Disease: Rumination syndrome

Overview

Rumination syndrome is a condition in which people repeatedly and unintentionally spit up (regurgitate) undigested or partially digested food from the stomach, rechew it, and then either reswallow the food or spit it out. The food hasn't been digested, so people with rumination syndrome often report that the food tastes normal, not acidic like vomit. Rumination typically occurs every day, and at every meal, usually within 30 minutes of eating.

The precise cause of rumination syndrome is unknown, but it's clear that rumination is a subconscious behavior, not a conscious decision. Rumination syndrome is frequently confused with bulimia nervosa, gastroesophageal reflux disease (GERD) and gastroparesis. Some people have rumination syndrome and constipation caused by a rectal evacuation disorder.

The condition has long been known to occur in infants and people with developmental disabilities, which may be related to an unvoiced desire to reject food. But it can also occur in other children, adolescents and adults. It's not clear how many people have this disorder.

Source: http://www.mayoclinic.com

Diagnosis

Diagnosis at Mayo Clinic

Mayo Clinic doctors start by obtaining an accurate medical history and asking about symptoms. This initial exam, and sometimes observation of a person's behavior, may be enough to diagnose rumination syndrome.

While the diagnosis can be made in the vast majority of cases with a careful history, high-resolution esophageal manometry and impedance measurement can be used to confirm the diagnosis. This testing also provides an image of the disordered function for use in biofeedback. Biofeedback is part behavioral therapy for rumination syndrome. During biofeedback, the imaging can help the patient diaphragmatic breathing skills to counteract regurgitation.

Mayo doctors may sometimes use other tests to rule out other causes of symptoms of rumination syndrome:

  • Esophagogastroduodenoscopy. This test allows your doctor to inspect your esophagus, stomach and the upper part of your small intestine (duodenum) to rule out any obstruction. The doctor may remove a small tissue sample (biopsy) for further study.
  • Gastric emptying. This procedure lets your doctor know how long it takes food containing a marker to empty from your stomach. Another version of this test also can measure how long it takes food to travel through your small intestine and colon.

Another test — called single-photon emission computerized tomography (SPECT) of the stomach — lets your doctor see how your stomach functions, and is helpful in deciding whether or not to use medications to relax the stomach. A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures.

Source: http://www.mayoclinic.com

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