Rumination disorder is a rare disorder characterized by the involuntary regurgitation of undigested or partially digested food. After regurgitation, the food is rechewed and reswallowed or removed from the mouth. This condition is also known as rumination eating disorder or rumination syndrome. Since so little is known about this condition, rumination disorder myths abound and misdiagnoses are common. Therefore, it is important to separate the rumination disorder facts from the myths.

1. Myth: Rumination disorder is caused by gastrointestinal problems.

Fact: The cause of rumination syndrome is unknown.

Medical scientists don’t know what causes rumination disorder. A gastrointestinal (GI) problem occurs when the system that processes food isn’t working right. Rumination syndrome is not a GI problem like vomiting disorder or reflux disease. However, it is often misdiagnosed as a GI problem. When medicines to treat GI problems fail, doctors consider rumination disorder. In fact, other GI problems must be ruled out before rumination disorder is diagnosed. Most of those with rumination disorder have normally functioning GI tracts.

What is known is that rumination episodes start with an increase in abdominal pressure. Individuals may also feel the need to belch or have nausea before a regurgitation episode. Rumination disorder regurgitation is involuntary. In some individuals, the initial trigger is indigestion, physical injury, emotional stress or viral illness. But, once the trigger passes, the regurgitation behaviors continue. Unfortunately, an initiating trigger cannot be determined for most people with the disorder.

2. Myth: Rumination disorder is harmless.

Fact: Untreated rumination disorder is dangerous.

At first, rumination syndrome may seem harmless. However, few people are aware of this disorder. As a result, many patients with rumination disorder are misdiagnosed for years before receiving treatment. If left untreated, it can cause many problems. While some are mild, like bad breath, others can be life-threatening, like choking.

Rumination syndrome can also cause:

  • Abdominal discomfort
  • Weight loss
  • Malnutrition
  • Electrolyte abnormalities
  • Tooth decay
  • Dehydration
  • Pneumonia
  • Difficulty breathing
  • Death

3. Myth: Rumination disorder and bulimia are the same disorder.

Fact: Unlike bulimia nervosa, rumination disorder does not involve weight concerns.

The medical field does not agree on whether rumination syndrome is an eating disorder or not. It is categorized as a feeding and eating disorder by psychologists. On the other hand, gastroenterologists classify it as a functional gastroduodenal disorder. Regardless, rumination disorder is not the same as bulimia. The disorders differ in age of onset, motivation, behavior and result. Here is a quick comparison of rumination disorder vs bulimia:

  • Rumination disorder can develop at any age, while bulimia is most often diagnosed in adolescence
  • Rumination disorder is an attempt to provide relief, while bulimia is an attempt to control weight
  • Rumination syndrome regurgitation is effortless and involuntary, while bulimia purging involves purposeful gagging and retching
  • Rumination disorder regurgitated food is undigested and of low-acidity, but bulimia regurgitation is digested and acidic
  • Rumination based regurgitation occurs within 10 minutes of consuming a normal-sized meal, while bulimia involves a cycle of binging and purging
  • The regurgitated food of someone with rumination disorder may be rechewed, reswallowed or spat out, while the reason for a bulimia purge is elimination

4. Myth: Rumination disorder only affects children.

Fact: Rumination disorder can develop at any age.

Rumination disorder was first described in children with developmental abnormalities. It wasn’t until recently that rumination disorder was diagnosed in adults and adolescents. It is now known that rumination disorder can occur at any age and is not limited to those with intellectual disabilities.

Though the primary symptom of rumination disorder relates to regurgitation, additional symptoms differ. Infants may make sucking movements during regurgitation. They may also tighten their stomachs, tilt back their heads or arch their backs. Children, adolescents and adults may experience stomach troubles, constipation, diarrhea, heartburn and nausea. Sometimes, medication and treatment will be recommended to address these symptoms.

5. Myth: Rumination disorder is difficult to treat.

Fact: Rumination disorder is relatively easy to treat.

The main treatment for rumination disorder is diaphragmatic breathing. Patients can be taught diaphragmatic breathing by their doctor or may be referred to a physiotherapist, behavioral psychologist or yoga instructor. Diaphragmatic breathing can be taught in as little as one session. Relief from rumination disorder may only take a few sessions. If regurgitation is associated with anxiety or has caused physical damage, medications may be prescribed.

If you are affected by rumination disorder and are using substances to cope, contact The Recovery Village today to learn how we can help.