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Rumination Syndrome: Recognition and Treatment.
Herit Vachhani1, Bruno De Souza Ribeiro2, Ron Schey3,4
1Division of Gastroenterology, Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA.
Current Treatment Options in Gastroenterology
|January 22, 2020
Summary
Rumination disorder is often underdiagnosed in adults. Clinical diagnosis using ROME-IV/DSM-5 criteria, supported by esophageal manometry and pH impedance testing, is key for effective treatment strategies.
Area of Science:
- Gastroenterology
- Digestive Disorders
- Clinical Diagnosis
Background:
- Rumination disorder is frequently underdiagnosed or misdiagnosed in adults.
- Symptoms may be mistaken for regurgitation, obscuring the characteristic re-chewing and re-swallowing behavior.
- It requires inclusion in the differential diagnosis for unexplained regurgitation.
Purpose of the Study:
- To review current diagnostic methods for rumination disorder.
- To discuss established and emerging treatment options.
- To highlight the challenges in diagnosing and managing this condition.
Main Methods:
- Clinical diagnosis using ROME-IV or DSM-5 criteria.
- Objective testing including high-resolution esophageal manometry and 24-h pH impedance testing.
- Evaluation of treatment modalities, including behavioral, pharmacological, and surgical approaches.
Main Results:
- High-resolution esophageal manometry and 24-h pH impedance testing can confirm rumination disorder.
- Gastroduodenal manometry and EMG are less favored due to technical challenges and patient burden.
- Behavioral techniques combined with baclofen show promising results for management.
Conclusions:
- Rumination disorder diagnosis relies on clinical criteria and objective testing.
- Management is complex, often requiring a multimodal approach.
- Further research is needed to refine diagnostic criteria and explore novel therapeutic interventions.
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