Rumination syndrome in children and adolescents: a school survey assessing prevalence and symptomatology

Abstract

BackgroundRumination syndrome (RS) is a functional gastrointestinal disorder (FGD) increasingly recognized in children and adolescents. The epidemiology of this condition in school aged children is poorly understood. The main objective of this study was to assess the prevalence of rumination and other related associations in a cohort of Sri Lankan children.MethodsChildren aged 10-16 years were randomly selected from 8 schools in 4 provinces in Sri Lanka. RS was diagnosed using Rome III criteria. Data was collected using a self administered questionnaire distributed in an examination setting. It was translated into Sinhala, the native language and pretested before distribution.ResultsA total of 2163 children were included in the study (55% boys, mean age 13.4 years, SD 1.8 years). Prevalence of RS was 5.1% (n = 110); boys 5.1% and girls 5.0%. When symptoms were analyzed, 73.6% reported re-swallowing of regurgitated food, while the rest spat it out. In 94.5% regurgitation occurred during the first hour after the meal. Only 8.2% had daily symptoms while 62.7% had symptoms weekly. Abdominal pain, bloating and weight loss were the commonest symptoms associated with RS (19.1%, 17.3% and 11.8% respectively). No significant association was observed between exposure to stressful events and rumination (p > 0.05). Twenty (18.2%) with RS fulfilled Rome III criteria for at least one other FGD. School absenteeism was seen in 11.8% of affected children.ConclusionRS was reasonably common in this cohort of school-aged children and adolescents in Sri Lanka. However, symptoms were severe enough to affect schooling only in 12% of affected children. Around one fifth with RS had at least one other overlapping FGD.

Rumination Disorder: An Unexplained Case of Recurrent Vomiting

“…[3] In line with the previous case report from India highlighting the role of supportive psychotherapy,[6] our patient improved on a combined regimen of pharmacotherapy and HRT who failed to respond to standard pharmacotherapy for gastroenterological disorders. Our patient, as of this report is maintaining the gains from HRT and fluoxetine combined therapy, our observation is short term.…”

Functional gastrointestinal disorders in Greek Children based on ROME III criteria: identifying the child at risk

“…14,15,19 In the abovementioned population study from the US, the prevalence of constipation was 12.8%. 13 For all other FGIDs, the reported frequencies in various populations have been lower than 10%: Abdominal migraine (0.75-9.3%), 13,14,[20][21][22] aerophagia (0.5-7.5%), 13,14,23 functional dyspepsia (0.2-2.5%), [13][14][15]22 FAP (0.3-4.4%), 13,15,17,22 CVS (0.0-1.9%), [13][14][15]24 NRFI (0.0-1.9%), 13,14 rumination (0.0-5.1%) 13,14,17,25 and FAPS (0.3-1.9%). 13,15,22,26 In IBS, a metanalysis focusing on Asian populations reported extreme variations between 2.8% and 25.7%, with a pooled prevalence of 12.4%.…”

Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity

“…15 Moreover, the symptoms can resemble or overlap with those of GERD, gastroparesis, and BN; and RD may not routinely be considered when a patient presents with recurrent vomiting or regurgitation. 5,16 Although the overall prevalence is unknown, available evidence supports that RD is more common among infants, children (5%), 17 and persons with developmental disabilities (5-10%). 18 In addition to its associated psychological distress, rumination can also cause medical complications such as malnutrition, 11 significant weight loss, 16 electrolyte disturbances, 16,19 and dental complications including caries, erosion, and halitosis.…”