Persistent functional vomiting

Fullerton, Donald T.; Neff, Susan G.; Getto, Carl J.

doi:10.1002/1098-108x(199209)12:2<229::aid-eat2260120213>3.0.co;2-l

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…In addition to social neglect, the individual may suffer from a lack of stimulation or from social embarrassment (Pany-Jones, 1994). An individual also may experience a range of health problems associated with rumination, including weight loss, dehydration, malnutrition, growth impairment, tooth decay, electrolyte imbalance, decreased resistance to disease, high fever, failure to thrive, irritability, and diarrhea (Fullerton, Neff, & Getto, 1992;Johnston, 1993;Luiselli et al, 1993). Finally, death may result from rumination, with malnutrition estimated at 25% of institutionalized infants (Parry- Jones, 1994).…”

Section: Discussionmentioning

confidence: 99%

Rumination.

Vollmer¹,

Roane²

1998

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OverviewRumination is an aberrant eating disorder found primarily in infants and individuals with mental retardation. The behavior involves the apparently deliberate regurgitation of food, retainment of the regurgitated food in the mouth, and rechewing or reswallowing the food (Fee & Matson, 1992;Johnston, 1993). Individuals who ruminate appear to do so with no apparent nausea and may gain satisfaction o r pleasure from the act (Humphrey, Mayes, Bider, & Good, 1989; Mayes, Humphrey, Handford, & Mitchell, 1988). Researchers have reported several response topographies associated with the initiation of a rumination sequence: (a) putting a finger into the oral cavity (Luiselli, 1989), (b) thrusting the tongue forward (Luiselli, 1989), ( c ) rocking the body from side to side or arching the back (Franco, Campbell, Tamburrino, & Evans, 1993), and (d) elevating the lower torso higher than the upper torso with sudden forward movements (Johnston, 1993). Episodes of rumination can be brief (e.g., one regurgitation) or may last several hours (Johnston, 1993).Two types of rumination have been described in the literature: psychogenic rumination and self-stimulatory rumination (Mayes et al., 1988). Psychogenic rumination is described as a deliberate, self-satisfying behavior that occurs in otherwise normally developing infants (Franco et al., 1993). Mayes et al. (1988) analyzed 26 infants with psychogenic rumination and found that the mean age of onset was 5.0 months (range = 0.7-17.0 months). In addition, 85% of these infants were functioning within normal developmental limits. Self-stimulatory rumination occurs in individuals with mental retardation, and has an onset ranging from infancy to adulthood (Franco et al., 1993). Mayes et al. (1988) analyzed 40 individuals with self-stimulatory rumination and found that the 564

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Section: Discussionmentioning

confidence: 99%

Rumination.

Vollmer¹,

Roane²

1998

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“…It is hypothesized that when the material comes back up, the premonitory urge temporarily resolves, negatively reinforcing abdominal wall contraction. Of note, abdominal wall contraction etiology is unstudied, but some patients retrospectively report a stressor or trigger associated with RS onset [e.g., gastroenteritis (20,22), medical procedure (19), respiratory infection (as in Zachary’s case), psychosocial stressor (36,37), comorbid psychological symptoms (7,17,38), eating disorder history (39,40)].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…In our experience, these medications have no effect on regurgitation frequency (e.g., one patient discontinued PPIs but continued diaphragmatic breathing and experienced no change in symptom frequency; Murray et al (52)). Retrospective chart reviews also have shown that patients report no effect of such medications (17,37). Given current evidence, we recommend clinicians prescribe baclofen to treat RS (conditionally) and only prescribe other medications to treat comorbid conditions.…”

Section: Treatmentmentioning

confidence: 99%

“…One case series (N = 5) reported Nissen fundoplication as effective in resolving regurgitations (66); however, retrospective chart evidence has revealed that effects of fundoplication may not provide long-term resolution of regurgitations (37). In addition, other techniques have been reported in chart reviews (e.g., botulinum toxin injections) with no reported effect.…”

Section: Treatmentmentioning

confidence: 99%

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Diagnosis and Treatment of Rumination Syndrome: A Critical Review

et al. 2019

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Rumination syndrome (RS) is characterized by the repeated regurgitation of material during or soon after eating with the subsequent rechewing, reswallowing, or spitting out of the regurgitated material. Rumination syndrome is classified as both a “Functional Gastroduodenal Disorder” (by the Rome Foundation’s Functional Gastrointestinal Disorders: Disorders of Gut-Brain Interaction, 4th edition) and a “Feeding and Eating Disorder” (by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition). Rumination syndrome is a disorder that is often inaccurately diagnosed or missed, resulting in patients experiencing protracted symptoms and not receiving treatment for long periods. There is a lack of clear consensus for RS diagnosis, mechanisms that maintain RS, and treatment. Guided by existing research and our clinical expertise, we synthesize available evidence and provide recommendations for clinical use. We present a case example and critically summarize the literature to date to (i) increase clinicians’ understanding of heterogeneous clinical presentations, (ii) suggest assessment strategies to facilitate accurate diagnosis, and (iii) provide a schematic for intervention options. Overall, we recommend clinicians recognize the heterogeneous features of RS when considering diagnosis, assess for RS symptoms by clinical history, and treat RS with targeted diaphragmatic breathing while using other methods as augmented intervention or alternative treatment.

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“…Attention deprivation may increase the frequency of maladaptive behavior that produces attention. Rumination may also hinder academic performance when it is severe enough to prevent individuals from attending school or work (Fullerton, Neff, & Getto, 1992; Vollmer & Roane, 1998).…”

Section: Introductionmentioning

confidence: 99%

A multi‐component approach to the treatment of chronic rumination

Wrigley¹,

Kahn²,

Winder³

et al. 2010

Behavioral Interventions

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A multi-component intervention was used to treat chronic rumination exhibited by an adult female diagnosed with a developmental disability. The intervention consisted of: (a) interruption of precursor behavior, (b) the alternation of 10-min periods of continued instruction that involved walking and working with (c) 10-min periods in which instructions were not delivered but a variable time 5-s schedule of noncontingent attention was programmed, and (d) a 1-min differential reinforcement of other behavior (DRO) schedule. During the intervention, rumination decreased by 82% relative to baseline. Next, components of the multi-component intervention were systematically removed to evaluate their individual contribution. Results suggested that each individual component contributed to the overall treatment effects.

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Persistent functional vomiting

Cited by 9 publications

References 15 publications

Rumination.

Rumination.

Diagnosis and Treatment of Rumination Syndrome: A Critical Review

A multi‐component approach to the treatment of chronic rumination

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