Recognition and Management of the Patient with Rumination Syndrome
DOI:
https://doi.org/10.52787/agl.v52i2.199Keywords:
Functional gastrointestinal disorders, disorders of gut-brain interaction, rumination syndrome, regurgitation, vomiting, refractory gastroesophageal reflux diseaseAbstract
Rumination syndrome is a functional gastroduodenal disorder characterized by the repetitive, effortless regurgitation of recently ingested food into the mouth followed by rechewing and reswallowing or expulsion of the food bolus. In clinical practice, most patients report the presence of “reflux” or “vomiting” and, if a detailed history is not taken with directed questions, the symptoms are often misinterpreted; which leads to multiple complementary tests and unnecessary treatments that do not solve the problem. In patients with a clinical diagnosis of refractory gastroesophageal reflux disease, it is essential to distinguish between persistent postprandial regurgitation and rumination syndrome. The importance of this differential diagnosis lies in the fact that rumination syndrome benefits from behavioral interventions, unlike medical or surgical treatments indicated in patients in whom the presence of refractory gastroesophageal reflux disease is confirmed.
References
-1. Stanghellini V, Chan FKL, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal Disorders. Gastroenterology. 2016;150(6):1380-92.
-2. O’Brien MD, Bruce BK, Camilleri M. The rumination syndrome: clinical features rather than manometric diagnosis. Gastroenterology. 1995;108(4):1024-9.
-3. Soykan I, Chen J, Kendall BJ, Mccallum RW. The Rumination Syndrome (Clinical and Manometric Profile, Therapy, and Long-Term Outcome). Dig Dis Sci. 1997;42(9):1866-72.
-4. Josefsson A, Hreinsson JP, Simrén M, Tack J, Bangdiwala SI, Sperber AD, et al. Global Prevalence and Impact of Rumination Syndrome. Gastroenterology. 2022;162(3):731-42.e9.
-5. Wang X, Luscombe GM, Boyd C, Kellow J, Abraham S. Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria. World J Gastroenterol. 2014;20(43):16293-9.
-6. Almansa C, Rey E, Sánchez RG, Sánchez AA, Díaz-Rubio M. Prevalence of functional gastrointestinal disorders in patients with fibromyalgia and the role of psychologic distress. Clin Gastroenterol Hepatol. 2009;7(4):438-45.
-7. Nakagawa K, Sawada A, Hoshikawa Y, Nikaki K, Sonmez S, Woodland P, et al. Persistent postprandial regurgitation vs rumination in patients with refractory gastroesophageal reflux disease symptoms: identification of a distinct rumination pattern using ambulatory impedance-pH monitoring. Official journal of the American College of Gastroenterology| ACG. 2019;114(8):1248-55.
-8. Chial HJ, Camilleri M, Williams DE, Litzinger K, Perrault J. Rumination syndrome in children and adolescents: diagnosis, treatment, and prognosis. Pediatrics. 2003;111(1):158-62.
-9. Rajindrajith S, Devanarayana NM, Crispus Perera BJ. Rumination syndrome in children and adolescents: a school survey assessing prevalence and symptomatology. BMC Gastroenterol. 2012;12:163.
-10. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10(7):712-21.e4.
-11. Chitkara DK, Van Tilburg M, Whitehead WE, Talley NJ. Teaching diaphragmatic breathing for rumination syndrome. Am J Gastroenterol. 2006;101(11):2449-52.
-12. Amarnath RP, Abell TL, Malagelada JR. The rumination syndrome in adults. A characteristic manometric pattern. Ann Intern Med. 1986;105(4):513-8.
-13. Halland M, Parthasarathy G, Bharucha AE, Katzka DA. Diaphragmatic breathing for rumination syndrome: efficacy and mechanisms of action. Neurogastroenterol Motil. 2016;28(3):384-91.
-14. Thumshirn M, Camilleri M, Hanson RB, Williams DE, Schei AJ, Kammer PP. Gastric mechanosensory and lower esophageal sphincter function in rumination syndrome. Am J Physiol. 1998;275(2):G314-21.
-15. Gourcerol G, Dechelotte P, Ducrotte P, Leroi AM. Rumination syndrome: when the lower oesophageal sphincter rises. Dig Liver Dis. 2011;43(7):571-4.
-16. Kessing BF, Bredenoord AJ, Smout AJPM. Objective manometric criteria for the rumination syndrome. Am J Gastroenterol. 2014;109(1):52-9.
-17. Malcolm A, Thumshirn MB, Camilleri M, Williams DE. Rumination Syndrome [Internet]. Vol. 72, Mayo Clinic Proceedings. 1997. Pp. 646-52.
-18. Absah I, Rishi A, Talley NJ, Katzka D, Halland M. Rumination syndrome: pathophysiology, diagnosis, and treatment. Neurogastroenterol Motil [Internet]. 2017;29(4).
-19. Halland M, Pandolfino J, Barba E. Diagnosis and Treatment of Rumination Syndrome. Clin Gastroenterol Hepatol. 2018;16(10):1549-55.
-20. Vachhani H, De Souza Ribeiro B, Schey R. Rumination Syndrome: Recognition and Treatment [Internet]. Vol. 18, Current Treatment Options in Gastroenterology. 2020. Pp. 60-8.
-21. Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ, Roman S, Savarino E, et al. ESNM/ANMS consensus paper: Diagnosis and management of refractory gastro-esophageal reflux disease. Neurogastroenterol Motil. 2021;33(4):e14075.
-22. Murray HB, Zhang F, Call CC, Keshishian A, Hunt RA, Juarascio AS, et al. Comprehensive Cognitive-Behavioral Interventions Augment Diaphragmatic Breathing for Rumination Syndrome: A Proof-of-Concept Trial. Dig Dis Sci. 2021;66(10):3461-9.
-23. Robles A, Romero YA, Tatro E, Quezada H, McCallum RW. Outcomes of Treating Rumination Syndrome with a Tricyclic Antidepressant and Diaphragmatic Breathing. Am J Med Sci. 2020;360(1):42-9.
-24. Barba E, Burri E, Accarino A, Malagelada C, Rodríguez-Urrutia A, Soldevilla A, et al. Biofeedback-guided control of abdominothoracic muscular activity reduces regurgitation episodes in patients with rumination. Clin Gastroenterol Hepatol. 2015;13(1):100-6.e1.
-25. Barba E, Accarino A, Soldevilla A, Malagelada J-R, Azpiroz F. Randomized, Placebo-Controlled Trial of Biofeedback for the Treatment of Rumination. Am J Gastroenterol. 2016;111(7):1007-13.
-26. Burton Murray H, Juarascio AS, Thomas JJ. Augmenting Diaphragmatic Breathing with Behavioral Exposure: Single-Case Experimental Design for Rumination Disorder. Cogn Behav Pract. 2020;27(3):347-56.
-27. Thomas JJ, Murray HB. Cognitive-behavioral treatment of adult rumination behavior in the setting of disordered eating: A single case experimental design [Internet]. Vol. 49, International Journal of Eating Disorders. 2016. p. 967-72.
-28. Drossman DA, Tack J, Ford AC, Szigethy E, Törnblom H, Van Oudenhove L. Neuromodulators for functional gastrointestinal disorders (disorders of Gut−Brain interaction): A Rome foundation working team report. Gastroenterology. 2018;154(4):1140-71.e1.
-29. Murray HB, Juarascio AS, Di Lorenzo C, Drossman DA, Thomas JJ. Diagnosis and Treatment of Rumination Syndrome: A Critical Review. Am J Gastroenterol. 2019;114(4):562-78.
-30. Hasler WL. Baclofen effects on esophageal function: a possible therapy for GERD? Gastroenterology. 2002;123(5):1736-7.
-31. Koek GH, Sifrim D, Lerut T, Janssens J, Tack J. Effect of the GABAB agonist baclofen in patients with symptoms and duodeno-gastro-oesophageal reflux refractory to proton pump inhibitors. Gut. 20031;52(10):1397-402.
-32. Van Herwaarden MA, Samsom M, Rydholm H, Smout AJP. The effect of baclofen on gastro-oesophageal reflux, lower oesophageal sphincter function and reflux symptoms in patients with reflux disease. Alimentary Pharmacology & Therapeutics. 2002;16:1655-62.
-33. Vela MF, Tutuian R, Katz PO. Baclofen decreases acid and nonacid post prandial gastrooesophageal reflux measured by combined multichannel intraluminal impedance and pH. Aliment Pharmacol Ther. 2003;17(2):243-51.
-34. Blondeau K, Boecxstaens V, Rommel N, Farré R, Depeyper S, Holvoet L, et al. Baclofen improves symptoms and reduces postprandial flow events in patients with rumination and supragastric belching. Clin Gastroenterol Hepatol. 2012;10(4):379-84.
-35. Oelschlager BK, Chan MM, Eubanks TR, Pope CE 2nd, Pellegrini CA. Effective treatment of rumination with Nissen fundoplication. J Gastrointest Surg. 2002;6(4):638-44.
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Mercedes Manresa
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
