Which statement best distinguishes GERD-related regurgitation from regurgitation due to a pharyngoesophageal diverticulum on history?

• A. GERD regurgitation is sour liquid with heartburn.
• B. Diverticulum regurgitation involves regurgitation of undigested food with halitosis and coughing.
• C. Both regurgitations are identical in history.
• D. Diverticulum regurgitation presents with weight gain.

Answer: (B)

Differentiating regurgitation by what the material is and what associated symptoms occur helps tell GERD from a pharyngoesophageal diverticulum. In GERD, regurgitation is typically of acidic or sour-tasting liquid and comes with heartburn or reflux symptoms. In a pharyngoesophageal diverticulum, food can get trapped in the pouch and later regurgitated as undigested material, often with foul breath (halitosis) and a cough from aspiration. The timing can be hours after a meal rather than immediately after, and weight loss can occur due to dysphagia. So the statement describing regurgitation of undigested food with halitosis and coughing best distinguishes diverticular regurgitation from GERD.