Rumination Disorder

Oct 7, 2020 | Eating Disorders

What Is Rumination Disorder?

Rumination disorder is an illness that is characterized by repetitive, habitual bringing up of food from the stomach. This food is often partly digested. It’s generally brought up with little effort and painlessly. This action is not associated with feelings of nausea or disgust. This disorder can affect anyone at any age.

The vomiting associated with rumination disorder is different from that related to a stomach bug. There are no corresponding feelings of nausea or involuntary retching. The brought up food may be re-chewed and re-swallowed or the food is just spit it out. People with rumination disorder often do not feel in control of their disorder.

The exact cause of rumination disorder, as well as the prevalence is unknown. Rumination disorder can lead to malnutrition, weight loss, dental erosions, and electrolyte disturbances if left untreated.

Possible signs of rumination disorder:

  • Vomiting food that has been partly digested on a regular basis
  • No obvious physical illness that causes this behavior
  • Re-chewing and swallowing food that’s been brought up
  • Making efforts to hide the behavior,  by coughing or covering their mouth
  • Avoiding eating around others
  • Avoiding eating before socializing
  • Weight loss / Malnutrition / Not making expected weight gains
  • Straining and arching the back with the head held back, making sucking movements with their tongue
  • Appearance of finding the behavior satisfying
  • Feelings of hunger and irritability between episodes of bringing up the food

Rumination disorder has been linked to other eating disorders, such as bulimia nervosa, however how these conditions are related is still not known.The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) identifies the following diagnostic criteria for rumination disorder:

  • Recurrent regurgitation of food for at least a one-month period. Regurgitated food may be spit out, re-chewed, or re-swallowed.
  • Regurgitation isn’t caused by a medical condition, such as a gastrointestinal disorder.
  • Regurgitation doesn’t always occur in relation to another eating disorder, such as anorexia nervosa, binge-eating disorder, or bulimia nervosa.
  • When regurgitation occurs alongside another intellectual or developmental disorder, symptoms are severe enough to require medical assistance.

Treatment

Treatment for rumination disorder is the same in both children and adults. Treatment focuses on changing the learned behavior that triggers the regurgitation. At this time an effective treatment for rumination disorder in children and adults is diaphragmatic breathing training. It involves learning how to breathe deeply and relax the diaphragm. When the diaphragm is relaxed regurgitation cannot occur.

Other treatments for rumination disorder can include:

There is currently no medication approved for treating rumination disorder.