Do any of you readers remember that epic moment in the movie Dodgeball when Ben Stiller’s character asks Christine Taylor’s character for a date, and she rudely “disses” him with the remark, “I just threw up in my mouth a little bit”? Well, guess what? There’s actually a word for that literally distasteful action—vurping (vomiting plus burping). It’s usually accompanied by an icky taste in the back of the mouth.
Although we all might get a good laugh at the gag (double entendre intended), there’s a reason why it happens. Vurping can be minimized or prevented altogether and, although usually harmless, it can be cause for a health concern. I spoke with Robynne Chutkan, MD, a gastroenterologist at The Digestive Center for Wellness in Chevy Chase, Maryland, to get more insight about it.
Dr. Chutkan likened a vurp to the upper gastrointestinal tract’s answer to the lower end’s wet fart (aka “shart”). One is a burp with food…the other a toot with stool. She explained that when you chew and swallow, the upper esophageal sphincter, a muscular valve at the very top of the esophagus, moves chewed food down the esophagus, via a wavelike action, to the sphincter at the base of the esophagus, which opens to allow food into the stomach.
“Burping happens when the lower esophageal sphincter opens up and lets air escape the stomach and come out the mouth. The sound is the upper esophageal sphincter vibrating as air is released. When you vurp, food comes up with the air,” she said.
Normally, this happens when you have overeaten or swallowed a lot of air. “The typical scenario is that you’ve gone out to dinner and have really overdone it with too much rich food, alcohol and/or talking while eating. The pressure from food or air causes that lower esophageal sphincter to open,” explained Dr. Chutkan. Stomach pressure from bending over suddenly might also force the issue.
Plus, vurping tends to happen at night…when the stomach isn’t as active and food takes longer to move through the body. You may actually wake up choking—your body’s attempt to clear the throat. And if that weren’t enough to make vurping no laughing matter, it can be especially dangerous in an older person—or anyone—who has a poor gag reflex and who may not choke but instead aspirate—or breathe in—the regurgitated food particles. Once in the lungs, the irritation and contamination can set off pneumonia.
Pregnant women are also at risk for vurping—one, because of the pressure of the womb-cradled baby on the stomach and, two, because shifts in hormone levels, especially progesterone, affect muscle response and can cause the lower esophageal sphincter to open more easily.
PREVENTING THE VURP
If you vurp only occasionally—especially after a large meal or late-night eating—it’s probably not a cause for alarm, according to Dr. Chutkan, who offers this advice to prevent or minimize its occurrence…
- Make breakfast your heaviest meal, lunch a modest one, and dinner light. That is, ease up on food portions as the day goes on so that, by the time you are lying down to rest at night, there’s less contents and digestive work in your stomach, which will lessen the chance of vurping while reclining or asleep.
- Avoid carbonated beverages or chewing gum. Avoid eating and talking at the same time. All of these promote air buildup in the stomach that gets released in a burp or a vurp. Be sure to eat slowly to lessen the chances of gulping air.
- Chew on fennel seeds or drink fennel, ginger or chamomile tea to calm your stomach.
- Avoid caffeine and alcohol, and don’t smoke. They all can provoke the vurping response.
- Cut back on high-fat foods. Because they take longer to digest, they actually slow down the emptying of the stomach, keeping you full longer and increasing the chances of a vurp.
- Don’t rely on antacids. “Vurping isn’t caused by an overproduction of acid. You need an adequate amount of acid to break down your foods. It’s better to just unlearn the behavior that is causing the problem,” said Dr. Chutkan.
WHEN VURPING SIGNALS A HEALTH PROBLEM
If vurping is frequent and occurs not just when you’ve had a big meal, it’s time to make an appointment with a gastroenterologist. Frequent vurping can be a sign of…
- A loose lower esophageal sphincter muscle, usually causing gastroesophageal reflux disease (GERD). The gastroenterologist may recommend lifestyle modification as noted above and/or prescribe GERD medication. If these strategies do not work, he or she might recommend a surgical procedure to tighten the sphincter.
- Ulcers or gall bladder problems…if the vurping is accompanied by abdominal pain.
- An eating disorder, specifically purging. In this scenario, the body becomes so good at vomiting that it has figured out, from the repetitive cycles, how do it with little prompting. The lower esophageal sphincter becomes very loose and reactive. Gastroenterological as well as psychological treatment are needed to correct this.
- A condition called gastroparesis, or delayed emptying of the stomach, that affects nerves that help the stomach empty and can be a cause of severe vurping.
So, again, everything in moderation, don’t talk with food in your mouth, just like mother said…and know when to seek professional medical help for yourself or a loved one when something ordinarily ordinary, like vurping, is not looking ordinary anymore but signaling a health concern.