Overview

Rumination syndrome is a condition in which people repeatedly and unintentionally spit up (regurgitate) undigested or partially digested food from the stomach, rechew it, and then either reswallow it or spit it out.

Because the food hasn't yet been digested, it reportedly tastes normal and isn't acidic, as vomit is. Rumination typically happens at every meal, soon after eating.

It's not clear how many people have this disorder. Treatment may include behavioral therapy or medications. Behavioral therapy that involves teaching people to breathe from the diaphragm is the usual treatment of choice.

Symptoms

  • Effortless regurgitation, typically within 10 minutes of eating
  • Abdominal pain or pressure relieved by regurgitation
  • A feeling of fullness
  • Bad breath
  • Nausea
  • Unintentional weight loss

Rumination syndrome isn't usually associated with retching.

When to see a doctor

Consult a doctor if you or your child persistently regurgitates food.

Causes

The precise cause of rumination syndrome isn't clear. But it appears to be caused by an increase in abdominal pressure.

Rumination syndrome is frequently confused with bulimia nervosa, gastroesophageal reflux disease (GERD) and gastroparesis. Some people have rumination syndrome and linked to rectal evacuation disorder, in which poor coordination of pelvic floor muscles leads to chronic constipation.

The condition has long been known to occur in infants and people with developmental disabilities. It's now clear that the condition isn't related to age, as it can occur in children, teens and adults. Rumination syndrome is more likely to occur in people with anxiety, depression or other psychiatric disorders.

Complications

Untreated, rumination syndrome can damage the tube between your mouth and stomach (esophagus).

Rumination syndrome can also cause:

  • Unhealthy weight loss
  • Malnutrition
  • Dental erosion
  • Bad breath
  • Embarrassment
  • Social isolation

Rumination syndrome care at Mayo Clinic

Sept. 27, 2018
References
  1. AskMayoExpert. Nausea and vomiting (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  2. Absah I, et al. Rumination syndrome: Pathophysiology, diagnosis, and treatment. Neurogastroenterology and Motility. 2017;29:1.
  3. Halland M, et al. Rumination syndrome. https://www.uptodate.com/contents/search. Accessed Aug. 28, 2018.
  4. Wyllie R, et al., eds. Gastric motility disorders. In: Pediatric Gastrointestinal and Liver Disease. 5th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 28, 2018.
  5. Halland M, et al. Diagnosis and treatment of rumination syndrome. Clinical Gastroenterology and Hepatology. In press. Accessed Aug. 28, 2018.
  6. Feldman M, et al. Nausea and vomiting. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 28, 2018.
  7. Talley NJ. Rumination syndrome. Gastroenterology & Hepatology. 2011;7:117.
  8. Picco MF (expert opinion). Mayo Clinic, Jacksonville, Florida. Sept. 11, 2018.