Regurgitationens

Regurgitationens refers to regurgitation, the passive backward flow of stomach or esophageal contents into the mouth. It is distinct from vomiting, which is a coordinated, often forceful expulsion accompanied by nausea and retching. Regurgitation may be effortless, brief, and can occur during sleep or after meals.

Causes and mechanisms: It occurs when the lower esophageal sphincter is weak or temporarily incompetent, when esophageal motility is impaired, or when there is mechanical obstruction or a diverticulum. Common conditions include gastroesophageal reflux disease, hiatal hernia, esophageal strictures, achalasia, and Zenker's diverticulum. In infants, physiological regurgitation can be common due to immature esophageal sphincter.

Clinical features: Regurgitated material is often undigested or partially digested and may be sour-tasting. Regurgitation can lead to dental erosion and, if aspirated, to pneumonia or respiratory symptoms.

Diagnosis: Diagnosis relies on history and exam, with distinction from vomiting. Tests may include endoscopy, esophageal pH monitoring, and esophageal manometry to identify GERD, dysmotility, or obstruction.

Management: Treatment targets the underlying cause. Lifestyle measures include smaller, more frequent meals, avoiding recumbency after eating, and weight management. Pharmacologic therapy may involve acid suppression (e.g., proton pump inhibitors) or prokinetics. In cases of structural disease or refractory GERD, surgical interventions (fundoplication, hernia repair) or endoscopic procedures may be considered.

Epidemiology and impact: Regurgitation is common in infants and less so in adults, where it signals potential pathology rather than a normal physiologic process. If regurgitation is persistent or accompanied by weight loss, dysphagia, or respiratory symptoms, medical evaluation is advised.