What is rumination syndrome?

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.

Who gets rumination syndrome?

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.

What are the signs and symptoms of rumination syndrome?

The signs and symptoms of rumination syndrome include:

  • Regurgitating and re-chewing food on a regular basis
  • Digestive problems, such as indigestion and stomach aches
  • Dental problems, such as bad breath and tooth decay
  • Weight loss
  • Chapped lips

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.

What causes rumination syndrome?

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.

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