Common Indicators Of Rumination Syndrome

Rumination syndrome is a functional gastroduodenal disorder characterized by an individual who inadvertently and repeatedly spits up or regurgitates partially digested food from the stomach. The patient chews it up again, and then they either spit it out or re-swallow it. The cause of rumination syndrome is not always clear, but an increase in pressure within the abdominal area is known to play a role. When an individual's rumination syndrome goes untreated, damage to the esophagus may occur.

Rumination syndrome may be diagnosed with a physical exam, behavioral observation, or a high-resolution esophageal manometry and impedance measurement. Behavior therapy is often used to treat this disorder by teaching the patient to recognize when rumination happens and how to implement breathing exercises during those occurrences. Medications are also commonly used to treat problematic complications of rumination disorder such as esophageal damage.

Bad Breath

Bad breath or halitosis is best described as when an individual's breath smells unpleasant or foul regularly. The regurgitation of food in rumination syndrome patients happens shortly after ingesting the food. This means the food has been chewed up and mixed with saliva containing an enzyme called amylase. As the food is swallowed, the enzymes in the saliva continue the digestion process until the food reaches the stomach. Stomach acids are then secreted in response to the expansion of the stomach wall. Before enough stomach acid is produced, the food stays within the range of plant enzyme breakdown.

This range means the degree of digestion sustained depends on how many raw plant enzymes are present. Regardless, the regurgitated food will have been digested to some degree. Enzymes in the saliva, food, and stomach are still present in the partially digested food. When the food is re-chewed, these enzymes populate the mouth on the tongue, between the teeth, and in the throat. Because of frequent regurgitation, the oral cavity will always have more digestive components present than it should. This excess is what causes the rumination syndrome patient to have persistent bad breath.

Frequent Regurgitation

Regurgitation occurs when food comes up into the mouth from the stomach or esophagus without forceful abdominal muscle contractions or nausea. Rumination means regurgitation is frequently occurring with no apparent physical cause other than involuntary habit. This regurgitation in patients with rumination syndrome usually occurs between fifteen and thirty minutes after the ingestion of food and can be described as effortless. The food does not taste particularly sour to affected individuals.

The best explanation for this type of regurgitation is that voluntary but subconscious contractions of the abdominal wall cause an increased amount of pressure and simultaneous relaxation of the sphincter in the esophagus. After the food reaches the mouth again, the patient re-chews it, and they either swallow or spit it out. The circumstances of the individual at the time of the regurgitation usually influence the decision to either swallow or spit the regurgitant. Food does not regurgitate when a rumination syndrome patient is asleep. Individuals with this disorder also do not respond to treatments for gastroesophageal reflux disease.