Section: Causes
There are many causes of regurgitation. It is important to understand that although there are multiple diseases of the esophagus that cause regurgitation, there are other disorders that are considered systemic (involving the whole body), that have an effect on the esophagus, and regurgitation is only one of the symptoms being exhibited. The following are the most commonly reported disorders associated with regurgitation.
Megaesophagus (esophageal hypomotility) is the decreased/absent esophageal movement or peristalsis that often results in dilatation (stretching beyond normal size) of the esophagus. It may be congenital (existing from birth) or acquired (noninheritable trait that results later in life).
Esophageal inflammatory disease.
Esophagitis is an inflammation of the esophagus. It may be a primary entity or secondary to other disorders.
Myositis is an inflammatory/immune disorder that affects the muscles.
Intrathoracic extraluminal (in the chest cavity but outside of the esophagus) disease.
Vascular ring anomaly is a congenital disorder that causes an entrapment and compression of the esophagus and, in turn, a partial obstruction (blockage). Megaesophagus and regurgitation often occur secondary to this obstruction.
Intrathoracic (in the chest) tumors or masses may compress the esophagus from the outside, causing regurgitation.
A hiatal hernia is an abnormality of the diaphragm allowing part of the stomach to be displaced into the chest cavity. Regurgitation is one of the most common signs seen with this disorder.
Intraluminal (inside) esophageal obstruction.
An esophageal stricture is an abnormal narrowing of the esophagus, often secondary to either esophagitis or some inflammatory event, such as a foreign body.
Esophageal foreign bodies often cause regurgitation due to an associated esophagitis or physical blockage. Foreign bodies usually lodge at the narrowed areas if the esophagus, including the thoracic inlet, at the base of the heart, or at the hiatus of the diaphragm.
Tumors or masses can grow within the esophagus, causing obstruction and regurgitation.
An esophageal diverticulum is an out-pouching of the esophagus. It can be congenital or acquired.
Neuromuscular dysfunction resulting in megaesophagus.
Myasthenia gravis is a disorder affecting the neuromuscular (nerve and muscle)junctions often causing generalized weakness, in addition to megaesophagus/ regurgitation.
Polymyositis is a disorder associated with inflammation and weakness of the muscles, including the esophagus.
Endocrine disorders (hypothyroidism, hypoadrenocorticism) can be associated with regurgitation.
Certain toxicities (lead, organophosphate) can affect the esophagus and cause megaesophagus and regurgitation.
Systemic lupus erythematosis is an immune disorder affecting multiple systems, occasionally causing megaesophagus and regurgitation.
Polyneuritis is a disorder associated with the inflammation of multiple nerves, occasionally causing megaesophagus and
regurgitation.
Idiopathic (unknown cause) megaesophagus is one of the most common causes of regurgitation. This is generally a diagnosis of exclusion, after all of the above diseases have been ruled out with appropriate diagnostics.
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