Rumination Syndrome Treatment

Our Rumination Syndrome Treatment Program includes outpatient and intensive outpatient levels of care. Care level is determined by our team based on thorough review of clinical history, previous testing and treatment, and an initial clinic visit evaluation when necessary.

• Intensive Outpatient Program involves an initial clinic visit with a pediatric gastroenterologist and psychologist, followed by three to four days of treatment that includes one to two treatment meals per day.
• General Outpatient Program includes single-treatment meals scheduled periodically and based on patient need.

Both levels of care are designed to teach patients the necessary skills to learn how to manage their symptoms of rumination and how to apply these skills in their daily lives. The primary skills used to treat rumination syndrome are reswallowing after regurgitation, and use of diaphragmatic breathing at specific times during and after eating and drinking. We practice these steps while eating and drinking as part of our treatment program. Medications can also sometimes be helpful or necessary in treating other symptoms related to rumination syndrome.

Our treatment programs are designed for patients who are fully invested in participating in rumination treatment. We have learned that an individual’s motivation for and dedication to the treatment is the most important in terms of treatment success. Anyone who is unsure if they want to participate in the behavioral treatment or questions the diagnosis of rumination syndrome are not ready for our treatment program.

Sometimes, other symptoms make participating in the behavioral rumination treatment difficult. Examples are severe nausea or abdominal pain that prevent someone from eating by mouth, even very small amounts. These other symptoms may need to be improved before rumination treatment can begin.

Several studies of the treatment of rumination syndrome have produced some very positive and exciting findings. Research has highlighted many important parts of treatment.

1. Education. Families who take an active role in learning, understanding, and treating rumination have the best outcomes.
2. Treating the 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 focusing on increasing awareness of what your abdominal muscles are doing, learning new behaviors for the abdominal muscles instead of tightening, and keeping the body relaxed during mealtimes.
4. Retraining the stomach to hold food again. Patients benefit from starting very slowly with small amounts and then gradually increasing their stomach’s ability to tolerate greater amounts of food and fluid.