[Dysphagia] regurgitation

[scott-dailey at uiowa.edu (Dailey, Scott)]

Regurgitation/rumination can have multiple functions.  (function in the sense that it fills some purpose for the individual).  First, being "stimulated by reflux."  Second, "self stimulatory behavior"  the individual has learned to volitionally regurgitate and "enjoys" that feeling.  Third, gastric emptying difficulties.  Fourth, attention-- someone interacts, says something to them when they do it.  Or avoidance.  If asked to do something they regurgitate because in the past someone has backed off the demand because of or coincidentally with the regurgitation.   There are likely other possible reasons.    
 
One way to evaluate why it is happening to is set up different conditions and track the regurgitation.  For example, have the person actively engaged in a preferred activity and count number of regurgitations, as compared to a demand task that is less preferred, and as compared to a sit alone condition.    You can also track frequency of regurgitation in time relationship to meals and drinks.  It is most likely to happen when the stomach is full.  If it is happening several hours after a meal, gastric emptying may be an issue.  Typically reflux medications are recommended to help decrease the irritation cause by "voluntary" reflux.

Scott Dailey,
Speech-Language Pathologist
University of Iowa Hospitals and Clinics.

	-----Original Message----- 
	From: dysphagia-bounces at b9.com on behalf of kathleen wright 
	Sent: Wed 11/8/2006 4:30 PM 
	To: Julie Huffman; dysphagia at b9.com 
	Cc: 
	Subject: [Dysphagia] regurgitation
	
	

	What causes regurgitation in adults who have MR?  I know of a gentleman who is doing it apparently on purpose and ruminating.  He stopped the regurgitation and rumination while he was on Zyprexa, and started it up again when he was taken off the drug.  Any thoughts as to cause and most efficacious treatment?
	Many thanks.
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