REGURGITATES and RECHEWS FOOD

RUMINATION DISORDER

 

Topics in Mental Health

 

By Shlomo Y. Radcliffe

 

What is Rumination Disorder?

Rumination is an eating disorder in which a child repeatedly involuntarily regurgitates swallowed food, re-chews it and then either swallows it or spits it out.

 

Symptoms of Rumination Disorder (DSM-IV)

 

In order to diagnose a child with rumination disorder the child must meet the following symptoms:

 

·        The child displays repeated regurgitations and re-chewing of food for at least one month

·        The child’s behaviour does not exclusively occur during the course of Anorexia Nervosa or Bulimia Nervosa

·        The child’s behaviour is not the cause of an associated gastrointestinal or other general medical condition.

·        If the child’s behaviour exclusively occurs during the course of another pervasive developmental disorder (PDD) or mental retardation then it severely requires independent clinical attention.

 

Rumination is most common in infants and onset will usually occur before a child’s first birthday. Some speculate that rumination in infants is caused by insufficient attentive nurturing or physical contact; however, the cause may be biological in nature. Rumination is also more common in people with mental retardation, but age of onset is generally later and symptoms may not appear until early adulthood.

 

Treatment of Rumination Disorder

 

Most treatments for rumination are generally quite effective. Treatment for rumination often depends on the suspected cause or causes of rumination in an individual. In the case of an infant with this disorder, if the rumination is thought to be caused by insufficient parental bonding or attention, a temporary measure may involve getting someone else other then the father or mother to feed the infant. Treatment continues with parent education and therapy which will often create a stronger bond between parent and child. In treating adult patients the use of chewing gum has been found to be effective in preventing rumination. In patients with anorexia, bulimia or other eating disorders it has been shown that the resolution of these conditions helps to resolve the rumination which would otherwise occur. In patients suffering from mental retardation it has been found that giving them filling meals may reduce rumination. Behaviour modification techniques may often help get prevent rumination.

 

Although infantile rumination will often disappear on its own, it is still very important that the rumination be treated because untreated infants are at risk of serious health problems and even death caused by dehydration and malnutrition.