Introduction

• Backward flow of ingested food from the esophagus.
• Regurgitation is a clinical sign NOT A DIAGNOSIS.
• Cause: esophageal irritation, motility disorder or obstruction.
• Signs: food returned with lack of abdominal effort, production of mucoid saliva between meals.
• Diagnosis: signs, radiography, esophagoscopy.
• Treatment: depends on cause but most cases also require treatment for esophagitis if regurgitation has been persistent.
• Prognosis: depends on cause but can be good with appropriate treatment.

Pathogenesis

Etiology

Esophageal obstruction

• Physical:
  • Vascular ring anomaly Vascular ring anomalies.
  • Stricture Esophagus: stricture.
  • Intraesophageal neoplasia Esophagus: neoplasia.
  • Esophageal foreign body Esophagus: foreign body.
  • Extraesophageal mass, eg mediastinal lymphadenopathy.
• Functional:
  • Systemic myopathy
  • Addison's disease.
  • Myaesthenia gravis Myasthenia gravis.
  • Dysautonomia Dysautonomia.
  • Idiopathic megaesophagus Megaesophagus.
• Esophagitis Esophagitis :
  • Gastro-esophageal reflux.
  • Hiatus hernia Hiatal hernia.
  • Secondary to chronic vomiting Vomiting.
  • Post-anesthetic gastro-esophageal reflux.
  • Gastro-esophageal intussusception.
• Trauma:
  • Secondary to esophageal foreign body Esophagus: foreign body.
  • Iatrogenic, eg esophagoscopy Esophagoscopy.

Timecourse

• Usually relatively acute onset over days.

Diagnosis

Treatment

Outcomes