Regurgitation – food coming back up
What is regurgitation?
Regurgitation means that previously eaten food rises from the stomach to the esophagus or mouth. It is characteristic that this sometimes happens only for many hours after the meal. Thus, food that has been eaten in the evening can still be largely recognizable the next morning. Unlike normal vomiting, it does not have to be accompanied by powerful cauldron or vomit movements.
Regurgitation can occur when food is insufficiently moved from the stomach to the intestines, but also when the passage is obstructed by narrowing or other structural deviation. Therefore it is important for persistent complaints to be clear first what the cause is.
Within Chinese medicine, the main question is why the normal downward movement of the Stomach is disturbed. Depending on the underlying pattern acupuncture and Chinese herbs can be used supportively.
Possible western causes
Regurgitation is a symptom and not a separate Western diagnosis. It may occur in:
- disorders in the motility of the stomach or oesophagus;
- achalasia or oesophageal spasms;
- gastritis;
- gastrointestinal ulcers;
- narrowing of the stomach exit (pylorus stenosis);
- stomach or oesophagus diverticles;
- gastrooesophageal reflux;
- changes following gastric surgery;
- certain systemic disorders, including sclerodermia;
- diabetes or hypothyroidism;
- rarer: a tumor or other structural disorder of stomach or oesophagus.
Certain medicines can also affect the movement of stomach and intestines.
Regurgitation is not the same as vomiting, where a more active vomit reflex usually occurs. It also differs from acid reflux, in which acidic stomach content rises. In case of swallowing problems, food can also come back, but this usually happens soon after swallowing.
For new or persistent regurgitation, swallowing problems, unintentional weight loss, blood in the recovered material or black stools medical examination is important.
Possible causes
Regurgitation can occur when the normal motility of stomach and esophagus is disturbed or when food cannot be properly transported from the stomach to the intestines. A narrowing, inflammation or structural damage can play a role in this.
Eating and living habits can also contribute. Large or heavy meals, a lot of alcohol and an irregular diet may add to the burden on the stomach. In some people, stress and long-term stress clearly affect the onset or worsening of symptoms.
In Chinese medicine, food is also very restrictive for a long time and many cold or raw foods are seen as factors that can weaken the digestive function in sensitive people.
How can acupuncture help with regurgitation?
In regurgitation, acupuncture treatment is tailored to the cause of the symptoms and the underlying TCM pattern. Within Chinese medicine, the functional movement of the Stomach should normally be directed downwards. When this movement is blocked or reversed, food and stomach contents can actually rise.
Treatment may be directed at:
- Restore the Stomach's downward movement
- support the function and motility of digestion
- Reduce food and fluid accumulation
- Dampness and Phlegm reduce when blocking gastric function
- Regulating stuck Qi when stress and tension play an important role
- Spleen and Stomach strengthen in weak digestion
- Stomach-Heat reduce when heat phenomena are present
In case of obvious structural narrowing, mass or severe damage to the stomach or oesophagus acupuncture cannot eliminate the mechanical cause. Regular medical diagnostics and treatment are then paramount.
How can Chinese herbal medicine help with regurgitation?
Chinese herbs are also chosen based on the underlying pattern. Therefore, there is no standard herbal treatment for anyone with regurgitation.
For example, when food comes back because the digestion is weak and cold, the emphasis is on heating and strengthening. In case of heavy, full feeling with plenty of mucus or moisture, reducing Dampness and Phlegm can be important. When complaints are clearly provoked by tension, regulating Qi may be more prominent.
Treatment may be directed at:
- Lead Stomach-Qi down again
- Enhance Spleen and Stomach
- heat digestion at Cold and weakness
- Reduce phlegm and accumulated moisture
- Bring back stuck Qi
- Reduce Stomach-Heat
- improve blood circulation when prolonged stagnation is involved
Acupuncture and herbs are chosen from the same pattern diagnosis, but work in different ways and can therefore be combined.
How does Chinese medicine view regurgitation?
Within Chinese medicine, the Stomach organ system plays a central role. An important function of Stomach is to receive and process food. According to TCM, this includes a natural downward movement: food should be transported further to the intestines from the Stomach.
When this movement is disturbed and turned upwards, it speaks of rebellious Stomach-Qi . Qi can be seen as the functional activity and movement of the body. The wrong direction of motion may manifest itself as nausea, peasantry, reflux, vomiting or regurgitation.
The Spleen is also important. Within TCM, the Spleen supports the processing and transport of food and moisture. If this function weakens, food and moisture can be more easily left behind. According to TCM Dampness and Phlegm, it can occur, which further impede normal movement.
With other people, tension plays an important role. Stress can disrupt the free movement of Liver-Qi, causing the Stomach not to move down well anymore. Heat and, in case of prolonged complaints, Blood stasis can also play a role.
A recognizable combination of such mechanisms and associated symptoms is called a TCM pattern.
What is a TCM organ system?
A TCM organ system is broader than the anatomical organ of Western medicine. It describes a coherent set of body functions. More about this can be found at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of signs and symptoms that indicates which functions according to Chinese medicine are out of balance. Read more about this at TCM basics .
The most common patterns in regurgitation are described below. Other patterns are possible and multiple patterns may occur at the same time. Not everyone with the same pattern has all the symptoms mentioned. The pattern is determined based on the overall picture of complaints.
Most common TCM patterns
Spleen- and Stomach-Yang-Qi-deficiency
Brief explanation
With this pattern, digestion is not strong enough to process and transport food properly. Food can stay in the Stomach for a long time and only rise again many hours later. Cold and general digestive weakness are at the forefront.
Common symptoms: regurgitation of partially digested or still recognizable food, often hours after meals or the next morning, bloated or full of feeling after eating, low appetite, tiredness, paleness, convulsion and loose stools. The returned food is often not highly acidic and may be mixed with watery or weary fluid.
Examples of Western disorders: chronic gastritis, gastroparesis, gastroptosis, hypothyroidism and symptoms following certain gastric surgery.
Phlegm blokkeert the Stomach
Brief explanation
When moisture is not sufficiently processed according to TCM, Dampness can thicken to Phlegm. This means not only visible mucus, but also an accumulation that can block the normal movement of Stomach-Qi. This makes food easier to stay behind.
Common symptoms: regular regurgitation, a full or swollen sensation in the upper abdomen that can reduce after returning food, plenty of saliva or mucus, a heavy or oppressive feeling on the chest, nausea and sometimes dizziness. The material returned may be slimy, foamy or watery. Phlegm-Heat can prevent a dirty taste and more heat phenomena.
Examples of western disorders: gastric emptying and other motility disorders and conditions that impede gastric emptying.
Liver-Qi attacks the Stomach
Brief explanation
This pattern occurs especially when regurgitation is clearly associated with stress, frustration or emotional tension. According to TCM, stuck Liver-Qi disturbs the normal downward movement of the Stomach. Complaints can occur once after severe stress, but also more easily with prolonged stress.
Common symptoms: regurgitation that occurs during stress or worsens, tension or pressure in the stomach, upper abdomen or chest, a lumpy throat, sighing, irritability, frustration and bloating. Burning heartburn or acid reflux may also occur. In women PMS or menstrual symptoms may be associated with stomach discomfort.
Examples of Western disorders: functional dyspepsia, oesophageal spasms, achalasia, chronic gastritis and other functional gastrointestinal symptoms in which stress has a clear influence.
Stomach-Heat
Brief explanation
At Stomach-Heat, there is too much heat in the Stomach according to TCM. As a result, normal downward movement is disturbed and stomach contents can be pushed up. Much alcohol and a lot of strong heating or spicy nutrition can contribute. If the pattern exists for a long time, the moisture and Yin of the Stomach may also weaken.
Common symptoms: regurgitation with an acidic or unpleasant smell or taste, burning or hot feeling in the stomach area, dry mouth and lips, poor breath, thirst, restlessness or irritability, dark urine and a tendency to constipation.
Examples of Western disorders: gastritis, gastroesophageal reflux and inflammation processes of stomach, esophagus or stomach exit.
Blood stasis
Brief explanation
Blood stasis is more a pattern with regurgitation in long-term and more severe complaints than with simple functional disturbance. According to TCM, circulation has been obstructed for a long time. In the source text this pattern is explicitly associated with a possible mass or structural deviation that hinders food passage.
Common symptoms: frequent or persistent regurgitation, prolonged fullness of the upper abdomen, clearly localized pain and sometimes firm or hard resistance. Dark or purple discolorations may also occur.
Blood in the returned material or black, tarry stools are alarm symptoms for which medical assessment is necessary.
Examples of Western disorders: structural narrowing of stomach or oesophagus and other conditions where the passage is physically obstructed.
In case of suspicion of structural deviation, TCM is not a substitute for further medical examination.
Outlook
The prognosis strongly depends on the cause. In particular, when there is a functional disturbance of motility and no structural deviation is present, treatment can focus on supporting gastric function and reducing factors that provoke the symptoms.
In case of chronic complaints, a longer treatment course may be required. In the initial phase acupuncture is a common guideline once a week; in the case of more serious complaints more frequent treatment can be considered temporarily. If the symptoms improve steadily, the frequency can be reduced.
When scarring, narrowing, tumor or other structural disorder hinders passage, the prognosis with acupuncture alone or Chinese herbs is less favourable and regular medical treatment is paramount.
What can you do for yourself?
Eating habits can be important during regurgitation. Smaller meals, quiet food and good chewing can reduce the burden on the stomach. Large and heavy meals and a lot of alcohol can increase the symptoms.
When stress is a clear trigger, walking, quiet exercise, breathing exercises or other forms of relaxation can help.
Nutrition advice may also vary according to TCM pattern. For example, clear Cold and digestive weakness fits a different approach than when Stomach-Heat is at the forefront.
Contact
Do you regularly suffer from food coming back and want to know if acupuncture and/or Chinese herbal medicine can fit in with your complaints? During a first appointment we look not only at the regurgitation itself, but also at your digestion, nutrition, stress, any other symptoms and the underlying TCM pattern. On this basis a personal treatment plan will be drawn up.