Rumination Disorder

Reviewed by Amy Baker Dennis, PhD, FAED

Rumination disorder involves the regular regurgitation of food that occurs for at least one month. Regurgitated food may be re-chewed, re-swallowed, or spit out. Typically, when someone regurgitates their food, they do not appear to be making an effort, nor do they appear to be stressed, upset, or disgusted.1

Diagnostic Criteria


The DSM-5 TR criteria for rumination disorder are:2

  • Repeated regurgitation of food for a period of at least one month. Regurgitated food may be re-chewed, re-swallowed, or spit out.
  • The repeated regurgitation is not due to a medication condition (e.g., gastrointestinal condition).
  • The behavior does not occur exclusively in the course of anorexia nervosa, bulimia nervosa, binge eating disorder, or avoidant/restrictive food intake disorder.
  • If occurring in the presence of another mental disorder (e.g., intellectual developmental disorder), it is severe enough to warrant independent clinical attention.

Treatment Considerations1,3


Once a physical cause for rumination disorder has been ruled out, the most common way rumination disorder is treated involves a combination of breathing exercises and habit reversal. A person with rumination disorder is taught to recognize the signs and situations when rumination is likely, and then they learn diaphragmatic breathing techniques to use after eating that prevent them from regurgitating their food. They eventually learn to prevent the rumination habit by replacing it with deep breathing techniques. If a person does not respond to these breathing techniques, other behavioral therapies such as biofeedback can be helpful. Beyond behavioral therapies, if an individual continues to experience symptoms provider’s may recommend taking certain types of medication (Baclofen and tricyclic antidepressants).

Since treatment providers specializing in rumination disorder are limited, if you or a loved one is exhibiting any concerning behaviors associated with rumination consult with a primary care doctor or pediatrician as soon as possible.

Learn more about treatment for eating disorders here.
Learn more about finding eating disorder treatment providers in your area here.

Sources


[1] Murray, H. B., Juarascio, A. S., Di Lorenzo, C., Drossman, D. A., & Thomas, J. J. (2019). Diagnosis and Treatment of Rumination Syndrome: A Critical Review. The American journal of gastroenterology, 114(4), 562–578. https://doi.org/10.14309/ajg.0000000000000060

[2]American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787

[3]  Sasegbon, A., Hasan, S. S., Disney, B. R., & Vasant, D. H. (2022). Rumination syndrome: pathophysiology, diagnosis and practical management. Frontline gastroenterology, 13(5), 440–446. https://doi.org/10.1136/flgastro-2021-101856