Rumination syndrome, which is also known as Merycism, is a condition that affects the functioning of the stomach and esophagus. It is characterized by the effortless, repeated and unintentional spit up undigested regurgitation of recently ingested food from the stomach. People that suffer from this syndrome re-chew the food and then either re-swallow the food or spit it out. Rumination syndrome may go undiagnosed because it is often confused with other conditions. In order for rumination syndrome to be diagnosed, a person should have symptoms that persist over weeks or months.

 

Symptoms

Symptoms can begin to manifest at any point from the ingestion of the meal to 120 minutes thereafter. However, the more common range is between 30 seconds to 1 hour after the completion of a meal. Symptoms tend to cease when the ruminated contents become acidic.

In some individuals, the regurgitation is small, occurring over a long period. In others, the amount can be bilious, short lasting and must be expelled. While some only experience symptoms following some meals, most experience episodes following any ingestion, from a single bite to a massive feast. Unlike typical vomiting, the regurgitation is typically described as effortless and unforced. There is no retching, nausea, heartburn, odour or abdominal pain associated with the regurgitation, as there is with typical vomiting. Also, the undigested food lacks the bitter taste and odour of stomach acid and bile.

 

Causes

The cause of rumination syndrome is unknown. However, recent studies have drawn a correlation between hypothesized causes and the history of patients with the disorder. In infants and the cognitively impaired, the disease has normally been attributed to over-stimulation and under-stimulation from parents and caregivers, causing the individual to seek self-gratification and self-stimulus due to the lack or abundance of external stimuli. The disorder has also commonly been attributed to a bout of illness, a period of stress in the individual's recent past, and to changes in medication.

In adults and adolescents, hypothesized causes generally fall into one of either category: habit-induced, and trauma-induced. Habit-induced individuals generally have a past history of bulimia nervosa or of intentional regurgitation (such as, magicians and professional regurgitators), which forms a subconscious habit that can continue to manifest itself outside the control of the affected individual. Trauma-induced individuals describe an emotional or physical injury, which preceded the onset of rumination, often by several months

 

Risk Factors

Although initially described in infants and the developmentally disabled, it is now widely recognized that rumination syndrome occurs in males and females of all ages and abilities.

 

Complications

There are no significant medical complications resulting from rumination syndrome itself. The common complications of rumination syndrome are relatively mild and variable and include weight loss, vitamin and mineral deficiencies, and dental problems including cavities and erosion of enamel caused by stomach acid. Fortunately, with appropriate treatment, many of the complications associated with rumination syndrome are reversible.

 

Prevention

There is no known prevention. However, normal stimulation and healthy parent-child relationships may help reduce the odds of rumination disorder