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Rumination Syndrome

Rumination syndrome is a rare disorder that affects children and some adults. A child with this condition usually eats meals normally, but after about an hour or two, undigested food comes back up into his or her mouth from the esophagus. Typically this happens at every meal, day after day.

Facts about rumination syndrome

The word rumination comes from cows, or animals that regurgitate food as part of their normal digestive process. Rumination syndrome used to be considered a rare disorder that primarily seemed to affect children with mental disabilities. Now doctors are realizing that rumination may be more common.

Although still rare, it is being diagnosed in both children and adults. Researchers speculate that this may be happening simply because doctors are recognizing and diagnosing rumination syndrome more frequently than they did in the past, not because it is happening more often.

What are the symptoms?

Rumination is different from vomiting. With rumination, the food is undigested and often still tastes the same as when it was first eaten. Researchers believe that although rumination is unconscious, it is from the voluntary muscle relaxation of the diaphragm that it has become a learned habit. It may be a variation of the typical belching reflex–instead of burping up gas, the reflex causes actual food to come back up.

How is it diagnosed?

Since vomiting is much more common, rumination syndrome is often misdiagnosed as a vomiting disorder such as gastroparesis or gastroesophageal reflux disease.

In order to diagnose rumination syndrome properly, doctors need to ask the right questions. For instance, asking what the food tastes like when it comes up is important. If the answer is that it still tastes good, this means that the food is undigested, making rumination syndrome a good possibility. Vomited food has been digested and typically is not kept in your mouth.

How is it treated?

No drugs are available to effectively treat rumination syndrome. According to the most recent research, by far the best way to stop rumination syndrome is to relearn how to eat and digest food properly with diaphragmatic rebreathing training.

This technique is typically taught by a behavioral psychologist, and it's easy to learn. It has to be used at the start of every meal to avoid regurgitation that occurs. Over time, most people can master the breathing technique and eliminate the unpleasant symptoms of rumination syndrome.

Can it be prevented?

Experts aren't sure why rumination syndrome starts in the first place, so it's unclear what can be done to prevent it. But the diaphragmatic rebreathing training is quite effective at stopping it.

Managing rumination syndrome

The good news about rumination syndrome is that it doesn't seem to do much physical damage. In rare instances, it can cause problems with the esophagus. And in some adolescents, it has caused a small amount of weight loss.

Work with your doctor or your child's doctor to recognize the symptoms and then with a behavioral psychologist to put an end to the pattern. 

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