Rumination Disorder - Anatomy of Psych

What is rumination disorder?

Rumination order is characterized by repeated regurgitation of food occurring after feeding or eating over a period of at least one month. The prevalence of this disorder is not well understood, but it is common amongst those with intellectual disability. In infants, age of onset is usually between 3-12 months.

What does rumination disorder look like?

Signs & Symptoms

DSM-5 Criteria

Criterion A. Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out.

Criterion B. The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition (e.g. gastroesophageal reflux, pyloric stenosis).

Criterion C. The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.

Criterion D. If the symptoms occur in the context of another mental disorder (e.g. intellectual developmental disorder or another neurodevelopmental disorder), they are sufficiently severe to warrant additional clinical attention.

Risk Factors

Low stimulation
Neglect
Life stressors
Difficulties in the parent-child relationship

Differential Diagnosis

Gastrointestinal conditions
Anorexia nervosa
Bulimia nervosa

How is rumination disorder investigated?

Gastrointestinal investiations

How is rumination disorder treated?

Metoclopramide
Cimetidine
Haloperidol

References

[1] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

[2] Boyd, M. A. (2019). Psychiatric & mental health nursing for Canadian practice. Wolters Kluwer.

[3] Townsend, M. C. (2015). Psychiatric mental health nursing. F.A. Davis.