Rumination disorder is a condition in which a person keeps bringing up food from the stomach into the mouth (regurgitation) and rechewing the food.
Rumination disorder most often starts after age 3 months, following a period of normal digestion. It occurs in infants and is rare in children and teenagers. The cause is often unknown. Certain problems, such as lack of stimulation of the infant, neglect, and high-stress family situations, have been linked with the disorder.
Rumination disorder may also occur in adults.
- Repeatedly bringing up (regurgitating) food
- Repeatedly rechewing food
Symptoms must go on for at least 1 month to fit the definition of rumination disorder.
People do not appear to be upset, retching, or disgusted when they bring up food. It may appear to cause pleasure.
Exams and Tests
The health care provider must first rule out physical causes, such as hiatal hernia, pyloric stenosis, and gastrointestinal system abnormalities that are present from birth (congenital). These conditions can be mistaken for rumination disorder.
Rumination disorder can cause malnutrition. The following lab tests can measure how severe the malnutrition is and determine what nutrients need to be increased:
Rumination disorder is treated with behavioral techniques. One treatment associates bad consequences with rumination and good consequences with more appropriate behavior (mild aversive training).
Other techniques include improving the environment (if there is abuse or neglect) and counseling the parents.
In some cases, rumination disorder will disappear on its own, and the child will go back to eating normally without treatment. In other cases, treatment is needed.
Complications may include:
When to Contact a Medical Professional
Call your provider if your baby appears to be repeatedly spitting up, vomiting, or rechewing food.
There is no known prevention. However, normal stimulation and healthy parent-child relationships may help reduce the odds of rumination disorder.
Katz ER, Kitts RL, DeMaso DR. Rumination and pica. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 23.
Katzman DK, Kearney SA, Becker AE. Feeding and eating disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/ Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 9.