Rumination disorder

Definition

Rumination disorder is a condition in which a person keeps bringing up food from the stomach into the mouth (regurgitation) and rechewing the food.

Causes

Rumination disorder usually starts after age 3 months, following a 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

• Repeatedly bringing up (regurgitating) food
• Repeatedly re-chewing food

Symptoms must go on for at least 1 month to fit the definition of rumination disorder.

People do not appear to be upset, retching, or disgusted when they bring up food. It may appear to cause pleasure.

Exams and Tests

The health care provider must first rule out physical causes, such as hiatal hernia and pyloric stenosis. These conditions can be mistaken for rumination disorder.

Rumination disorder can cause malnutrition. Lab tests (such as serum electrolytes, endocrine - hormone functions, and a blood test for anemia) can measure how severe the malnutrition is and determine what nutrients need to be increased.

Treatment

Rumination disorder is treated with behavioral techniques. One treatment associates bad consequences with rumination and good consequences with more appropriate behavior (mild aversive training).

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

Outlook (Prognosis)

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

Possible Complications

• Failure to thrive
• Lowered resistance to disease
• Malnutrition

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 relationships may help reduce the odds of rumination disorder.