[Recognition and Management of the Patient with Rumination Syndrome]

Rumination syndrome is a functional gastroduodenal disorder characterized by the repetitive, effortless regurgitation of recently ingested food into the mouth followed by rechewing and reswallowing or expulsion of the food bolus. In clinical practice, most patients report the presence of "reflux" or "vomiting" and, if a detailed history is not taken with directed questions, the symptoms are often misinterpreted; which leads to multiple complementary tests and unnecessary treatments that do not solve the problem. In patients with a clinical diagnosis of refractory gastroesophageal reflux disease, it is essential to distinguish between persistent postprandial regurgitation and rumination syndrome. The importance of this differential diagnosis lies in the fact that rumination syndrome benefits from behavioral interventions, unlike medical or surgical treatments indicated in patients in whom the presence of refractory gastroesophageal reflux disease is confirmed.