Have You Heard Of The Rumination Syndrome?

What is Rumination Syndrome?

Rumination syndrome, also known as rumination disorder is a rather peculiar condition where the person instantly regurgitates food that is either undigested or partially digested, chews it and swallows it once again. This disorder has perplexed scientists and doctors for many years and only recently, a few pharmacological and therapeutic lines of treatment for it have emerged. Unfortunately, Rumination
syndrome is a chronic one. Therefore, the only way to normalize life for a person suffering from it is effective symptom management.

What Causes Rumination Syndrome?

Since this symptom has been discovered relatively recently, scientists and doctors have not been able to pinpoint its actual cause. However, some studies have suggested that people undergoing extreme stress or emotional problems tend to develop rumination disorder. People who develop this disorder have reported that in most cases, regurgitation is the natural response of their body to relieve abdominal discomfort. Scientists have thus developed a theory stating that continuous repetition of this regurgitation response becomes an unconsciously learned behaviour, which is ultimately known as Rumination Syndrome.

What are the Signs and Symptoms?

One of the most common and noticeable symptoms of this disorder is repeated regurgitation of food that has just been swallowed. This regurgitation usually happens within ten minutes of eating any solid food. A person affected with this disorder usually complains of intense pain in the upper abdomen that gets relieved after regurgitation. Some of the more subtle signs and symptoms of this syndrome include chapped lips and sudden dental health deterioration like tooth decay.

How is it Diagnosed?

Under usual circumstances, when patients report that they have been regurgitating, re-chewing, and re- swallowing their food for at least 3 months, they are diagnosed with Rumination syndrome. However, recent studies have developed certain criteria based on which a person can be accurately diagnosed to have rumination syndrome.

• When a person has been regurgitating and re-swallowing their food for over a month and it begins to severely impact other activities in their daily lives, they can be diagnosed with rumination disorder.
• Rumination syndrome is often confused with certain types of gastrointestinal disorders like Gastroesophageal reflux disease (GERD), Gastroparesis, Achalasia, and Pyloric stenosis. Hence, another criterion for the diagnosis of rumination syndrome is that the regurgitation should not be a result of the aforementioned disorders.
• Since most of the criteria for diagnosis of rumination syndrome rely on an elimination method, the third criterion deals with the elimination of other mental illnesses. This means that the regurgitation should not be solely linked with Anorexia nervosa, Bulimia nervosa, or even Binge eating disorder.
• Moreover, three main types of diagnostic tests are used by doctors in attempts to rule out the possibility of the aforementioned gastrointestinal disorders. These tests include gastric emptying test, upper endoscopy, and even abdominal X-rays. When not significant gastrointestinal causes are found with these tests, a person can be diagnosed with rumination syndrome.
• One of the more modern methods of accurately diagnosing rumination syndrome is known as Antroduodenal Manometry. In this test, a fine catheter is pushed through the nose past the oesophagus and into the stomach to measure the pressure difference. This pressure difference has also been known to cause frequent regurgitation in people suffering from rumination syndrome.

What are the Lines of Treatment for Rumination Syndrome?

1. Holistic Treatment: Holistic lines of treatment like a reversal of habitats or lifestyle changes have yielded desirable results in the treatment of this disorder. An important goal of this method of treatment is to reduce comorbidities like anxiety, stress, nausea, as well as any discomfort in the stomach.
2. Behavioural Therapy: However, since this disorder is primarily categorized as a mental health disorder, the most effective lines of treatment are behavioural therapy. The method of treatment known as Diaphragmatic Breathing is a technique used by caregivers to help people suffering from rumination syndrome, to regularise their breathing patterns.
3. Medicinal Remedy: Pharmacological treatment has largely been unsuccessful in treating this rare syndrome so far. However, a prescription drug by the name of Baclofen has shown promising results to some extent in preventing the involuntary regurgitation response that is common in this disorder.
4. Psychotherapy: Some studies have also proven that a decent percentage of people suffering from this disorder can be treated with psychotherapy. The use of verbal communication and relaxation techniques through psychotherapy and counselling can thus be considered one of the effective forms of treatment of this rare disease. Complications Associated with This Disorder While there is very little data of patient records of this disease due to its rarity, some complications associated with it have been recorded. Doctors suggest that this disorder be treated at the earliest because, without effective treatment, the constant regurgitation may severely damage the oesophagus (food pipe). Rumination syndrome, when it affects younger children, may cause complications like:

• Malnutrition,
• Developmental failures,
• Electrolytic fluid imbalance,
• Severe dehydration.

Since this disorder can affect people of any age group, older children and adults who suffer from it can experience furthermore complications like:

• Bad breath,
• Dental erosion,
• Sudden and unnatural weight loss,
• Isolation from social life,
• Pneumonia,
• Choking hazards, and
• Death, in the severest of cases.

Conclusion

Theoretical studies on Rumination syndrome have revealed that emotional stress leads to a discomforting sensation in the abdomen, which is the primary cause of uncontrollable regurgitation. Since not much research and case-based evidence exists on this unusual and rare syndrome, people suffering from it can often feel helpless. However, with the recent advancements in psychology, behavioural therapies are providing promising responses.

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