rumination syndrome

Q: The rumination syndrome is described as recurrent vomiting in mentally disadvantaged children.

A) True

B) False

Answer: B

The rumination syndrome is frequently misdiagnosed as vomiting, gastroparesis, or gastroesophageal reflux disease (GERD). Instead, it is primarily a behavioral disorder. Unlike previously believed, it is not only limited to mentally-disadvantaged children, but it can also occur in normal adolescents and adults.

It requires only two conditions for 3 months for diagnosis (with symptom onset at least 6 months before diagnosis), and is known as the Rome IV criteria.

• Persistent or recurrent regurgitation of recently ingested food into the mouth with subsequent spitting or remastication and swallowing
• Regurgitation is not preceded by retching

Supportive symptoms are:

• Effortless regurgitation events are usually not preceded by nausea
• Regurgitant contains recognizable food that might have a pleasant taste
• The process tends to cease when the regurgitated material becomes acidic

The primary treatment is behavioral modification via diaphragmatic breathing techniques.

#GI

#psychiatry

References:

1. Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal Disorders. Gastroenterology 2016; 150:1380.

2. Pomenti S, Katzka DA. Current state of rumination syndrome. Dis Esophagus. 2024 Aug 29;37(9):doae041. doi: 10.1093/dote/doae041. PMID: 38741462.