Rumination Syndrome

What is Rumination Syndrome?

The condition is defined from the name rumination which means the ability to regurgitate food back into the mouth after ingestion. Rumination syndrome can be defined as the effortless reversal of swallowing, where partial or complete ingested food materials are pushed outwards into the mouth for re-chewing and eventual re-swallowing. ^1,3

The presence of the complication can only be diagnosed by a doctor upon deducing the absence of other probable causes of the condition. However, the condition can easily be confused with acute vomiting, and thus its prevalence can only be deduced if the victim has suffered from the ailment for few weeks to months.

Prevalence

Initially, the incidence of the disease was limited to newborns and among those with challenged development of their digestive tract. However, this has come to be proved otherwise as there are numerous cases reported of the same in mature males and females.

Disregarding developmental complications, rumination syndrome is more expressed in females rather than males. Surprisingly, the majority of victims of the ailment are excellent in sporting activities and other co-curricular activities.

Symptoms

The primary symptom of the ailment is regurgitation of swallowed food. However, in infants and puberty infections, other symptoms may prevail. Such symptoms include:

• Heartburn
• Dizziness
• Diarrhea
• Constipation
• Stomach disorders

However, the prevalence of these symptoms should prompt seeking the services of a physician even before testing for rumination syndrome.

Causes

The primary cause of the ailment has yet to be deduced as it is a functional disorder and not attributed to by an infection or any form of inflammation. Amongst children, rumination may occur as a result of stress. This is manifested as an indication of rebuffing the ingested food.

Lack of appeal to the food may be due to a previous eating disorder. However, the condition prevails in later times even after disturbing occurrence has been done away with. In the majority of cases, rumination occurs without the trigger of any discernible factors.

Other Probable Causes

Persistent regurgitation and vomiting can be attributed to abnormal gastroparesis, mechanical obstruction of the intestines, eating disorders, pseudo-obstruction of the intestines and side effects of taking some medication.

Previous infections may also act as triggers to regurgitation. Viral infections such as GI disease may result in the condition. During the infection period, the body adapts to the vomiting behavior which remains intact even after the ailment has been cured. This persists as the abdominal muscles have already become used to the habit of contracting and thus the vomiting.

Diagnosis

Diagnosis of rumination syndrome can only be done with regards to the observable symptoms and the absence of another ailment that can be confused with the condition. Symptom-based criteria are used to check for the prevalence of the disease in newborns, adolescents, and mature persons.

Discerning for the condition is easier in infants, but further testing must be done in puberty victims to exclude any other probable causes.

Diagnostic tests

There is no diagnostic test that has been proved to discern the presence of rumination syndrome. All of the vast tests subjected to victims are usually done so as to rule out other bases for regurgitation. Examples of tests conducted include:

• Barium swallow
• Abdominal x-ray tests
• Checking for stomach emptying
• Upper endoscopies

Barium Swallow

Also called the upper GI series, Barium Swallow is an x-ray test done in the upper part of the gut to deduce any prevailing complications. As the internal organs are invisible on the X-ray, barium is ingested to create a temporary lining on the walls of the digestive tract, making the parts easily visible on an x-ray.

Assessment of Stomach Emptying

Commonly known as gastric emptying study. This checks the rate at which food materials are emptied from the stomach and into the intestines.

The process involves mixing food with a harmless radioactive compound and monitoring its presence in the stomach after it has been swallowed. This monitoring deduces the rate at which the food is digested.

Upper Endoscopy

This involves monitoring of the upper gut for complications. This is done by passing a thin tube fitted a camera. This discerns the tract for presence of abnormalities.

Treatment

Rumination syndrome can be addressed by behavioral alteration. The most common technique involves adopting a practice that tends to reverse the urge to regurgitate.

Ideally, this is done through diaphragmatic breathing, a technique that competes with and reverses rumination. Rumination is therefore stopped gradually as the two practices cannot be done concurrently.

However, medical procedures have not been the best of approaches to correct the condition. Surgical procedures such as fundoplication, a process that involves the covering of the upper stomach to the lower gut may control the ailment effectively, but subjects often complain of discomfort upon food ingestion.

It has therefore been found that the best approach to intervene the complication is by behavioral alteration, though it best yields fruits in the early stages of onset.

Success Treatment

Majority of victims, both young and mature who undergo behavioral modification have found the procedure quite fruitful. The outcome of the process has often been termed as successful with eventual to complete reversal of the rumination syndrome.

Other complications that come handy with rumination are often corrected by medical approaches and therapeutic intercessions which yield desirable results.

Complications

Other complications that may come hand in hand with rumination are not as a result of the primary syndrome. Majority of the glitches may come as result of contrary testing and testing before the correct diagnosis is done.

Such complications are often trivial and variable and whose effects are reversible upon following the ideal treatment procedure. These range from reduced body weight, deprived minerals, and dental problems.

Conclusion

Rumination syndrome is an uncommon ailment that perseveres among infants, adolescents and even among mature persons and whose un-documentation has made difficult to diagnose and cope with. Diagnostic procedures for the condition should be done early on after disregarding all other probable causes. Followed by early behavioral therapy, the ailment can be managed efficiently, yielding superb outcomes.

Reference List

1. Rumination Syndrome. Retrieved from https://en.wikipedia.org/wiki/Rumination_syndrome
2. Rumination Syndrome. Available at http://www.mayoclinic.org/diseases-conditions/rumination-syndrome/basics/definition/con-20037142
3. Rumination Syndrome. Retrieved from http://www.aboutkidsgi.org/upper-gi/rumination-syndrome.html
4. The rumination syndrome in adults. Retrieved from http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2007;volume=53;issue=3;spage=203;epage=206;aulast=Papadopoulos
5. Rumination Syndrome. Retrieved from http://www.chop.edu/conditions-diseases/rumination-syndrome