rumination disorder:
Rumination disorder: Almost everyone knows what rumination is. anorexia nervosathe bulimia and the Binge eating disorder, but there are other eating behavior disorders that are much less frequent and that it is worth knowing about due to the potential dangers that they entail. It is the much less frequent rumination disorder that is worth knowing about due to the potential dangers that it entails.
The rumination It is an involuntary gastroenterological phenomenon that involves regurgitation from the stomach to the mouth of food, which is chewed and swallowed again. The process starts 15 minutes after meals and can happen up to 20 times.
This can give rise toweight problems and malnutrition because the nutrients are not being absorbed.
Causes
The most important causes of rumination disorder are mostly psychosocial in origin.. Some of the most common causes are: having lived in a cognitively unstimulating psychosocial environment, having received negligent care from the main attachment figures (and even situations of abandonment), experiencing highly stressful events in their lives (such as a death of a loved one, city changes, separation by parents…) and traumatic situations (child sexual abuse).
In addition, difficulties in the parent-child bond are considered one of the most important predisposing factors in the development of this disorder in children and adolescents.
Treatment
Treatment will be different depending on age and intellectual capacity of the individual presenting it.
In adults and adolescents, biofeedback and relaxation techniques or diaphragmatic breathing after ingestion or when regurgitation occurs have been shown to be useful.
In children and people with intellectual deficits behavior modification techniquesincluding treatments that use operant techniques, are the ones that have shown the most efficacy.
Some examples are: withdrawing attention from the child while he is performing the behavior we want to reduce and giving him primary or unconditioned reinforcements (affection and attention) or materials (a treat) when he does not regurgitate. Other authors bet on putting an unpleasant taste (bitter or acid) on the tongue when the typical movements of rumination are beginning.
In the case of children, it is important for the family to understand the disorder. And learn some guidelines for action to problem behavior. And as is usually advised in these cases, be very patient. If the relationship between the parents and the child is not good, it is necessary to work on the emotional difficulties that may be maintaining the problem.
Diagnosis
The doctor will ask about your or your child’s current symptoms and medical history. An initial examination and sometimes observation of a person’s behavior are usually enough to diagnose rumination syndrome.
High-resolution esophageal manometry and impedance measurement can be performed to confirm the diagnosis. This test shows if there is increased pressure in the abdomen. Also, it provides a picture of impaired function for use in behavioral therapy.
Other tests may be used to rule out other possible causes of your or your child’s symptoms, including:
- Esophagogastroduodenoscopy. This test allows the doctor to examine the esophagus, stomach, and upper part of the small intestine (duodenum). To rule out any obstruction. The doctor may remove a tissue sample (biopsy) for further analysis.
- Gastric emptying. This procedure lets the doctor know how long it takes for marked food to leave the stomach. Another version of this test also measures how long it takes for food to travel through the small intestine and colon.
Medicines
If frequent rumination is affecting the esophagus, proton pump inhibitors may be prescribed. Such as esomeprazole (Nexium) or omeprazole (Prilosec). These medications can protect the lining of the esophagus. Until behavioral therapy reduces the frequency and severity of regurgitation.
Some people with rumination syndrome may benefit from treatment with medications that help relax the stomach after eating.
How to prepare for the consultation
You can start by seeing your or your child’s primary care provider. Or you may be referred right away to a doctor who specializes in digestive disorders (gastroenterologist).
Below is information to help you prepare for your appointment.
What you can do
When making your appointment, ask if you need to do anything ahead of time, such as fasting before having a specific test. Make a list of the following:
- Symptomsincluding those that may not seem related to the reason for the consultation
- Essential personal informationincluding major stressors, recent life changes, and family medical history
- all medications, vitamins or other supplements you take, including dosages
- Questions you can ask to the doctor
Ask a family member or friend to come with you. If possible, to help you remember the information you receive.
Regarding rumination syndrome, here are some basic questions you can ask your doctor:
- What is the most likely cause of these symptoms?
- Are there other possible causes?
- Is it necessary to carry out a study?
- Is it likely to be temporary or long lasting?
- What treatment do you recommend?
- Is there an alternative to the primary approach you indicate?
- Are dietary restrictions recommended?
- Do you have brochures or other printed material about this disease? What websites do you recommend?
What to expect from the doctor
Your doctor will likely ask you a number of questions, such as:
- When did the symptoms start?
- Do symptoms occur with every meal?
- How severe are the symptoms?
- Is there anything that improves your or your child’s symptoms?
- Does anything seem to make the symptoms worse?
what can you do in the meantime
In some people, chewing gum can relieve some of the symptoms of rumination disorder.