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According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), rumination is characterized by both voluntary or involuntary regurgitation and rechewing of the partially digested food that is then re-swallowed or spat out. The regurgitation process is sometimes preceded by a belching sensation, but the individual does not typically throw-up nor experience nausea. Furthermore, regurgitant in rumination does not have a sour or a bitter taste.

Diagnosing Rumination Disorder DSM-5 307.53 (F98.21)

The DSM-5 sets forth certain diagnostic criteria, which must be met in order for a diagnosis of rumination disorder to be made. Evaluate the following to correctly identify the feeding and eating disorder:

  • The individual consistently regurgitates food over a period of 1 month or longer. The food is re-chewed, re-swallowed, or spat back out.
  • The aforementioned action cannot be attributed to a gastrointestinal condition or other medical condition.
  • This eating disturbance is not solely a factor of another eating disorder the individual faces, such as anorexia nervosa, bulimia nervosa, or binge-eating disorder.
  • And if it occurs within the realm of another mental illness (like generalized anxiety disorder, for example) or a neurodevelopmental disorder (like intellectual disability, for example), the behavior must be sufficiently severe to demand independent clinical attention.

Course and Development of Rumination Disorder

Rumination disorder used to be solely recognized and diagnosed in infants as well as the developmentally disabled. But now, the illness is documented to occur in both males and females of all ages and with no particular disabilities. Unfortunately, the exact cause of this behavior is not yet known, but experts have ruled out infection and inflammation as possible culprits due to rumination being a functional gastrointestinal disorder.

In children, rumination may occur during times of serious stress, such as after being or feeling rejected; and even if the stressor is confronted or absolves, it sometimes persists. The disorder may also manifest in children who have suffered other, more serious eating disorders such as bulimia nervosa. However, rumination typically occurs for no apparent reason and in the absence of identifiable factors.

Getting Treatment for Rumination Disorder

Individual cases of rumination may vary in severity, but individuals can experience very serious effects from the disorder, such as malnutrition, weight loss, dehydration, developmental disabilities, gastric disorders, dental issues, choking, pneumonia, and even death. Therefore, it’s very important for affected individuals to seek treatment for the disorder. Treatment options include but are not limited to…

    …behavior therapy, which is used to treat those who have rumination disorder but no developmental disabilities. This form of therapy helps individuals identify when rumination occurs and teaches them to practice diaphragmatic breathing during these instances; this prevents abdominal contractions and ensuing regurgitation. Unfortunately, this treatment may not be effective on individuals who have mental or developmental disabilities. Instead, specialists may use aversive training to make them have negative associations with the behavior.

    …medication, if rumination is causing damage to the esophagus. In this case, proton pump inhibitors may be prescribed to protect the lining of the esophagus until the aforementioned behavior therapy successfully reduces the frequency as well as the severity of the behavior.

*If you or someone you know is suffering with rumination disorder, seek medical assistance near you now*

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