Why Nationwide Children's?

What is rumination syndrome?

Rumination syndrome is a functional gastrointestinal disorder (FGID). It is a rare condition in which food and drink that has been swallowed but not yet digested is involuntarily regurgitated, or brought back up, soon after eating or drinking.  

What causes rumination syndrome?

Symptoms of rumination syndrome often begin with a triggering event. This could be a viral infection, a gastrointestinal disorder or stress happening in a child’s life. 

What are the symptoms of rumination syndrome?

Along with effortless regurgitation of food or drink soon after intake, other symptoms associated with rumination syndrome can include:

• Dehydration
• Weight loss
• Bad breath
• Nausea
• Fatigue or decreased energy
• Decreased quality of life

Some school-aged children with rumination syndrome end up missing school and stop participating in sports and other activities because they are embarrassed or experience anxiety as a result of their condition. 

How is rumination syndrome diagnosed?

A medical professional reviews a patient’s medical history and previous tests to make sure there is no other diagnosis that could better explain the symptoms. Often, the patient’s medical history and symptoms are enough to make a diagnosis. Sometimes, patients will be asked to eat or drink something for the medical professional to observe the symptoms to confirm the diagnosis. 

How is rumination syndrome treated?

The Rumination Syndrome Program team will create an individualized plan for your child based on their age, medical history and symptoms. The care plan may involve outpatient management, intensive outpatient treatment or an inpatient stay.

Treatment of rumination syndrome has four main components:

1. Education. Families who take an active role in learning, understanding and treating rumination have the best outcomes. 
2. Treating related symptoms. Treating symptoms such as nausea or bloating that occur after eating can reduce the frequency of the rumination behavior. 
3. Resetting the brain-gut connection. Treatment includes making the patient aware of what their stomach muscles are doing when rumination occurs, and teaching them how to keep their body relaxed during mealtimes.  
4. Retraining the stomach to hold food again. Patients benefit from starting very slowly with small amounts of food and then gradually increasing their stomach’s ability to tolerate greater amounts of food and fluid.

Is there a cure for rumination syndrome?

In most cases, symptoms are greatly reduced or even eliminated. Our patients learn skills to manage their symptoms so they are less bothersome and don’t interfere with their daily functioning. Some patients stop having regurgitation altogether, but some continue to have some symptoms at times.

The cornerstones of our treatment program are:

• Treating the whole patient, including their rumination, overall GI functioning, nutritional needs, psychological functioning, coping and physical conditioning
• Teaching the patient strategies to keep down enough food and fluid to maintain weight
• Preparing the patient for continuing their treatment at home in a real-world setting

This approach ensures patients have a better quality of life following treatment.

What are the outcomes of the Nationwide Children’s Rumination Syndrome Program?

Since our program began in 2010, we have treated patients from around the world. Nearly 90% of patients were able to dramatically improve their rumination symptoms upon completing the program. More than 80% of patients who were on total parenteral or feeding tubes left the program no longer needing supplemental feedings.

Email us at RuminationSyndrome@NationwideChildrens.org and tell us about your child, whether they are under the care of a GI physician and have a diagnosis of rumination syndrome. A team member will reply within 48 hours.

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