Regurgitation happens when a mixture of gastric juices, and sometimes undigested food, rises back up the esophagus and into the mouth.
In adults, involuntary regurgitation is a common symptom of acid reflux and GERD. It may also be a symptom of a rare condition called rumination disorder. In babies, regurgitation is normal within the first year of life.
This article will explore the common causes, diagnosis, and treatment for involuntary regurgitation in both adults and babies.
The cause of regurgitation may vary based on whether it’s occurring in a baby or adult.
Acid reflux is a condition that’s characterized by reflux, heartburn, and bad breath. Common triggers include:
- eating large meals
- eating certain foods
- lying down soon after eating
Rumination syndrome is a rare condition that causes frequent regurgitation of undigested food. This regurgitation happens frequently right after eating a meal.
Doctors don’t fully know the causes of it yet. Risk factors include having a mental health condition or undergoing a stressful experience.
Rumination syndrome is rare, so unless there’s constant regurgitation, the regurgitation is more likely due to acid reflux or GERD.
Other causes of regurgitation in adults include:
- certain medications
- eating disorders
Blockages in the esophagus due to scarring or cancer can cause frequent regurgitation. Early pregnancy hormones can cause a relaxed esophageal sphincter, which can lead to regurgitation.
Some medications can also irritate the lining of the esophagus, which can cause regurgitation of bile. Smoking can exacerbate conditions like acid reflux and lead to increased reflux and regurgitation.
Bulimia may also cause regurgitation. Bulimia is an eating disorder characterized by bingeing and purging food.
Bulimia is a much more serious cause of voluntary regurgitation. It requires mental health treatment.
Regurgitation is common in infants and babies. However, some babies experience frequent regurgitation.
When this regurgitation isn’t accompanied by other symptoms, it’s known as functional infant regurgitation. This condition is characterized by frequent regurgitation more than once per day during the first year of life.
GERD can also affect infants, although not as commonly as it affects adults. Due to the short length of the esophagus, infants with GERD are more likely to experience regurgitation instead of just reflux.
Symptoms of regurgitation vary based on the underlying cause. Pay attention to specific symptoms when it comes to regurgitation in babies.
Many of the symptoms that accompany regurgitation are due to the conditions that cause regurgitation, such as acid reflux and GERD.
Symptoms of acid reflux and GERD include:
- heartburn or chest pain
- bitter or sour taste at the back of the throat
- trouble swallowing
- feeling a lump in the throat
- regurgitation of stomach acid or undigested food
When regurgitation happens frequently on its own without the other symptoms of acid reflux or GERD, it may be rumination syndrome.
Symptoms of rumination syndrome include:
- frequent regurgitation soon after eating
- fullness in the belly
- bad breath
- weight loss
Due to the size of the esophagus in infants and babies, regurgitation is common in the early years of life.
If your infant has functional infant regurgitation, you may notice the following symptoms:
- frequent regurgitation, at least twice daily
- regurgitation for at least 3 weeks
- occurs within the first year of life
There are usually no other symptoms that accompany this condition outside of the regurgitation. However, if the regurgitation is a symptom of GERD, it may be accompanied by:
- trouble swallowing food and liquids, which can cause gagging or choking
- irritability, back arching, or avoidance during eating
- frequent cough and pneumonia
If you notice your infant is having other symptoms, it may be an indicator of a more serious condition. Watch out for:
- blood or bile in the regurgitation
- problems feeding
- excessive crying
- problems breathing
Acid reflux is generally a temporary condition that doesn’t require a formal diagnosis. However, because GERD requires long-term dietary and lifestyle management, your doctor may want to perform some diagnostic tests.
These tests may include:
These tests can help your doctor determine the extent of esophageal damage and complications due to GERD.
To diagnose rumination syndrome, your doctor will first eliminate the possibility of other conditions, such as GERD. Additional testing may be necessary, including an EGD test and gastric emptying test.
These tests look for any blockages or slowed transit time that may be causing the frequent regurgitation.
Infant regurgitation is a frequent and normal side effect of feeding in the early years of life.
It’s difficult for doctors to test for functional infant regurgitation. However, if there are no additional symptoms, a diagnosis can be made if the regurgitation occurs at least twice daily for 3 weeks during the first year of life.
- upper GI endoscopy and biopsy
- upper GI series
- esophageal pH measurements
As you can imagine, these tests can be invasive for an infant. They’re often used only in moderate to severe cases of infant GERD.
Medication is a popular first-line treatment option for people with acid reflux and GERD. There are a handful of medications that can treat these conditions, including:
- antacids, such as Rolaids, which can relieve mild GERD symptoms
- H2 blockers, such as Pepcid, which can reduce stomach acid production
- PPIs, such as Prilosec, which can reduce stomach acid production long term
Occasionally, your doctor may prescribe prokinetics and antibiotics to increase stomach emptying and reduce the risk of regurgitation.
There are currently no medications used to treat rumination syndrome. Instead, treatment relies on lifestyle changes.
There are currently no medications or surgeries used to treat functional infant regurgitation.
However, if your infant has regurgitation due to GERD, your pediatrician might recommend the same GERD medications used in adults.
The American Academy of Allergy, Asthma & Immunology recommends making the following lifestyle changes to reduce GERD symptoms:
- Aim for a healthy weight.
- Stop smoking.
- Limit caffeine and alcohol consumption.
- During mealtime, eat smaller meals, chew your food thoroughly, and don’t lie down after eating for at least 2 to 3 hours.
- When lying down at night, prop up your head and neck with extra pillows.
Treatment options for rumination syndrome focus on changing the behaviors that are causing the regurgitation, including:
- retraining the diaphragm to relax after eating
- staying upright during and after meals
- reducing stress during mealtime
In some cases, psychotherapy may be necessary.
For infants with frequent regurgitation, doctors suggest that certain changes during feeding can help reduce regurgitation:
- Feed your baby in a quiet, undisturbed location to reduce stress and fussing during feedings.
- Thicken the formula or milk with 1 tablespoon cereal per ounce of liquid to help with digestion.
- Don’t overfeed your infant. Overfeeding can cause increased regurgitation.
Similar lifestyle recommendations for GERD in adults can be applied to infants, such as trying smaller, more frequent feeding sessions and elevating the head after meals.
If you or your infant is experiencing regurgitation that makes it difficult to keep food down or is accompanied by other symptoms, it’s time to see a doctor.
Your doctor can help narrow down the cause of the frequent regurgitation using your medical history and diagnostic testing.
Once a cause is established, you and your doctor can work together to find medication and lifestyle changes to help reduce the regurgitation.
If your regurgitation is a symptom of an eating disorder such as bulimia, there are resources that can help.
The National Eating Disorders Association has a map on their website that can help you find an eating disorder specialist near you.
Regurgitation happens when digestive fluids and undigested food rise from the esophagus into the mouth.
In adults, involuntary regurgitation is a symptom of conditions such as acid reflux, GERD, and rumination syndrome. In infants, frequent regurgitation is a common symptom of functional infant regurgitation and GERD.
There are a variety of tests your doctor will use to diagnose the cause of your frequent regurgitation. Medications and lifestyle changes are the first line of defense in decreasing your regurgitation and improving your quality of life.