The main treatment for rumination syndrome is behavioral therapy to stop regurgitation.
Rumination syndrome (also known as rumination disorder or merycism) is a feeding and eating disorder in which undigested food comes back up from a person’s stomach into his or her mouth (regurgitation). Once the food is back in the mouth, the person may chew it and swallow it again, or spit it out. This behavior usually occurs after every meal, and may appear effortless. Rumination may follow a sensation of burping/belching and typically does not involve nausea or retching. In rumination, the regurgitated food does not tend to taste sour or bitter because it has not had time to fully mix with stomach acid and be digested.
This act of regurgitation is a reflex action that can be a learned and intentional act or can be unintentional. People who have rumination syndrome are not regurgitating food because of a stomach illness or because they feel sick.
Rumination syndrome has been long known to occur in babies and in people with developmental disabilities, but can occur in people of all ages. Children and adults with high levels of stress or anxiety may be at higher risk for rumination syndrome.
The signs and symptoms of rumination syndrome include:
Babies who have rumination syndrome may strain or arch their backs (which could also be a sign of gastroesophageal reflux) or make sucking noises with their mouths.
The exact causes of rumination syndrome are not known. Some people may develop this syndrome if they have emotional problems or if they are undergoing stressful events.
Mechanically, one explanation is that food expands the stomach, which is followed by an increase in abdominal pressure and a relaxation of the lower esophageal sphincter (the juncture where the esophagus [food tube from mouth] meets the stomach). The sequence of events allows stomach contents to be regurgitated.
Rumination syndrome can usually be diagnosed based on a medical history and physical exam. In many cases, the patient’s symptoms—specifically, the patient has been regurgitating, chewing and swallowing food for at least 3 months, but is not vomiting the food—are enough to make a diagnosis of rumination syndrome.
Officially, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, a person must meet the following criteria to be diagnosed with rumination syndrome:
Doctors may use tests to rule out other medical issues, such as blockages. These tests may include:
The main treatment for rumination syndrome is behavioral therapy to stop regurgitation. The behavioral therapy that is usually prescribed for rumination syndrome is diaphragmatic breathing.
The diaphragm is a large, dome-shaped muscle located at the base of the lungs. Diaphragmatic breathing is intended to help you relax the diaphragm and use it correctly while breathing to strengthen it.
To perform diaphragmatic breathing to help control regurgitation:
Practice this exercise for 5 to 10 minutes, three to four times a day. You can increase the effort of the exercise by placing a book on your abdomen. Individuals can also practice “belly breathing” after each bite or meal, as needed.
If it is not treated, rumination syndrome can damage the esophagus (the tube leading from the mouth to the stomach). Other complications may include:
It may be possible to reduce your risk of rumination syndrome by learning more positive coping strategies for stressful situations.
Many people with rumination syndrome live otherwise healthy lives. Rumination syndrome usually does not affect a person’s daily routines.
Contact your doctor if you or your child have signs or symptoms of rumination syndrome, especially if you/or your child is regurgitating food on a regular basis.
If you have rumination syndrome, you may want to ask your doctor:
Last reviewed by a Cleveland Clinic medical professional on 08/09/2019.
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