Rumination Syndrome

Symptoms

To be considered rumination syndrome, regurgitation of recently ingested food needs to occur for at least six weeks, though it may come and go. Regurgitation typically:

• Is effortless (as opposed to forced vomiting)
• Isn't associated with heartburn, abdominal pain or nausea
• Begins within 30 minutes of ingesting a meal
• Is associated with either re-swallowing or spitting out food
• Stops within 60 minutes or when regurgitated food becomes acidic-tasting
• Doesn't occur while lying down or sleeping
• Isn't associated with a physical obstruction
• Doesn't respond to standard treatment for gastroesophageal reflux disease (i.e., medical therapy or lifestyle modification measures)

Frequency of rumination varies greatly between patients. Some ruminate only a few times a week, while others ruminate after every meal.

Rumination syndrome can be confused with gastroparesis, an upper gastrointestinal motility disorder that results in slow stomach emptying. The chart below helps distinguish symtoms of gastroparesis from rumination syndrome: