What is Rumination Disorder?

Overview

Rumination Disorder (RD) is characterised by consistent (at least once a month) and repeated episodes of involuntarily regurgitating food and either re-swallowing or spitting it out, after it has already been chewed and swallowed. RD is diagnosed in the absence of other medical conditions.

Rumination Disorder (RD) is recognised as a stand-alone disorder by the Diagnostic Manual of Mental Disorders (DSM-5-TR). To receive a formal diagnosis of RD, the regurgitating of food must not be attributed to another medical issue, nor does it transpire in the course of a diagnosable eating disorder (e.g. Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder).

The prevalence of RD ranges from 0.1% to 4% in children and 0.8% to 8% in adults (Sasegbon et al, 2022). Regurgitation is different from vomiting as the regurgitated food is undigested. It reportedly tastes normal and isn’t acidic, as vomit is, and usually occurs within 10 minutes of eating (Mayo Clinic, 2022).

The individual with RD may experience other mental and physical conditions alongside regurgitating behaviours, but their experiences with regurgitation is severe enough to warrant separate clinical treatment.

Treatment Options

Treatment for RD typically involves breathing and relaxation exercises, self-awareness strategies and habit reversal. For example, the individual needs to become aware of the situations which gives rise to regurgitation and are then encouraged to practise breathing and relaxation exercises in the moment to minimise the chances of regurgitating. (Sasegbon et al, 2022)

Signs & Symptoms of Rumination Disorder

As a result of regurgitating food, an individual with RD may experience:

• Bloating and abdominal pain relieved by regurgitation

• Feeling of fullness

• Bad breath

• Nausea

• Weight-loss

• Risk of malnutrition

• Tooth decay

• Social isolation

(Mayo Clinic, 2022)

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). Washington, DC: American Psychiatric Press.

Mayo Clinic. (2022). Rumination Syndrome. [Accessed on 13 Dec 2022] https://www.mayoclinic.org/diseases-conditions/rumination-syndrome/symptoms-causes/syc20377330

Sasegbon, A., Hasan, S. S., Disney, B. R., & Vasant, D. H. (2022). Rumination Syndrome: Pathophysiology, Diagnosis and Practical Management. Frontline Gastroenterology, 13, 440-446