Why do I have regurgitation of food?

Which sphincter prevents regurgitation of food from the stomach?

Our food pipe starts in the neck and connects the back of the throat to the stomach. At both ends of the food pipe or oesophagus, there is a ring of muscle which prevents food and acid from the stomach from coming back into the throat.

Which conditions can present as regurgitation or dysphagia?

Regurgitation of undigested food or acid can be due to slowly growing conditions such as:

The tightness of the upper ring muscle (Cricopharyngeal spasm)
Web formation in the food pipe
Out-pouching of the food pipe (Pharyngeal Pouch)
Stricture or tightness of the food pipe because of a previous injury such as a burn
The food pipe muscles unable to relax due to a stroke.

In some cases, it can present suddenly due to obstruction of the food pipe due to a foreign body. You should attend A&E if you suspect that you have a sudden onset complete dysphagia.

In some patients, this can be the presentation of cancer in the food pipe. Suppose you notice progressive difficulty in swallowing over the period of 3-6 weeks. In that case, you should see your doctor and get an urgent referral to an ENT doctor to rule out oesophageal cancer.

When should I be concerned about my regurgitation or difficulty in swallowing (Dysphagia)?

If you notice that you are choking and coughing as soon as you drink or eat.

If you think you need extra effort and multiple swallows to push the food down your food pipe, or you notice weight loss with or without a neck lump. If you see food regurgitating into your nose, you should see an ENT doctor. In patients with pharyngeal pouch or diverticulum of the upper food pipe, you may notice a bubbling or gurgling sound in the neck, frequent chest infections and in some cases, neck lump that you are able to press.

What happens when you see an Ear, Nose & Throat doctor?

When you visit your ENT doctor, you will have a complete history and examination. In the clinic, you will have an assessment of the upper food pipe by doing endoscopy and the doctor may organise a special scan in the form of a barium swallow or MRI scan. The doctor may discuss with you to do an assessment under anaesthesia and take a biopsy or tissue sample.

How is regurgitation or dysphagia managed?

Management of regurgitation depends on the cause of dysphagia. In some cases, management may be multidisciplinary with the ENT doctor working together with a SALT (Speech and Language specialist), nutritionist, dietitian and your doctor. In complex cases, functional assessment of swallowing is done in the clinic, which provides useful information to your doctor, aiding diet modification and rehabilitation exercises.

Helping Patients with Specialist Expertise and Kindness

Mr Gaurav Kumar

Consultant Ear, Nose & Throat Surgeon

Book an Appointment

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entsurgeonclinic@gmail.com

07494914140

Disclaimer: For general information only, always seek medical advice from your treating consultant.

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