Regurgitation describes the passive, retrograde movement of food and water from the mouth or the oesophagus.
It is important to differentiate regurgitation from vomiting as they represent very different disease aetiologies.
Regurgitation is the hallmark sign of oesophageal disorders.
- Congenital vascular ring anomaly
- Foreign body
- Extraoesophageal compression: thyroid carcinoma, pulmonary alveolar cell carcinoma
- Rare miscellaneous causes: cricopharyngeal achalasia, oesophageal diverticulum, oesophageal atresia
- Gastrooesophageal reflux
- Persistent vomiting
- Hiatal hernia
- Caustic agents
- Congenital megaoesophagus: idiopathic or myasthenia gravis
- Acquired megaoesophagus
- Neuropathy: polyradioculoneuropathy
- Immune-mediated: polyneuritis, polymyositis, SLE, myasthenia gravis, dermatomyositis
- Metabolic: hypothyroidism, hypoadrenocorticism
- Lead toxicity
- Canine distemper
- Foreign body
- Other obstructions
|Passive event||Abdominal effort|
|No prodromal nausea||Prodromal nausea|
|Undigested tubular food||Usually digested food|
|Possibly painful||No swallowing pain|
|Usually alkaline pH||Alkaline or acidic pH|
There may be additional signs such as coughing and dyspnoea secondary to aspiration pneumonia.
Weakness may be present due to a systemic disorder such as myasthenia gravis, Addison's disease, polymyositis.
Animals usually have a ravenous appetite.
Dysphagia may be present if the pharynx is involved.
Diagnosis should take into account the signalment and history.
Physical examination may involve oesophageal palpation, lung auscultation to check for aspiration pneumonia, checking for underlying or concurrent diseases.
Plain radiography: may detect a radioopaque foreign body.
Contrast radiography: for radiolucent foreign bodies, obstructions, megaoesophagus.
Endoscopy may also be indicated to visualise the problem.
The initiating cause should be treated, which may involve removal of a foreign body or resection of a persistent right aortic arch.
Minimising the chances of aspiration pneumonia is important, and includes: feeding solid large pieces of food from a height.
General medical management may include: sucralfate liquid to act as a chemical bandage for the oesophagus, ranitidine and omeprazole to inhibit gastric acid secretion which may contribute to oesophagitis.
Complications following oesophageal disease include: aspiration pneumonia which should be treated aggressively, oesophageal strictures, continued oesophagitis, perforation, fistula, diverticulum formation, motility disorders.
The prognosis is usually guarded.
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|Feline Medicine Q&A 07|
Allenspach, K. (2009) Dysphagia and regurgitation in small animals RVC student notes
Pasquini, C. (1999) Tschauner's guide to small animal clinics Sudz Publishing
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