Mechanism of regurgitation and heartburn pain

Regurgitation• Regurgitation refers to emitting already swallowed

food or drink• Ethiology :– Normal infant regurgitation - some babies are

"pukey babies“– Reflux– GERD– Stomach conditions– Esophageal sphincter muscle disorder– Pyloric stenosis

• Therapy :– Metochlorpramid

Heartburn• Heartburn, or pyrosis, is characterized by burning

retrosternal discomfort that may move up and down the chest like a wave.

• Heartburn is a characteristic symptom of reflux esophagitis and may be associated with regurgitation or a feeling of warm fluid climbing up the throat.

• Heartburn is produced by heightened mucosal sensitivity and can be reproduced by infusion of dilute (0.1 N) hydrochloric acid (Bernstein test) or neutral hyperosmolar solutions into the esophagus.

Pathopysiology

Hormonal fluctuations, mechanical stress, the

effects of certain foods & drugs

Lower Esophageal Sphincter (LES)

pressureLES pressure

Intragastric pressure

normally contracted LES relaxes

inappropriately

allows reflux of gastric acid or bile secretions

into the lower esophagus

the reflux irritates and inflames the

esophageal mucosa

HEARTBURN