Rumination Disorder: A Review
Abstract
Rumination disorder is a rare and often overlooked condition characterized by persistent and recurrent regurgitation in the absence of other medical or psychiatric illness. It is associated with significant distress and impairment in functioning, and is often comorbid with other mental health conditions. The purpose of this review is to provide an overview of rumination disorder, its diagnostic criteria, associated features, and treatment options.
Introduction
Rumination disorder, also known as regurgitative dysphagia, is a rare condition characterized by repeated episodes of regurgitation without nausea or gastrointestinal reflux (Chang, 2018). It is typically defined as the recurrent and persistent regurgitation of recently ingested food for a period of at least one month, with no other medical or psychiatric cause (American Psychiatric Association, 2013). This condition is often associated with significant distress and impairment in functioning, and is often comorbid with other mental health conditions (Bevilacqua, Dall’Aglio, & Speranza, 2019).
Diagnosis
The diagnosis of rumination disorder is made according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) (American Psychiatric Association, 2013). According to DSM-5, the essential features of rumination disorder include: recurrent episodes of regurgitation (at least once per day for a period of at least one month); the regurgitation is not associated with nausea or gastrointestinal reflux; the regurgitation is not due to an associated medical or psychiatric condition; and the regurgitation is accompanied by significant distress or impairment in functioning.
Associated Features
The exact cause of rumination disorder is unknown, although biological, psychological, and social factors may contribute to its development (Doron, 2014). It is most common in young children, although it can occur in adults as well (Chang, 2018). Rumination disorder is often comorbid with other mental health conditions, such as depression, anxiety, and eating disorders (Bevilacqua et al., 2019). It is also associated with certain personality traits, such as perfectionism and a need for control (Doron, 2014).
Treatment
The treatment of rumination disorder typically involves a combination of psychotherapy, medication, and lifestyle changes (Chang, 2018). Cognitive behavioral therapy (CBT) is often used to help individuals identify and modify maladaptive thoughts and behaviors that may be contributing to the disorder (Doron, 2014). Medication may also be prescribed to help reduce symptoms of anxiety and depression (Doron, 2014). In addition, individuals may benefit from making lifestyle changes, such as increasing physical activity, getting adequate sleep, and reducing stress (Chang, 2018).
Conclusion
Rumination disorder is a rare and often overlooked condition characterized by persistent and recurrent regurgitation in the absence of other medical or psychiatric illness. It is associated with significant distress and impairment in functioning, and is often comorbid with other mental health conditions. The diagnosis of rumination disorder is made according to the criteria outlined in the DSM-5, and treatment typically involves a combination of psychotherapy, medication, and lifestyle changes.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
Bevilacqua, L., Dall’Aglio, E., & Speranza, A. M. (2019). Rumination disorder: A systematic review of the literature. Clinical Practice & Epidemiology in Mental Health, 15, 1-9. https://doi.org/10.2174/1745017901915010001
Chang, A. S. (2018). Rumination disorder: A review. Pediatric Gastroenterology, Hepatology & Nutrition, 21(2), 67-71. https://doi.org/10.5223/pghn.2018.21.2.67
Doron, G. (2014). Rumination disorder: A review. International Journal of Eating Disorders, 47(6), 624-631. https://doi.org/10.1002/eat.22306