What Is Rumination Disorder?

Rumination disorder is a rare and chronic behavioral disorder that causes a person to regurgitate undigested food. This means that undigested food will come back up from your stomach into your mouth. After which, you might either spit it out or swallow it again.

This process might be accompanied by feeling a need to belch or belching. Regurgitating the food is generally a reflex and not a conscious act; although, it can become a learned behavior.

While the condition can affect people of all ages, it’s more likely to occur in babies and children who have developmental disorders. The disorder is also known as rumination syndrome or merycism. 

Symptoms of Rumination Disorder 

The most prominent symptom of rumination disorder is the regurgitation of your food. However, it’s often accompanied by other symptoms that typically affect your digestive system. Other symptoms of the condition include:

• Weight loss 
• Bad breath 
• Tooth decay 
• Stomach aches 
• Indigestion 
• Chapped lips 

Identifying Rumination Disorder 

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides diagnostic criteria for identifying rumination disorder. For a diagnosis to be made, the following requirements must be met:

• Repeatedly regurgitating food for at least one month. 
• Regurgitation symptoms are not caused by other medical conditions like chronic acid reflux, for instance.
• To be diagnosed with rumination disorder, rumination cannot be a symptom of another eating disorder such as bulimia or anorexia. 
• If the disorder is co-occurring with other mental health conditions, symptoms of rumination disorder must be severe enough to necessitate medical care. 

In coming to a diagnosis, your doctor will obtain a detailed medical history and run several tests to rule out the possibility of other medical conditions being responsible for your symptoms. Tests that you might undergo include:

• X-rays of your esophagus and stomach 
• An endoscopy to examine your stomach and esophagus 
• A gastric emptying test to measure how long it takes food to go from your stomach to your small intestine 

Causes of Rumination Disorder 

It’s unclear what exactly causes rumination disorder. Some research shows a link between emotional stress and developing the condition.

Although experts believe rumination to be unconscious, it can also become a learned habit. Relaxing your diaphragm when eating and just after eating has been seen to trigger regurgitation. This is similar to belching or burping after eating. However, with rumination disorder, undigested food comes up. 

Another possible reason is the expansion of your stomach whenever you eat. There’s an increase in pressure in your stomach when this happens, and the muscles at the end of your esophagus weaken. These events cause your stomach to regurgitate the food that you’ve eaten.

Treatment for Rumination Disorder 

Treatment for rumination disorder typically depends on a couple of factors. The age of the person with the condition, how severe your symptoms are, and your medical history are all considered. There’s currently no form of medication that can be used to treat rumination disorder.

Learning how to eat and digest your food correctly is key to preventing it from regurgitation.

Diaphragmatic Breathing 

Diaphragmatic breathing is a form of behavioral therapy proven to help control regurgitation in people with rumination disorder.

Diaphragmatic breathing aims to strengthen your diaphragm and control regurgitation. The diaphragm is the dome-shaped muscle at the bottom of your lungs. This process teaches you to relax your diaphragm during and after every meal.

Rumination is unlikely to occur when your diaphragm is relaxed. A behavioral psychologist will typically coach you through the best techniques for diaphragmatic breathing. 

How to Perform Diaphragmatic Breathing 

Diaphragmatic breathing can easily be done at home with or without the help of a behavioral psychologist.

Here’s a step by step instruction to help you perform diaphragmatic breathing at home:

• Lie flat on your back and place a hand on your chest, below your ribs. Put the other hand on the top of your chest. 
• Breathe through your nose and feel your stomach swell under your hand. Slowly breathe out and feel your stomach flatten underneath your hand. 
• Repeat the process for about five to ten minutes up to four times a day. 
  

Coping With Rumination Disorder 

Rumination disorder can be a pesky and embarrassing condition. However, the condition causes no severe complications and can effectively be treated with behavioral therapy in both children and adults. Continuing your diaphragmatic breathing exercises is very important to help keep your regurgitation under control.

It’s unclear why rumination disorder occurs, so it's unclear as to whether there are prevention strategies. However, with the proper diagnosis and treatment, you can get help with controlling it and/or correcting it.