Rumination Disorder

About Rumination Disorder

Rumination disorder is a feeding and eating disorder involving repeated regurgitation of food over a period of at least one month. Regurgitated food may be rechewed, reswallowed or spit out. The regurgitation typically occurs soon after eating, is effortless and is usually not preceded by nausea or retching, which distinguishes it from vomiting. The behavior is not explained by a gastrointestinal or other medical condition such as gastroesophageal reflux, and when it occurs alongside another mental or developmental condition, it is severe enough to warrant separate clinical attention. It was first recognized mainly in infants and in people with intellectual disability, but it also occurs in older children, adolescents and adults with typical development, where it is increasingly recognized and often mistaken for reflux or vomiting disorders. Research suggests that an unintentional, learned contraction of the abdominal wall muscles pushes stomach contents upward. Complications can include weight loss, malnutrition, bad breath, dental erosion and social embarrassment, leading people to avoid eating with others. Diagnosis often involves specialist gastroenterology assessment, sometimes with high resolution manometry. The best supported treatment is behavioral, especially diaphragmatic breathing used as a competing response that makes regurgitation physically difficult, combined with habit reversal approaches, with additional support for nutrition and any co occurring anxiety.