Rumination syndrome, a functional gastrointestinal disorder, is more common than previously thought based on a new study published in Gastroenterology.
Functional gastrointestinal disorders, are said to occur from miscommunication along the nerves between the gut and brain. Diagnosis depends on symptoms because the underlying structural and chemical changes taking place in these disorders are not known. Researchers suspect these diseases come about from disturbances in gut motility, altered mucosal and immune function, hypersensitivity of nerves in the gut, changes to gut microbes or altered processing of gut signals by the central nervous system. More common functional gastrointestinal disorders include IBS and GERD.
In a sample of 54,127 subjects from 26 countries, survey data showed rumination syndrome had an overall prevalence rate of 3.1%, higher than in previous studies. Brazil had the highest prevalence rate at 5.5% and Singapore the lowest at 1.7%. Prevalence rates in the US ranged from 2.8% to 3.1%.
The surveys included questions used to diagnose rumination syndrome. Diagnosis criteria include effortlessly regurgitating food or liquids at least 2 to 3 times a month for at least 3 consecutive months with the absence of vomiting or nausea before the regurgitation episodes the majority of the time (80% of the time in this case).
The study also showed a higher likelihood of rumination syndrome in women, those who are middle-aged (30 to 60 years old) and those with a higher BMI. Rumination syndrome was also associated with anxiety, depression and the existence of other functional gastrointestinal disorders. Patients with multiple disorders of the gut-brain interaction were found to be at a higher risk for developing rumination syndrome as well.
Rumination syndrome can be severe and lead to tooth damage, weight loss, electrolyte imbalances and avoidance of work and social eating.
Researchers in the study warn that it may be underdiagnosed. Gastroenterologists recommend that diagnosis be made by impedance pH monitoring that monitors reflux episodes in the esophagus over 24 hours. With a confirmed diagnosis, treatment with diaphragmatic breathing, cognitive-behavioral therapy and low-dose antidepressants can be recommended.
Sources: Medscape, Gastroenterology, Am J Gastroenterology, World J Gastroenterology