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Rethinking psychological treatment targets for pediatric rumination syndrome: Clinical implications from a case

William A Piña-Anastasiadis1, Lilianne M Gloe2, Annalee Johnson-Kwochka3

  • 1Children's Hospital Colorado Affiliated With the University of Colorado School of Medicine Aurora Colorado USA.

JPGN Reports
|November 17, 2025
PubMed

Insights

Rumination syndrome in children may be effectively treated by conceptualizing it as a "tic disorder of the gut." This approach aids in managing pediatric gut-brain interaction disorders through targeted assessments and multidisciplinary care.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Psychology
  • Gut-Brain Interaction Disorders

Background:

  • Rumination syndrome (RS) is a prevalent pediatric gut-brain interaction disorder.
  • Limited research exists on effective treatments for pediatric RS, hindering clinical decision-making.
  • Existing treatment strategies for similar conditions may offer valuable insights.

Purpose of the Study:

  • To explore the clinical utility of conceptualizing pediatric RS as a
  • tic disorder of the gut.
  • To demonstrate how this conceptualization can guide treatment strategies for pediatric RS.

Main Methods:

  • Presentation of two complex pediatric cases with RS.
  • Analysis of symptom presentation and temporary alleviation of distress through rumination.
  • Functional analysis and transdiagnostic symptom evaluation.

Main Results:

  • Rumination episodes temporarily alleviated cognitive distress and physical discomfort in both cases, similar to pediatric tic disorders.
  • The cases highlight the potential benefits of a
  • tic disorder of the gut
  • conceptualization.

Conclusions:

  • A targeted diagnostic assessment, including functional analysis and transdiagnostic evaluation, is recommended for pediatric RS.
  • Close comanagement between specialty physicians and psychologists is crucial for effective treatment.
  • This conceptualization offers clinical utility for psychologists and allied health professionals treating pediatric RS.

Keywords:
biopsychosocial treatmentcase reportdisorder of gut‐brain interaction

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