Rumination Syndrome

Rumination syndrome is a functional gastrointestinal disorder characterized by effortless postprandial regurgitation. Incidence and prevalence of rumination syndrome is largely unknown, but the disorder appears uncommon. Whilst the exact pathophysiology is remains to be elucidated, increased gastric pressure, coupled with negative intrathoracic pressure facilitates the process. Symptoms can range from relatively minor to severe. Weight loss, malnutrition can occur, and in children dental erosion has been observed. A clinical diagnosis can be made in most cases, although a post-prandial high resolution manometry study can objectively confirm the diagnosis. The cornerstone of therapy is diaphragmatic breathing. Baclofen can be used in refractory cases, and currently no defined role for surgery exists in this condition.