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Rumination disorder
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Rumination disorder

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Rumination disorder is a condition in which a person keeps bringing up food from the stomach into the mouth (regurgitation) and rechewing the food.

Rumination disorder usually starts after age 3 months, following a period of normal digestion. It occurs in infants and is rare in children and teenagers. The cause is often unknown. Certain problems, such as lack of stimulation of the infant, neglect, and high-stress family situations, have been associated with the disorder.

Rumination disorder may also occur in adults.

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  • Causes

    Rumination disorder usually starts after age 3 months, following a period of normal digestion. It occurs in infants and is rare in children and teenagers. The cause is often unknown. Certain problems, such as lack of stimulation of the infant, neglect, and high-stress family situations, have been associated with the disorder.

    Rumination disorder may also occur in adults.

  • Symptoms


    • Repeatedly bringing up (regurgitating) food
    • Repeatedly rechewing food

    Symptoms must go on for at least 1 month to fit the definition of rumination disorder.

    People do not appear to be upset, retching, or disgusted when they bring up food. It may appear to cause pleasure.

  • Exams and Tests

    The health care provider must first rule out physical causes, such as hiatal hernia, pyloric stenosis, and gastrointestinal system abnormalities that are present from birth (congenital). These conditions can be mistaken for rumination disorder.

    Rumination disorder can cause malnutrition. The following lab tests can measure how severe the malnutrition is and determine what nutrients need to be increased:

    • Blood test for anemia
    • Endocrine - hormone functions
    • Serum electrolytes
  • Treatment

    Rumination disorder is treated with behavioral techniques. One treatment associates bad consequences with rumination and good consequences with more appropriate behavior (mild aversive training).

    Other techniques include improving the environment (if there is abuse or neglect) and counseling the parents.

  • Outlook (Prognosis)

    In some cases rumination disorder will disappear on its own, and the child will go back to eating normally without treatment. In other cases, treatment is necessary.

  • Possible Complications


    • Failure to thrive
    • Lowered resistance to disease
    • Malnutrition
  • When to Contact a Medical Professional

    Call your health care provider if your baby appears to be repeatedly spitting up, vomiting, or rechewing food.

  • Prevention

    There is no known prevention. However, normal stimulation and healthy parent-child relationships may help reduce the odds of rumination disorder.

Related Information

  Failure to thrive...    

References

Katz ER, DeMaso DR. Rumination disorder. In: Kliegman RM, Behrman RE, Stanton BF, St. Geme JW III, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 21.1.

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Review Date: 2/10/2014  

Reviewed By: Christos Ballas, MD, private practice specializing in psychiatry, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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