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Evaluating Trends In Rumination Syndrome: A Retrospective Analysis
Shivangini Duggal1, Misbah Jilani2, Richard W McCallum3
1Department of Internal Medicine, Texas Tech University, El Paso, TX, USA.
Abstract:
Rumination syndrome is a functional gastrointestinal disorder marked by effortless postprandial regurgitation, typically occurring 10-15 min after meals. The condition, first noted in 1618, is now diagnosed by the Rome IV criteria through clinical symptoms in the absence of structural abnormalities. Diagnostic confirmation through high-resolution manometry reveals characteristic patterns of gastric pressurization and muscle coordination, while treatment primarily involves behavioral and medical therapies. This study evaluates the epidemiology, symptom profiles, time to diagnosis, and treatment outcomes for patients with rumination syndrome, with a focus on the impact of jejunostomy tube placement. A retrospective cohort study at Texas Tech University Gastroenterology Clinic reviewed charts of patients treated for rumination syndrome between July 2016 and February 2024. Outcomes assessed included the efficacy of jejunostomy tube placement in nutritional support and symptom improvement, in addition to behavioral therapy outcomes. Statistical analyses were conducted using STATA, with p < 0.05 considered significant. Among 133 patients (mean age 43.6 years, 78.2% female), 23 required jejunostomy tube (J-tube) placement. Patients with J-tubes had a significantly lower BMI (21.07 vs 28.13, p < 0.001) and experienced greater weight gain and symptom improvement compared to non-J-tube patients (100% vs 48.18%, p < 0.001). The average J-tube duration was 16 weeks, with an average weight gain of 38.8 pounds. This study highlights the efficacy of combined treatment approaches in managing rumination syndrome, particularly for patients requiring enteral nutritional support via jejunostomy tubes. This approach allows for weight stabilization and improved symptom management, facilitating long-term treatment adherence and quality of life improvements.
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