What is regurgitation?
Regurgitation is the involuntary return of partially digested food from the stomach into the mouth. This uncomfortable symptom is commonly caused by GERD since the LES is damaged to such a severe degree that stomach juices can freely reflux to the level of the throat. Although regurgitation from acid reflux can occur at any time, including after a meal, it is most alarming when it occurs at night. The usual scenario is abruptly waking at night with bitter liquid in the throat accompanied by a feeling of panic. In response to this, you likely sit up immediately. After a minute or so the regurgitation clears and a horrible bitter and usually burning feeling remains in the throat. You typically will run to the bathroom and drink water hoping for relief, and then search out Maalox, Mylanta or even some baking soda dissolved in water. As opposed to vomiting, regurgitation tends to happen without any warning.
Regurgitation is a reliable symptom
Regurgitation is a very reliable symptom since its occurrence is so unmistakable. It only occurs when the barrier to reflux, the LES, is severely damaged. RefluxMD classifies anyone with regurgitation as Stage 3 GERD. Regurgitation can be less severe in the early stages as the LES function gradually deteriorates, but it still generally is unmistakable.
The effect of PPI and lifestyle
While lifestyle changes can help, regurgitation responds poorly to acid suppressive therapy and it is easy to understand why. If the function of the reflux barrier, the LES, is compromised enough, free reflux occurs. PPIs and other acid suppressive medications do nothing to improve the barrier. Therefore, whatever is in the stomach, acid or non-acid material, will continue to reflux and regurgitation continues. Once significant regurgitation reoccurs, your condition has failed medical therapy.
Since medical therapy has failed, treatment options are limited to those that restore the barrier. This requires a minimally invasive surgical approach that should be seriously considered for a return to a normal quality of life.
Other potential complications
Aside from the very disturbing symptoms of regurgitating food and liquids, complications from regurgitation may include enamel erosion of the teeth, pneumonia from the regurgitated material passing into the lungs, and over the long term, severe lung damage (a condition called pulmonary fibrosis) that can be life-threatening.
If you experience episodes of regurgitation
Regurgitation is serious and you should take immediate action if you experience this symptom:
- Find a GERD Expert physician to perform diagnostic tests and evaluate your condition.
- Although they may only provide marginal benefits, seek lifestyle choices that reduce your other GERD symptoms.
- Consider all treatment options seriously, particularly maintaining a healthy BMI and adopting a GERD-friendly diet.
Reviewed by: Dr. Dengler, RefluxMD Medical Director