Symptoms:

• Repeatedly bringing up (regurgitating) food
• Repeatedly rechewing food

Symptoms must go on for at least 1 month to fit the definition of rumination disorder.

People do not appear to be upset, retching, or disgusted when they bring up food. It may appear to cause pleasure.

Signs and tests:

The health care provider must first rule out physical causes, such as hiatal hernia and pyloric stenosis. These conditions can be mistaken for rumination disorder.

Rumination disorder can cause malnutrition. The following lab tests can measure how severe the malnutrition is and determine what nutrients need to be increased:

• Blood test for anemia
• Endocrine - hormone functions
• Serum electrolytes

Treatment:

Rumination disorder is treated with behavioral techniques. One treatment associates bad consequences with rumination and good consequences with more appropriate behavior (mild aversive training).

Other techniques include improving the environment (if there is abuse or neglect) and counseling the parents.

Expectations (prognosis):

In some cases rumination disorder will disappear on its own, and the child will go back to eating normally without treatment. In other cases, treatment is necessary.

Complications:

• Failure to thrive
• Lowered resistance to disease
• Malnutrition

Calling your health care provider:

Call your health care provider if your baby appears to be repeatedly spitting up, vomiting, or rechewing food.

Prevention:

There is no known prevention. However, normal stimulation and healthy parent-child relationships may help reduce the odds of rumination disorder.