Rumination disorder is a clinical syndrome in which recently eaten food is brought back up and re-chewed.
Rumination disorder is most common in infants with developmental problems, However, rumination disorder can affect older children and adults without development conditions.
What are the symptoms of rumination disorder?
Symptoms of rumination disorder include:
- Repeated regurgitation of food
- Repeated re-chewing of food
- Weight loss
- Bad breath and tooth decay
- Repeated stomach aches and indigestion
- Raw and chapped lips
Infants with rumination may also make unusual movements that are typical of the disorder. These include straining and arching the back, holding the head back, tightening the abdominal muscles and making sucking movements with the mouth. These movements may be done as the infant is trying to bring back up the partially digested food.
What causes rumination disorder?
The exact cause of rumination disorder is not known, however, there are several factors that may contribute to its development:
- Physical illness or severe stress may trigger the behaviour.
- Neglect of the person or an abnormal relationship between the child and the mother or other primary carer may cause the child to engage in self-comfort. For some children the act of chewing is comforting.
- It may be a way for the child to gain attention.
How common is rumination disorder?
Since most children outgrow rumination disorder, and older children and adults with this disorder tend to be secretive about it out of embarrassment, it is difficult to know exactly how many people are affected. However it is generally considered to be uncommon.
Rumination disorder most often occurs in infants and very young children (between three and 12 months), and in children with development problems. It is rare in older children, adolescents and adults.
How is rumination disorder diagnosed?
If symptoms of rumination are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. The doctor may use certain tests - such as X-rays and blood tests - to look for and rule out possible physical causes for the vomiting such as a gastrointestinal condition. Testing can also help the doctor evaluate how the behaviour has affected the body by looking for signs of problems such as dehydration and malnutrition.
To help in the diagnosis of rumination disorder, a review of the child's eating habits may be conducted. It often is necessary for the doctor to observe an infant during and after feeding.