THE SECONDARY RUMINATION SYNDROME

Objective: To describe a case of rumination syndrome. The rumination s yndrome in humans is characterized, manometrically, by straining-induc ed intra-abdominal pressure peaks which precede the episodes of regurg itation. Patient: A 26-year-old woman with rumination syndrome suspect ed on the basis of her symptoms. Methods: A 24-h ambulatory study was performed to simultaneously monitor oesophageal pH (five levels), oeso phageal pressure and intragastric pressure. Results: All episodes of r egurgitation were associated with abdominal pressure peaks. However, s pontaneous gastro-oesophageal reflux rather than rumination appeared t o be the primary event, followed by abdominal straining which propelle d the refluxed material further upwards in the oesophagus. Conclusions : The term secondary rumination is proposed to describe the abnormalit y observed in this patient.