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Current state of rumination syndrome
Sydney Pomenti1, David A Katzka1
1Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY, USA.
Summary
Rumination syndrome (RS) is a behavioral disorder causing regurgitation due to increased gastric pressure. Treatment involves diaphragmatic breathing, biofeedback, and cognitive behavioral therapy for symptom management.
Area of Science:
- Gastroenterology
- Behavioral Medicine
- Digestive Disorders
Background:
- Rumination syndrome (RS) is an underdiagnosed condition characterized by recurrent regurgitation.
- Regurgitation in RS results from increased gastric pressure and reversed esophageal-gastric pressure gradients.
- RS shares features with gut-brain interaction disorders, GERD, and is associated with mood and eating disorders.
Purpose of the Study:
- To provide a comprehensive overview of rumination syndrome.
- To discuss diagnostic criteria and challenges.
- To outline current and potential treatment strategies.
Main Methods:
- Clinical diagnosis based on Rome Criteria.
- Supportive testing like fed impedance manometry when needed.
- Validated questionnaires for tracking treatment response.
Main Results:
- RS affects 3.1-5.8% globally across all demographics.
- Common misdiagnoses include GERD, gastroparesis, achalasia, and bulimia nervosa.
- Diaphragmatic breathing is the primary treatment, often augmented with biofeedback, CBT, or medication.
Conclusions:
- Early diagnosis and appropriate management of RS are crucial.
- Diaphragmatic breathing is an effective treatment for RS.
- Validated tools aid in monitoring patient progress and therapeutic outcomes.
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