Rumination Syndrome

Rumination syndrome is characterized by repeated unintentional spitting up undigested or partially digested food from the stomach. Re-chew it, and then either swallow it or spit it out.

Since the food which regurgitates is not digested and that is the reason why it is not acidic like vomit.

It occurs every day at every meal usually within 30 minutes of eating.

The condition most often occurs in infants and in people with developmental anomalies.

But it can also occur in other children, adolescent and adults.

The following signs and symptoms can occur in the case of rumination symptom:

• regurgitation of undigested food,
• weight loss,
• constant hunger,
• abdominal pain,
• constipation,
• malnutrition. 

The cause of rumination syndrome has not yet been established.

But some studies suggest rumination is due to a subconscious behavior and not a conscious one.

Some people are reported to have rumination syndrome along with constipation Caused by a rectal evacuation. 

The diagnosis of rumination syndrome is based upon medical history of the patient, history of the disease and a physical checkup.

In this initial examination doctor observes patient’s behavior. Which may be enough for the diagnosis of rumination syndrome.

Since rumination syndrome is frequently confused with bulimia nervosa, gastro-esophageal reflux and gastro paresis.

Some tests are recommended to rule the other disease out of suspicion, which include:

• Endoscopy of upper git in this test doctor inspects through a small camera inserted through the mouth and examine the esophagus, stomach and upper part of small intestine.
• The doctor may take a tissue sample (biopsy) for further studies.
• Gastric emptying - this procedure includes ingestion of a contrast and estimate the time taken for emptying of stomach.  This test can also be used to know how long it takes food to travel through small intestine and colon.
• SPECT - single photon emission computerized tomography helps to see the functions of stomach and in this a radioactive substance and a special camera are used to create useful 3d pictures.

The treatment of rumination syndrome depends on age and cognitive abilities.

If the disease is due to behavioral disability, then doctors prefer behavior therapy.

In this therapy clinicians use habit reversal behavior therapy. During this therapy people will learn to identify when rumination occurs and to breath in and out using abdominal muscles.

Such kind of breathing prevents regurgitation. In some people with mental disabilities such behavioral treatment may not be possible.

Treatments involve mild aversive tanning in which rumination is ass0ciated with negative consequences.

For infant’s treatment is focused on changing infant’s environment and behavior. In some cases, frequent rumination damages, the mucous membrane of esophagus to prevent this proton pump inhibitor are prescribed till the frequency and severity of regurgitation has reduced.

Some doctors may prescribe medications that relax stomach after eating which can also benefit the situation. 

Since the causes of rumination symptom are not established preventive methods cannot be predicted.

Alternatives and home remedies are not recommended because rumination syndrome occurs due to developmental disabilities.

Some lifestyle modifications can be made in order to improve rumination syndrome.

Eating at proper time and regular intervals, reducing stress.

Eating foods which are easily digestible, less spicy food will also help the condition.

There is a risk that untreated rumination syndrome can damage esophagus due to the acid from the stomach and cause unhealthy weight loss.