What is Rumination Disorder / Syndrome?

By Deborah Fields, B.Sc.Reviewed by Yolanda Smith, B.Pharm.

Rumination disorder, also known as rumination syndrome, is an eating disorder where a person brings up food from his or her stomach back into the mouth through regurgitation and chews it again before swallowing it.

The reasons for the disorder are not clear. It tends to affect both males and females. Patients who have it are usually at least three months old. Although it is more common in infants and children, adults can also experience it. To class the patient as having the disorder, the person has to have been ruminating for at least a month.

In comparison to food that is brought up through vomiting, ruminated food does not have the same acidic, bitter taste. The patient also does not express any of the common traits of vomiting such as retching, discomfort or distaste. The patient can suffer from malnutrition as a result of the condition as they are not receiving many of the benefits of digesting foods.

Causes

Rumination is often connected to negative environments for the patient such as a stressful home situation or maltreatment.

Symptoms and diagnosis

Food in rumination disorder tends to be regurgitated about 30 minutes from within it being swallowed. The process also happens every day. Medical staff will need to examine the reasons for the food coming back up to make sure that other diseases or eating disorders such as anorexia nervosa, are not causing the condition. Some diseases such as GERD, bulimia or pyloric stenosis, for example, can have similar symptoms.

The complication of malnutrition and weight loss can provide a clue to whether the patient has rumination disorder. Medical staff can carry out an endocrine hormone test, a test for anaemia and a serum electrolyte test to contribute to a decision.

A doctor could look out for further evidence about the general well-being of the patient. A resulting symptom is that the disorder can leave the patient more susceptible to disease as well as suffering from malnutrition and a hunger for more food.  The enamel on the teeth could be affected by the acidic food. The rotting food may also give the patient bad breath.

Treatment

Options for treatment can have very good results. Aversion training can make a difference. In this, staff treating the patient will help them to associate rumination with negative outcomes and non-rumination with positive outcomes.

As the condition can often be linked to a negative family environment, an improvement in the patient’s circumstances can also help to alleviate the issue. Some people can recover on their own and return to eating normally.

References

• Medline Plus on rumination disorder: https://www.nlm.nih.gov/medlineplus/ency/article/001539.htm
• Mayo Clinic on rumination disorder: http://www.mayoclinic.org/diseases-conditions/rumination-syndrome/basics/definition/con-20037142
• The BMJ, A 22 year old with persistent regurgitation and vomiting: case outcome: http://www.bmj.com/rapid-response/2011/10/31/rumination-syndrome-adolescents
• American Psychological Association, Probing the depression-rumination cycle: http://www.apa.org/monitor/nov05/cycle.aspx

Further Reading

• All Eating Disorder Content
• What is an Eating Disorder?
• What Causes Eating Disorders?
• Eating Disorder Signs
• Eating Disorders Diagnosis