Regurgitation - Revision history

Michuang0720 at 18:15, 25 June 2016

2016-06-25T18:15:21Z

Bara at 18:00, 18 July 2012

2012-07-18T18:00:10Z

Bara at 16:52, 9 September 2011

2011-09-09T16:52:27Z

HelenD: Created page with "==Introduction== Regurgitation describes the '''passive, retrograde movement of food and water''' from the mouth or the oesophagus. It is important to differentiate regurgitatio..."

2011-09-08T09:09:08Z

Created page with "==Introduction== Regurgitation describes the '''passive, retrograde movement of food and water''' from the mouth or the oesophagus. It is important to differentiate regurgitatio..."

New page

==Introduction==
Regurgitation describes the '''passive, retrograde movement of food and water''' from the mouth or the oesophagus.

It is important to differentiate regurgitation from [[Vomiting|vomiting]] as they represent very different disease aetiologies.

Regurgitation is the '''hallmark sign of oesophageal disorders'''.

Causes include:

'''Oesophageal obstruction''':
:Congenital [[Vascular Ring Anomalies|vascular ring anomaly]]
:[[Oesophageal Foreign Body|Foreign body]]
:[[Oesophageal Stricture|Stricture]]
:Neoplasia
:Extraoesophageal compression: thyroid carcinoma, pulmonary alveolar cell carcinoma
:Rare miscellaneous causes: cricopharyngeal achalasia, oesophageal diverticulum, oesophageal atresia

'''[[Oesophagitis]]''':
:gastrooesophageal reflux
:persistent vomiting
:[[Hiatal Hernia|hiatal hernia]]
:caustic agents

'''[[Megaoesophagus]]''':
:Congenital megaoesophagus: idiopathic or [[Myasthenia Gravis|myasthenia gravis]]
:acquired megaoesophagus
:neuropathy: polyradioculoneuropathy
:immune-mediated: polyneuritis, polymyositis, SLE, myasthenia gravis, [[Canine Dermatomyositis|dermatomyositis]]
:myopathy
:metabolic: [[Hypothyroidism|hypothyroidism]], [[Hypoadrenocorticism|hypoadrenocorticism]]
:[[Lead Poisoning|lead toxicity]]
:[[Canine Distemper Virus|Canine distemper]]
:Dysautonomia

'''Pharyngeal disorders''':
:[[Rabies|rabies]]
:foreign body
:other obstructions

==Clinical Signs==
{| class="wikitable collapsible"
|'''Regurgitation'''
|'''Vomiting'''
|-
|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==
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.

==Treatment==
'''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|aspiration pneumonia]] which should be treated aggressively, [[Oesophageal Stricture|oesophageal strictures]], continued oesophagitis, perforation, fistula, diverticulum formation, motility disorders.

The prognosis is usually '''guarded'''.

{{Learning
|flashcards = [[Feline Medicine Q&A 07]]
}}

==References==
Allenspach, K. (2009) '''Dysphagia and regurgitation in small animals''' ''RVC student notes''

Pasquini, C. (1999) '''Tschauner's guide to small animal clinics''' ''Sudz Publishing''

[[Category:To Do - Helen]]
[[Category:To Do - Review]]

@@ Line 1: / Line 1: @@
 ==Introduction==
 Regurgitation describes the '''passive, retrograde movement of food and water''' from the mouth or the oesophagus.
@@ Line 101: / Line 102: @@
 {{review}}
 [[Category:Oesophagus - Pathology]]
 [[Category:Expert Review]]

@@ Line 92: / Line 92: @@
 {{Learning
 |flashcards = [[Feline Medicine Q&A 07]]
 }}

@@ Line 17: / Line 17: @@
 '''[[Oesophagitis]]''':
-:gastrooesophageal reflux
+:Gastrooesophageal reflux
-:persistent vomiting
+:Persistent vomiting
-:[[Hiatal Hernia|hiatal hernia]]
+:[[Hiatal Hernia|Hiatal hernia]]
-:caustic agents
+:Caustic agents
 '''[[Megaoesophagus]]''':
 :Congenital megaoesophagus: idiopathic or [[Myasthenia Gravis|myasthenia gravis]]
-:acquired megaoesophagus
+:Acquired megaoesophagus
-:neuropathy: polyradioculoneuropathy
+:Neuropathy: polyradioculoneuropathy
-:immune-mediated: polyneuritis, polymyositis, SLE, myasthenia gravis, [[Canine Dermatomyositis|dermatomyositis]]
+:Immune-mediated: polyneuritis, polymyositis, [[SLE]], myasthenia gravis, [[Canine Dermatomyositis|dermatomyositis]]
-:myopathy
+:Myopathy
-:metabolic: [[Hypothyroidism|hypothyroidism]], [[Hypoadrenocorticism|hypoadrenocorticism]]
+:Metabolic: [[Hypothyroidism|hypothyroidism]], [[Hypoadrenocorticism|hypoadrenocorticism]]
-:[[Lead Poisoning|lead toxicity]]
+:[[Lead Poisoning|Lead toxicity]]
 :[[Canine Distemper Virus|Canine distemper]]
-:Dysautonomia
+:[[Key-Gaskell Syndrome|Dysautonomia]]
 '''Pharyngeal disorders''':
-:[[Rabies|rabies]]
+:[[Rabies|Rabies]]
-:foreign body
+:Foreign body
-:other obstructions
+:Other obstructions
 ==Clinical Signs==
@@ Line 60: / Line 60: @@
   |}
-There may be additional signs such as '''coughing and dyspnoea''' secondary to aspiration pneumonia.
+There may be additional signs such as '''coughing and dyspnoea''' secondary to [[Aspiration Pneumonia|aspiration pneumonia]].
-Weakness may be present due to a '''systemic disorder''' such as myasthenia gravis, Addison's disease, polymyositis.
+Weakness may be present due to a '''systemic disorder''' such as myasthenia gravis, [[Addison's disease]], polymyositis.
 Animals usually have a '''ravenous appetite'''.
@@ Line 73: / Line 73: @@
 '''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
+'''Plain radiography''': may detect a radioopaque foreign body.
 '''Contrast radiography''': for radiolucent foreign bodies, obstructions, megaoesophagus.
@@ Line 86: / Line 86: @@
 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|aspiration pneumonia]] which should be treated aggressively, [[Oesophageal Stricture|oesophageal strictures]], continued oesophagitis, perforation, fistula, diverticulum formation, motility disorders.
+'''Complications''' following oesophageal disease include: [[Aspiration Pneumonia|aspiration pneumonia]] which should be treated aggressively, [[Oesophageal Stricture|oesophageal strictures]], continued [[oesophagitis]], perforation, [[Oesophageal Fistula|fistula]], diverticulum formation, motility disorders.
 The prognosis is usually '''guarded'''.
@@ Line 99: / Line 99: @@
 Pasquini, C. (1999) '''Tschauner's guide to small animal clinics''' ''Sudz Publishing''
-[[Category:To Do - Helen]]
-[[Category:To Do - Review]]
+{{review}}