Rumination disorder

Definition

Rumination disorder is repeated regurgitation (backflow of food from the stomach into the mouth) and re-chewing of food. Symptoms must go on for at least 1 month to fit the definition of rumination disorder. There does not appear to be upset, retching, or disgust associated with the regurgitation, and it may appear to cause pleasure.

Causes

Rumination disorder usually starts after 3 months of age, following an period of normal digestion. It occurs in infants and is rare in children and teenagers. The cause is often unknown. Certain problems such as lack of stimulation of the infant, neglect, and high-stress family situations, have been associated with the disorder.

Symptoms

• Repeated regurgitation of food
• Repeated rechewing of food

Exams and Tests

The health care provider must first rule out physical causes of regurgitation, such as hiatal hernia and pyloric stenosis, which can be misdiagnosed as rumination disorder.

Rumination disorder can cause malnutrition. Laboratory tests (such as serum electrolytes, endocrine - hormonal functions, and a blood test for anemia) can measure the severity of the malnutrition and determine what nutrients need to be increased.

Treatment

Rumination disorder is treated with behavioral techniques, such as mild aversive training. This involves associating bad consequences with rumination and good consequences with more appropriate behavior.

Other techniques include improvement in the child's psychosocial environment (if there is abuse or neglect) and counseling for the parents.

Outlook (Prognosis)

In some cases rumination disorder will disappear on its own, and the child returns to eating normally without treatment. In other cases, treatment is necessary.

Possible Complications

Complications of rumination include malnutrition, lowered resistance to disease, and failure to thrive.

When to Contact a Medical Professional

Call your health care provider if your baby appears to be repeatedly spitting up, vomiting, or rechewing food.

Prevention

There is no known prevention. However, normal stimulation and healthy parent-child relations may help reduce the occurrence of rumination disorder.

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