Severe Pediatric Rumination Syndrome: Successful Interdisciplinary Inpatient Management

Green, Alex D.; Alioto, Anthony; Mousa, Hayat; Lorenzo, Carlo Di

doi:10.1097/mpg.0b013e3181fa06f3

Cited by 44 publications

(41 citation statements)

References 18 publications

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“…However, DiLorenzo et al have shown that, when psychiatric disorders are present, it is helpful to address these issues for successful treatment, indicating a substantial role of the psychiatric disorder in rumination syndrome. 29 …”

Section: Discussionmentioning

confidence: 99%

Novel association of rectal evacuation disorder and rumination syndrome: Diagnosis, comorbidities, and treatment

et al. 2014

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Background Patients with disorders of gastrointestinal function may undergo unnecessary treatment if misdiagnosed as motility disorders. Objective To report on clinical features, medical, surgical and psychiatric co-morbidities, and prior treatments of a patient cohort diagnosed concurrently with non-psychogenic rumination syndrome and pelvic floor dysfunction (also termed rectal evacuation disorder). Methods From a consecutive series (1994-2013) of 438 outpatients with rectal evacuation disorders in the practice of a single gastroenterologist at a tertiary care center, 57 adolescents or adults were diagnosed with concomitant rumination syndrome. All underwent formal psychological assessment or completed validated questionnaires. Results All 57 patients (95% female) fulfilled Rome III criteria for rumination syndrome; rectal evacuation disorder was confirmed by testing of anal sphincter pressures and rectal balloon evacuation. Prior to diagnosis, most patients underwent multiple medical and surgical treatments (gastrostomy, gastric fundoplication, other gastric surgery, ileostomy, colectomy) for their symptoms. Psychological co-morbidity was identified in 93% of patients. Patients were managed predominantly with psychological and behavioral approaches: diaphragmatic breathing for rumination and biofeedback retraining for pelvic floor dysfunction. Conclusions Awareness of concomitant rectal evacuation disorder and rumination syndrome and prompt identification of psychological co-morbidity are keys to instituting behavioral and psychological methods to avoid unnecessary treatment.

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Section: Discussionmentioning

confidence: 99%

Novel association of rectal evacuation disorder and rumination syndrome: Diagnosis, comorbidities, and treatment

et al. 2014

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“…Even though, rumination has been reported in males [15,16], the majority of patients in previous hospital based studies and case reports on this disorder were females [3,17-19]. In a previous review of 147 children with rumination syndrome, 68% were females [4].…”

Section: Discussionmentioning

confidence: 99%

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

2012

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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.

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“…The prevalence of rumination disorder is unknown. In part, this is due to significant variability in use of diagnostic terms (eg, regurgitation disorder, 29 rumination syndrome 30 ) and classification schemes 31 to describe essentially similar presentations. Additionally, a clear distinction is not always made between rumination or regurgitation as…”

Section: Prevalence Of Rumination Disordermentioning

confidence: 99%

Pica and Rumination Disorder in DSM-5

Hartmann¹,

Becker²,

Hampton³

et al. 2012

Psychiatric Annals

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T he major proposed change for both pica and rumination disorder in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition is their relocation from their current section, titled "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence," 1 to the newly proposed section, "Feeding and Eating Disorders." 2 This change emphasizes that these disorders occur across the age range, including adulthood. Also, specifiers for severity and course have been suggested for each of these disorders, in keeping with DSM-5 format. Additional minor, but noteworthy, changes in phrasing that clarify ascertainment of diagnostic criteria are summarized in this paper. PICA Proposed Diagnostic Criteria for Pica The sine qua non of pica is the recurring ingestion of nonnutritive substances. 1 Changes to phrasing of diagnostic criteria in DSM-5 are intended to guide clinicians in distinguishing eating

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Severe Pediatric Rumination Syndrome: Successful Interdisciplinary Inpatient Management

Abstract: This treatment protocol could benefit pediatric gastroenterologists, pediatricians, and child psychologists in managing both standard and severe cases of rumination syndrome.

Cited by 44 publications

References 18 publications

Novel association of rectal evacuation disorder and rumination syndrome: Diagnosis, comorbidities, and treatment

Novel association of rectal evacuation disorder and rumination syndrome: Diagnosis, comorbidities, and treatment

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

Pica and Rumination Disorder in DSM-5

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