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Difference Between Rumination and Regurgitation

Rumination is when stomach contents move back from the stomach, up the esophagus and into the mouth. This process occurs within a short time (about 15 minutes) after eating. Once back in the mouth the food may be rechewed and swallowed again. The condition is more common in infants, and appears related to abdominal pressure. An increase in pressure seems to force food back up into the mouth. Regurgitation may appear to be the same condition but it occurs much later after eating, such that food is already partly digested. Regurgitation is a common result of acid reflux and GERD where stomach juices and food moves back from the stomach into the mouth. In the case of regurgitation, the food tastes bitter because it is partly digested and acid is present. This can result in inflammation of the esophagus because of the acidic contents being regurgitated.

In short, rumination is a return of undigested food back to the mouth soon after eating. Regurgitation is when gastric acid and digested food returns from the stomach to the mouth sometime later after swallowing, and is due to acid reflux.

What is Rumination?

Definition:

This is a disorder where food is returned back into the mouth from the stomach, rechewed and then re-swallowed. It is not a voluntary process and seems to be linked to an increase in abdominal pressure. The food does not taste bitter or sour when it comes back up so it is food that has not yet been digested.

Complications and treatment:

The biggest problem with regurgitation is that the stomach contents that are moving back up contain stomach acid, and not just food. This poses a risk for the esophagus, which gets inflamed as the acid makes contact with the inner lining of the lumen. The result of this is that the person can develop esophagitis. Baclofen can sometimes provide short-term relief from rumination.

What is Regurgitation?

Definition:

Regurgitation is where a mix of stomach contents and gastric juices are brought back up from the stomach into the mouth. The food has a bitter or sour taste to it because it is mixed with various stomach enzymes and acid. The condition of regurgitation commonly occurs with gastroesophageal reflux disease (GERD). It actually is present in about 80% of people who suffer from GERD.

Complications and treatment:

Since regurgitation brings gastric acid into close proximity with the esophageal mucosa, it can cause an inflammatory response. This means that the acid inflames the esophagus leading to esophagitis, which causes further problems like difficulty in swallowing food and may even leading to bleeding of the tissues of the esophagus. Proton-pump inhibitor medicines, such as omeprazole are recommended to help reduce GERD.

Difference between Rumination and Regurgitation?

Definition

Rumination is the return of undigested food from the stomach to the mouth, after which it is re-swallowed. Regurgitation is when partly digested food and gastric acid move back from the stomach to the mouth.

Taste of the contents

In the case of rumination, the stomach contents don’t taste sour. In the case of regurgitation, the stomach contents do taste sour.

Causes

Rumination is due to increased abdominal pressure and may also be linked to stress. Regurgitation is usually due to GERD.

Complications

Rumination can lead to nausea and pain in the stomach. Regurgitation can lead to esophagitis.

Treatment

The treatment of rumination is difficult but sometimes baclofen helps for a while. Regurgitation can be treated using proton-pump inhibitors and antacids, which help with the GERD.

Prevalence

Approximately 3% to 5% of people suffer from rumination. About 80% of people who have GERD, suffer from regurgitation at some stage.

Table comparing Rumination and Regurgitation

Summary of Rumination Vs. Regurgitation

  • Rumination is when food returns to the mouth from the stomach quite soon after eating.
  • Regurgitation is when partly digested food and stomach acid return to the mouth from the stomach due to GERD.
  • Rumination is more common among infants than other age groups.
  • GERD is the main reason for developing regurgitation.

FAQ

How is rumination different from vomiting?

Vomiting is a forceful expulsion of stomach contents out of the mouth, and the food tastes sour. Rumination is return of food up into the mouth, and the food does not taste sour.

What is the difference between acid reflux and rumination syndrome?

In acid reflux you have a burning sensation and food has a sour taste to it, which is unlike rumination syndrome where it is undigested food coming back up.

What is regurgitation and rumination in newborns?

Rumination has no known cause while regurgitation may occur due to indigestion or some other medical problem with the child. 

What is the difference between rumination syndrome and gastroparesis?

Gastroparesis is when the stomach wont empty like it should, resulting in vomiting. Rumination syndrome is when food that is undigested is returned to the stomach, without vomiting happening.

What is the most distinguishing symptom of rumination disorder?

The person may belch and the food that is brought up is not digested yet.

What are the four types of rumination?

Rumination syndrome has four phases: food moves back into the mouth, food is rechewed, saliva is produced, and food is swallowed again.

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References :


[0]Gottfried, Jonathan. “Rumination”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/rumination

[1]Gottfried, Jonathan. “Rumination”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/rumination

[2]Kahrilas, Peter J. "Regurgitation in patients with gastroesophageal reflux disease." Gastroenterology & hepatology 9.1 (2013): 37.

[3]Sawada, Akinari, and Yasuhiro Fujiwara. "Belching Disorders and Rumination Syndrome: A Literature Review." Digestion 105.1 (2024): 18-25.

[4]Image credit: https://www.canva.com/photos/MAFGvlL0ksg-asian-female-patient-with-gastroesophageal-disorders-acid-re/

[5]Image credit: https://www.canva.com/photos/MACefGW3HpE-unhappy-man-suffering-from-stomach-ache/

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