Understanding Rumination Syndrome: Causes, Symptoms, and Effective Treatment

A rumination disorder, also known as rumination syndrome or merycism, is a feeding and eating disorder characterized by the regurgitation of undigested food from the stomach back into the mouth. The individual may then chew the regurgitated food again and swallow it, or spit it out. This condition typically occurs after every meal and often appears effortless. Unlike other eating disorders, rumination syndrome does not involve nausea or retching, and the regurgitated food does not taste sour or bitter.

What is Rumination Syndrome?

Rumination syndrome involves the regurgitation of undigested food from the stomach back up into the mouth, typically after a meal. It is a relatively rare disorder, and it can significantly impact an individual's quality of life. Unlike other eating disorders, it does not involve nausea or retching. The food that regurgitates does not have a sour or bitter taste because it has not had time to mix with stomach acid and be fully digested.

Causes of Rumination Syndrome

The exact cause of rumination syndrome is not fully understood. However, several factors may contribute to its development:

Emotional Problems: Some individuals with rumination syndrome may have underlying emotional issues that exacerbate the condition. Stressful Events: Stress or anxiety can trigger rumination syndrome in individuals who are already at risk due to emotional or psychological factors. Mechanical Factors: The regurgitation may be mechanically triggered by the expansion of the stomach, which can lead to an increase in abdominal pressure and a relaxation of the lower esophageal sphincter. This mechanism then allows the stomach contents to be regurgitated.

Emotional Causes: Emotional and psychological factors, such as fear, anxiety, and stress, play a significant role in the development and maintenance of rumination disorder. The fear of making the wrong decision or fear of failure can contribute to the regurgitation behavior.

Treatment for Rumination Syndrome

Behavioral therapy is the primary treatment for rumination syndrome, with the goal of stopping the regurgitation behavior. One common method used is diaphragmatic breathing, which helps relax the diaphragm and use it correctly while breathing. This technique is intended to strengthen the diaphragm and control regurgitation symptoms.

Steps for Diaphragmatic Breathing

Lie Down Comfortably: Lie on your back on a flat surface or in bed with your knees bent and your head supported. Use a pillow under your knees to support your legs. Position Your Hands: Place one hand on your upper chest and the other just below your rib cage. This allows you to feel the diaphragm move as you breathe. Inhale Slowly: Breathe in slowly through your nose, allowing your stomach to move out against your hand. Keep the hand on your chest as still as possible. For children, describe this as “breathing like an opera singer” with the hand on the belly moving out with each slow breath and moving in during exhalation. Exhale Slowly: Tighten your stomach muscles and let them fall inward as you exhale through pursed lips. Keep the hand on your upper chest as still as possible. Practice Regularly: Practice this exercise for 5 to 10 minutes, three to four times a day. To increase the effort, place a book on your abdomen. Individuals can also practice “belly breathing” after each bite or meal as needed.

When to Consult a Doctor

If you or your child are experiencing signs or symptoms of rumination syndrome, especially if you or your child is regurgitating food on a regular basis, it is essential to consult a healthcare provider. Prompt medical attention can help identify the underlying causes and provide appropriate treatment.

Conclusion: Rumination syndrome is a relatively rare and complex eating disorder that can have a significant impact on an individual's quality of life. Understanding the causes, recognizing the symptoms, and implementing effective treatment strategies, such as diaphragmatic breathing, can help manage this condition. If you suspect you or someone you know is suffering from rumination syndrome, seeking professional medical advice is crucial.