Rumination Disorder: What it Is, Symptoms and Treatment

Do you know someone who returns food for no apparent reason? Enter and discover rumination disorder.

He rumination disorder It may be an unknown disorder but it is no less important since if it appears at certain ages it can be fatal. When we talk about rumination may come to mind mental rumination, which is basically a passive coping strategy in which the person focuses their thoughts on a negative event, turning the same question over and over. However, when we talk about rumination disorder We are not referring to cognitive rumination but to a type of eating disorder.

To learn more about this disorder, enter and discover what it is, its symptoms and the most effective treatments to treat it.

What is rumination disorder?

He rumination disorder (also called rumination syndrome either mericism ) is a type of Eating Disorder (either TCA ) as are the anorexy pica disorder, bulimia, binge eating disorder, etc. Although the percentage of people who suffer from it is not known with certainty, it is known that it is often more common in certain groups such as, for example, people with intellectual disabilities. However, it can also occur in people without this characteristic and, in fact, it can occur throughout infancy, childhood, adolescence and adulthood. Specifically, the main characteristic of this disorder is the regurgitation repeated food intake, that is, food is expelled without the existence of nausea and cannot be explained by the presence of an organic disease or condition such as gastroesophageal reflux etc.

In the case of babies, the age of onset is between 3 and 12 months and although normally in this age group the disorder disappears spontaneously, it is in this precise population where its presence can be potentially fatal, especially if It occurs during the lactation stage and lasts over time. On the other hand, when it occurs in people with intellectual disability, the symptoms must be severe enough to require specific clinical attention. The presence of this disorder in people with disabilities can be explained by exerting a stimulation or relaxation function as well as other repetitive behaviors such as, for example, hitting oneself.

Symptoms of rumination disorder (or mericism):

Taking into account the DSM-5 (Statistical Manual of Mental Disorders), the symptoms of rumination disorder They are mainly the following:

1. Person regurgitates food repeatedly. These are chewed again, swallowed or spit out and the person bring back food that has already been previously swallowed without the existence of nausea, gagging or unpleasantness. Therefore, it regurgitates food without any effort and usually occurs minutes after finishing eating.
2. The regurgitation It must be frequent and occur at least three times a week and for at least a month.
3. Regurgitation cannot be explained by another eating disorder such as bulimia and anorexia. In the first two there may be regurgitation But it fulfills a function: to compensate for the calories ingested due to a concern with physical appearance and weight gain. Unlike these disorders, the person who suffers from rumination disorder It is not intended to compensate for calories nor is there a concern for body image.
4. People who suffer from this disorder may refer to this behavior as if they have no control over it.
5. When it occurs in children, the mericism It may be accompanied by a characteristic posture. Specifically, you can see how they arch their back, keeping their head back while making sucking movements with their tongue. Seeing them may give the impression that they enjoy this activity, but irritability is common between episodes of regurgitation.
6. The regurgitation in adults or in adolescents it may be accompanied by avoidance behaviors. Specifically, it is common to avoid social encounters that involve eating given the social rejection that the presence of this disorder can imply, thus affecting the person’s social functioning. Therefore, many people will avoid eating at work, school, etc. for fear of rejection and some will try to hide it by covering their mouth or coughing.
7. It can be associated with the malnutrition regardless of age, especially when intake restriction occurs (as in the case of adults). In childhood, the disorder becomes more important given that malnutrition can negatively influence the growth, development and learning of the child.

Treatment:

Treatment must take into account age, cognitive development, as well as the factors that trigger and maintain said disorder. Therefore, prior evaluation and diagnosis by a qualified professional is essential. Furthermore, the rumination disorder It may be accompanied by a medical condition or another mental disorder, such as generalized anxiety disorder. It is for this reason that professional attention is essential so that an evaluation can be carried out and, therefore, a personalized intervention can be planned.

Treatments usually begin with psychoeducation sessions; in almost all interventions, a prior explanation of the disorder is important so that the person can understand what is happening to them, as well as to treat possible associated feelings (guilt, shame, rejection, etc.). Depending on the case, the disorder will be treated in one way or another, sometimes requiring Pharmacotherapy

Regarding psychological treatment, the techniques that have proven to be most effective are the following:

• Diaphragmatic breathing: The treatment is mainly based on training the person in diaphragmatic breathing, which is basically a breathing technique. This type of breathing has also been effective for the treatment of anxiety disorders or to treat stress since it reduces the general activation of the body and has multiple benefits on both a physical and psychological level. In the case of rumination disorder, this technique is trained so that the person practices it minutes after meals. Sometimes, along with this procedure, biofeedback is also used, which basically consists of using instruments (electromyogram, etc.) so that the person is aware, in this case, of their muscle function during breathing.
• Behavior modification techniques: In the event that this disorder occurs in childhood, behavior modification techniques, such as operant techniques, have been shown to be effective. Specifically, different techniques are used that consist of giving reinforcement (a reward) when the child carries out behaviors that are incompatible with the rumination behaviors (such as, for example, practicing relaxation) with the aim of reducing the appearance of the former.

If you feel identified with the symptoms shown or you have a child who presents these behaviors, it is important to ask a professional for help to rule out other pathologies and receive appropriate treatment.