Rumination involves the recurrent or persistent sequence of:
(1) regurgitation of recently ingested food into the mouth
(2) chewing this material
(3) swallowing it again or spitting it out.
Occurrence
(1) infants
(2) mentally handicapped children or adults
(3) rarely in adults of normal intellect
It is more common in males.
Criteria for the diagnosis of the rumination syndrome - all of the following:
(1) A duration of symptoms >= 12 cumulative weeks over the past 12 months (may or may not be consecutive).
(2) Nausea and vomiting are absent
(3) The process stops when the regurgitated material becomes acidic.
(4) Exclusion of other causes following a complete examination.
Exclusions:
(1) pathologic gastroesophageal reflux
(2) achalasia
(3) other esophageal motility disorder with recognized pathologic basis
(4) gastric outlet obstruction
(5) delayed gastric emptying
