Rumination disorder is repeated regurgitation and rechewing of food which persists for at least one month. There does not appear to be upset, retching, or disgust associated with the regurgitation, and it may appear to cause pleasure.
Causes, incidence, and risk factors
Onset of rumination disorder usually occurs after three months of age, following an established period of normal digestion. It occurs in infants and is rare in children and adolescents. The cause is often unknown. Certain problems, such as lack of stimulation of the infant, neglect, and high-stress family situations, have been associated with the disorder.
Signs and tests
The health care provider must first rule out physical causes of regurgitation, such as hiatal hernia and pyloric stenosis, which can be misdiagnosed as rumination disorder. Rumination disorder can cause malnutrition. Laboratory tests (such as serum electrolytes , endocrine - hormonal functions, and a blood test for anemia) can measure the severity of the malnutrition and determine what nutrients need to be increased.
Treatment
Rumination disorder is treated with behavioral techniques, such as mild aversive training. This involves associating bad consequences with rumination and good consequences with more appropriate behavior. Other techniques include improvement in the child's psychosocial environment (if there is abuse or neglect) and psychotherapy for the parents.
Expectations (prognosis)
In some cases rumination disorder will remit spontaneously, and the child returns to eating normally without treatment. In other cases, treatment is necessary.
Complications
Complications of rumination include malnutrition , lowered resistance to disease, and failure to thrive .
Calling your health care provider
Call your health care provider if your baby appears to be repeatedly spitting up, vomiting , or rechewing food.
Prevention
There is no known prevention. However, normal stimulation and healthy parent-child relations may help reduce the occurrence of rumination disorder.