This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (20)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chial, H. J.
Right arrow Articles by Perrault, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chial, H. J.
Right arrow Articles by Perrault, J.
Related Collections
Right arrow Gastrointestinal Tract
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 111 No. 1 January 2003, pp. 158-162

Rumination Syndrome in Children and Adolescents: Diagnosis, Treatment, and Prognosis

Heather J. Chial, MD, Michael Camilleri, MD, Donald E. Williams, PhD*, Kristi Litzinger, MS, LPP* and Jean Perrault, MD{ddagger}

Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) Program
* Department of Clinical Health Psychology, Mayo Clinic Rochester, Rochester, Minnesota
{ddagger} McGill University Health Center, Montreal Children’s Hospital, Division of Gastroenterology and Nutrition, Montreal, Canada

--> Objectives. To characterize the clinical features, results of diagnostic testing, and treatment outcomes for children and adolescents with rumination syndrome.

Methods. Review of the medical records for all 147 patients ages 5 to 20 diagnosed with rumination syndrome at our institution between 1975 and 2000. Data are presented as mean ± the standard error of the mean.

Results. Sixty-eight percent were female. Age at diagnosis was 15.0 ± 0.3 years. Symptom duration before diagnosis was 2.2 ± 0.3 years, 73% missed school/work, and 46% had been hospitalized because of symptoms. Before diagnosis, 16 (11%) underwent surgery for evaluation or management of symptoms. Twenty-four (16%) had psychiatric disorders; 3.4% had anorexia or bulimia nervosa. All patients described postprandial regurgitation after almost every meal (2.7 ± 0.1 meals per day). Weight loss was described by 42.2% (median: 7 kg). Additional symptoms included: abdominal pain, 38%; constipation, 21%; nausea, 17%; and diarrhea, 8%. Structural studies were normal. Gastric emptying of solids at 4 hours was delayed in 26 of 56 patients. Esophageal pH testing in 24 patients showed reflux/regurgitation in 54%. Gastroduodenal manometry in 65 patients showed characteristic rumination-waves in 40%. Outcome data (at median follow-up 10 months) were available for 54 patients. Symptoms resolved in 16 (30%) and improved in 30 (56%).

Conclusions. Recognition of the clinical features of rumination syndrome in children and adolescents is essential; the diagnosis is often delayed and associated with morbidity. Extensive diagnostic testing is unnecessary. Early behavioral therapy is advocated, and patient outcomes are generally favorable.

Key Words: rumination • regurgitation • pediatric • motility • reflux

Abbreviations: CT, computed tomography

Received for publication Mar 26, 2002; Accepted Jun 27, 2002.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am. J. Physiol. Gastrointest. Liver Physiol.Home page
L. A. Szarka and M. Camilleri
Methods for measurement of gastric motility
Am J Physiol Gastrointest Liver Physiol, March 1, 2009; 296(3): G461 - G475.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
M. Fox, A. Young, R. Anggiansah, A. Anggiansah, and J. Sanderson
A 22 year old man with persistent regurgitation and vomiting: case outcome.
BMJ, July 15, 2006; 333(7559): 133 - 133.
[Full Text] [PDF]

Home page
 BMJHome page
S. A Azer
Lessons on functional diseases.
BMJ, July 15, 2006; 333(7559): 135 - 135.
[Full Text] [PDF]

eLetters:

Read all eLetters

Rebuttle to some "facts"
Justin K.W. O'Neill
Pediatrics Online, 13 Sep 2009 [Full text]