Rumination Syndrome

Treatment

Treatment of rumination syndrome depends on the presence of other disorders and the age and cognitive ability of the patient. A close collaboration among gastroenterologists, pediatricians and psychologists, in addition to education of patients and family members, is important to a successful outcome.

Behavioral therapy

Mayo Clinic has found habit reversal behavioral therapy to be very successful in most patients with normal intelligence. Treatment typically involves having patients record when they ruminate and teaching them to practice diaphragmatic breathing during those times. The individual is instructed to breathe in and breathe out with the abdominal muscles, keeping the chest motionless. This behavior prevents abdominal contractions and thus, regurgitation. (Reference: Am J Gastroenterol. 2006 Nov;101(11):2449-52.)

In mentally handicapped patients, treatment might involve mild aversive training (associating rumination with negative consequences) or other behavioral techniques. In patients with coexisting bulimia nervosa, treatment focuses on the eating disorder.

Medication

In patients where frequent rumination is causing acid injury to the esophagus, proton pump inhibitors or H2 receptor antagonists may be prescribed to protect the lining of the esophagus until behavioral therapy reduces the frequency and severity of regurgitation.

Outcomes

A large study of children and adolescents treated at Mayo Clinic for rumination syndrome found that symptoms were resolved or improved in more than 80 percent of patients at follow-up about 10 months after treatment. PubMed Reference