Eating Habits: Rumination disorder

Eating disorder

Eating disorders are a category of psychiatric conditions that cause unhealthy eating patterns to develop.They may begin with a fixation with food, body weight, or body shape.If left untreated, eating disorders can have substantial health repercussions and could result in death in severe circumstances. In fact, eating disorders are among the most lethal mental conditions, coming in second only to heroin addiction.

Although eating disorders can afflict persons of any gender at any age, men and gender nonconforming people are becoming more common. These groups frequently seek treatment at a lesser rate or may not report their eating problem symptoms at all.

Some of the eating disorders include Rumination disorder, Pica, Binge eating disorder, Anorexia nervosa, Bulimia nervosa, Night eating syndrome etc.

Rumination disorder

Rumination syndrome (also known as rumination disorder or merycism) is a feeding and eating condition characterised by regurgitation of undigested food from the stomach into the mouth. Once the food is back in the person’s mouth, he or she might chew it and swallow it again, or spit it out. This behaviour is common after every meal and may appear to be effortless.Rumination may occur after a burping/belching sensation but does not usually entail nausea or retching. Because the regurgitated meal hasn’t had time to fully combine with stomach acid and digest, it doesn’t taste sour or bitter.This regurgitation act is a reflex action that can be learnt and deliberate or unintentional.

Rumination syndrome has long been associated with babies and those with developmental impairments, but it can affect adults of all ages. Children and adults who are stressed or anxious may be more prone to rumination syndrome.

DIAGNOSIS

To be diagnosed with rumination syndrome, a person must meet the following criteria, according to the DSM-5:

• Food regurgitation on a regular basis for at least one month. Food that has regurgitated can be re-chewed, re-swallowed, or thrown up.
• It is not caused by a gastrointestinal or other medical issue (for example, gastroesophageal reflux or pyloric stenosis).
• The eating disorder cannot coexist with anorexia nervosa, bulimia nervosa, binge eating disorder, or avoidant/restrictive food intake disorder.
• If the eating disorder coexists with another mental disease (for example, intellectual disability), the symptoms must be severe enough to warrant medical attention.

Tests may be used by doctors to rule out other medical concerns, such as blockages. Among these tests are:

• Gastric emptying examination: The amount of time it takes food to move from the stomach to the small intestine.
• An upper endoscopy is performed: The oesophagus and stomach are examined by the doctor using an endoscope (a tiny tube with a camera on the end) placed down the throat.
• X-rays: Images of the oesophagus and stomach are provided to doctors.

TREATMENT

To halt regurgitation, behavioural therapy is the primary treatment for rumination syndrome. Diaphragmatic breathing is the most commonly prescribed behavioural therapy for rumination syndrome.To help control regurgitation, practise diaphragmatic breathing:

1. Lie flat on your back on a level surface or in bed, knees bent and head supported. Place a cushion beneath your knees to provide support for your legs. Place one hand on your upper chest and one on your rib cage. This will allow you to sense the movement of your diaphragm while you breathe.
2. Slowly inhale through your nose, allowing your tummy to move out against your hand. Maintain as much stillness as possible with your hand on your chest. We call this “breathing like an opera singer” for youngsters, with the palm on the tummy moving out with each slow inhale and in with exhale.
3. Tighten your stomach muscles and exhale via pursed lips, allowing them to sink inward. Maintain as much stillness as possible with your hand on your upper chest.
4. Exercise for 5 to 10 minutes three to four times per day.

Conclusion

Rumination syndrome, if left untreated, can affect the oesophagus (the tube that links the mouth to the stomach).It can also lead to malnutrition, stunted growth, dehydration, aspiration, choking, pneumonia, and death. Thus treatment is necessary and as fast as possible after diagnosis.

~Adrija Ghosh , KRSH Welfare Foundation