RUMINATION SYNDROME

Rumination is a syndrome characterized by repetitive regurgitation of small amounts of food from the stomach, The food is then partially or completely rechewed, reswallowed, or expelled. This syndrome is relati vely common in infants and mentally challenged persons, but it also oc curs in adults with normal intelligence. The rumination syndrome is an underappreciated condition in adults who frequently receive a misdiag nosis of vomiting due to gastroparesis or gastroesophageal reflux, Dif ficulties in establishing the correct diagnosis may be caused by a lac k of awareness of the condition among physicians. This syndrome must b e considered in the differential diagnosis of a patient with regurgita tion, vomiting (especially postprandial), and weight loss. Reassurance , explanations, and behavioral therapy are currently the mainstays of treatment in adults with normal intelligence who have the rumination s yndrome. Appropriately controlled trials are needed to establish the b est therapy.