Rumination disorder is the backward flow of recently eaten food from the stomach to the mouth. The food is then re-chewed and swallowed or spat out. A non-purposeful contraction of stomach muscles is involved in rumination. It may be initially triggered by a viral illness, emotional distress, or physical injury. In many cases, no underlying trigger is identified. Behavioral therapy is the mainstay of treatment..

Some cases of rumination disorder occur without a precipitating event or illness. Other people with the disorder describe also having ingestion, which may serve as a trigger. Studies have shown that some people with rumination disorder also have depression, anxiety, or an eating disorder. These conditions may likewise play a role in rumination disorder. Conditions like depression and anxiety are known to be more common in people with other functional gastrointestinal conditions as well, for example irritable bowel syndrome.

Signs and symptoms of rumination disorder includes the backward flow of recently eaten food from the stomach to the mouth. This typically occurs immediately to 15 to 30 minutes after eating. Rumination often occurs without retching or gagging. Rumination may be proceeded by a feeling of pressure, the need to belch, nausea, or discomfort. Some people with rumination disorder experience bloating, heartburn, diarrhea, constipation, abdominal pain, headaches, dizziness, or sleeping difficulties. Complications of severe disorder include weight loss, malnutrition, and electrolyte imbalance.

1. Repeated regurgitation and rechewing or expulsion of food that

a. Begins soon after eating
b. Does not occur during sleep
c. Does not respond to standard treatment for GERD

2. No Retching

3. Symptoms are not explained by inflammatory, anatomic, metabolic, or neoplastic processes

These criteria help distinguish rumination syndrome from other disorders of the GI tract, such as gastroparesis and achalasia where vomiting occurs hours after eating, gastroesophageal reflux where symptoms occur at night, and cyclic vomiting syndrome where the symptoms are chronic/persistent.

Antroduodenal manometry can assist in making and confirming the diagnosis. Antroduodenal manometry involves putting a catheter through the nose into the stomach and small bowel to measure pressure changes.

If behavioral therapy is unsuccessful, treatment with baclofen may be considered. There is limited data regarding optimal treatment of rumination disorder, but success with baclofen has been reported.