on the cause. In mild cases, over-the-counter antacids can help relieve symptoms. However, if the issue is related to GERD or another digestive disorder, stronger treatments may be necessary.

Treatment for Regurgitation May Include:

  • Antacids: For temporary relief from mild symptoms.

  • Proton Pump Inhibitors (PPIs): These reduce the production of stomach acid and are commonly prescribed for GERD.

  • H2 Blockers: These also reduce stomach acid but are less powerful than PPIs.

  • Lifestyle Changes: Dietary modifications, weight management, and elevating your head during sleep can help reduce symptoms.

How to Prevent Regurgitation

There are several strategies you can adopt to reduce or prevent regurgitation. These lifestyle changes can also help manage the symptoms of GERD and other related conditions.

Preventative Measures Include:

  • Maintain a healthy weight

  • Avoid large meals, especially before bedtime

  • Elevate your head while sleeping

  • Quit smoking

  • Limit alcohol and caffeine intake

  • Eat smaller meals more frequently

A Quick Review

Regurgitation is a common symptom of GERD and other digestive disorders. While occasional regurgitation is typically harmless, frequent occurrences or additional symptoms may require medical attention. Through lifestyle changes, medications, and in some cases, surgical procedures, you can manage regurgitation effectively.