Rumination Syndrome and Other Functional GI Disorders

Rumination syndrome is a functional gastrointestinal disorder defined by the Rome IV criteria as repeated regurgitation with rechewing or expulsion of food that begins shortly after meal ingestion, does not occur at night, and is not preceded by retching. It is usually underdiagnosed and untreated and frequently mistaken for vomiting or gastroesophageal reflux. Patients with rumination frequently complain of other gastrointestinal symptoms and have overlap with other disorders of gut-brain interaction. The diagnosis of rumination is clinical, and no tests are routinely needed. Manometry can confirm the diagnosis if necessary. Treatment is based on diaphragmatic breathing, making sure comorbidities are addressed and maintaining good nutritional status.