Rumination disorder: Difference between revisions
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{{SI}} | {{SI}} | ||
{{CMG}}; {{AE}} {{KS}} | {{CMG}}; {{AE}} Mark Warren, M.D., M.P.H.; Fellow, Academy of Eating Disorders [mailto:mwarren@eatingdisorderscleveland.org]; {{KS}} | ||
{{SK}} | {{SK}} Childhood rumination disorder; merycism, rumination syndrome | ||
==Overview== | ==Overview== | ||
Rumination is an [[eating disorder]] characterized by having the contents of the [[stomach]] drawn back up into the [[mouth]], chewed for a second time, and [[swallowing|swallowed]] again. In some animals, known as [[ruminant]]s, this is a natural and healthy part of [[digestion]] and is not considered an eating disorder. However, in other species (including humans), such behavior is atypical and potentially dangerous as the [[esophagus]] can be damaged by frequent exposure to [[stomach]] acids. Rumination is also associated with eating disorders such as anorexia nervosa, and can be the result of one's apprehension and nervousness after eating a normal meal. For those with purging behaviors, rumination can take place when the option of getting rid of a meal via throwing up is not available (thus, one might feel worried and visibly upset). Rumination has also been reported in developmentally normal children and adults who experience regurgitation of previously swallowed food, without disgust, nausea or an acidic taste. The food is either chewed and reswallowed or spat out. Remission of these episodes is seen in some cases while others persist. Many claim this as a pleasurable habit. | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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** Problems in the parent-child relationship | ** Problems in the parent-child relationship | ||
** Stressful life situations<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref> | ** Stressful life situations<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref> | ||
==Natural History, Complications and Prognosis== | |||
Rumination disorder typically occurs within the first 3-12 months of age and can lead to the child becoming [[malnourished]]. | |||
While rumination disorder may begin in childhood or infancy, adults may also have this chronic disorder, for which there is presently no known cure nor cause. While those diagnosed with this condition in childhood may 'grow out of it', it is by no means a medical fact that they are bound to do so by adolescence or adulthood. | |||
Remission of these episodes is seen in some cases while others persist. | |||
==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
Revision as of 18:25, 22 October 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mark Warren, M.D., M.P.H.; Fellow, Academy of Eating Disorders [2]; Kiran Singh, M.D. [3]
Synonyms and keywords: Childhood rumination disorder; merycism, rumination syndrome
Overview
Rumination is an eating disorder characterized by having the contents of the stomach drawn back up into the mouth, chewed for a second time, and swallowed again. In some animals, known as ruminants, this is a natural and healthy part of digestion and is not considered an eating disorder. However, in other species (including humans), such behavior is atypical and potentially dangerous as the esophagus can be damaged by frequent exposure to stomach acids. Rumination is also associated with eating disorders such as anorexia nervosa, and can be the result of one's apprehension and nervousness after eating a normal meal. For those with purging behaviors, rumination can take place when the option of getting rid of a meal via throwing up is not available (thus, one might feel worried and visibly upset). Rumination has also been reported in developmentally normal children and adults who experience regurgitation of previously swallowed food, without disgust, nausea or an acidic taste. The food is either chewed and reswallowed or spat out. Remission of these episodes is seen in some cases while others persist. Many claim this as a pleasurable habit.
Differential Diagnosis
- Anorexia nervosa
- Bulimia nervosa
- Gastrointestinal conditions
- Gastroesophageal reflux
- Gastroparesis
- Hiatal hernia
- Pyloric stenosis
- Sandifer syndrome
- Vomiting[1]
Epidemiology and Demographics
Prevalence
- Prevalence data for rumination disorder are inconclusive
- Higher in certain groups, such as individuals with intellectual disability[1]
Risk Factors
- Psycho social problems
- Lack of stimulation
- Neglect
- Problems in the parent-child relationship
- Stressful life situations[1]
Natural History, Complications and Prognosis
Rumination disorder typically occurs within the first 3-12 months of age and can lead to the child becoming malnourished.
While rumination disorder may begin in childhood or infancy, adults may also have this chronic disorder, for which there is presently no known cure nor cause. While those diagnosed with this condition in childhood may 'grow out of it', it is by no means a medical fact that they are bound to do so by adolescence or adulthood.
Remission of these episodes is seen in some cases while others persist.
Diagnostic Criteria
DSM-V Diagnostic Criteria for Rumination Disorder[1]
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AND D. If the symptoms occur in the context of another mental disorder (e.g., intellectual disability, Intellectual developmental disorder or another neuro developmental disorder),they are sufficiently severe to warrant additional clinical attention. Specify if:
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