Have you ever had a meal and just finished it, and within a few minutes, you feel like you're going to vomit, but it's not like you're going to vomit, it's like you're going to vomit, it's like you're going to vomit, it's just like you're going to vomit. You probably chew it again and swallow it. Or you might spit it out. If this happens all the time, after every meal you eat, it's important to be aware of this condition we're talking about today called Rumination Syndrome. It's a little unusual to hear, but some people suffer in silence.
Simply put, what is Rumination Syndrome?
This is a very special situation. It should not be confused with the vomiting we usually know. Vomiting is the forceful expulsion of the contents of the stomach after a stomachache or nausea. But that is not what happens in Rumination Syndrome. This happens spontaneously, without any force, pain, or nausea . It is like coming into the throat, but at the same time the swallowed food comes back up into the throat.
Imagine, there is a valve made of muscles like a gate between our esophagus and stomach to keep the food in our stomach from going up into our throat. We call this the `lower esophageal sphincter (LES).` Normally, this valve opens when we swallow food, and then it closes tightly again after the food goes into the stomach. But for some reason, this process is disrupted in a person with Rumination Syndrome. When the pressure inside the stomach increases, this valve simply opens in response. Then the undigested food that has gone into the stomach comes back up.
This is not something you do on purpose. It's like a habit that the body has developed on its own. That's why we call it an automatic and often unconscious process .
What are the main symptoms of this condition?
There are some symptoms that can help you identify this condition. See if you have these too. I will put them in a table to make it easier to understand clearly.
| Characteristic | Description |
|---|---|
| Food coming down the throat without pain | This is the main feature. Within a few minutes of eating, the food passes into the throat without any difficulty. |
| No nausea or vomiting. | The nausea that precedes vomiting is not felt at all in this case. |
| There is no sour taste in the food. | The taste of the food that comes into your throat is the same as when you ate it. It doesn't taste sour like vomit. This is because the food hasn't had enough time to mix with the acid in your stomach. |
| Chewing again and swallowing or spitting out | Some people chew and swallow the food that has reached their throat. Others spit it out. |
| Characteristics of young children | If a young baby has this condition, they may exhibit behaviors such as arching their back and making gurgling sounds. |
But in addition to these main symptoms, some people may also experience stomach pain, discomfort such as bloating, and sometimes even vomiting.
Why does this happen? What are the risk factors?
In fact, doctors still don't know exactly what causes this. It's still a mystery. Some doctors call it a `functional GI disorder`, which means a problem with the functioning of the digestive system. Others say it's a `behavioral disorder`.
Simply put, this may be a bad habit that the body has learned. This condition may begin after a major emotional trauma or stressful event. This means that it may be due to some problem in the relationship between our mind and body.
There are several risk factors that can contribute to this condition:
- Severe stress or trauma: This can start after facing a major problem or trauma in life.
- This can be seen with other mental illnesses: depression, anxiety, etc.
- Other Eating Disorders: This is more likely to occur in people who have other eating disorders.
- Developmental delays: This condition is especially common among young children and those with developmental problems.
- Emotional neglect during childhood: This can happen to children who do not receive the love and care they need from their parents or caregivers.
What complications can this cause?
Although this is not a life-threatening disease, it can cause some complications if it persists for a long time. Therefore, it is very important to be aware of this.
| Complication | Description |
|---|---|
| Weight loss and nutritional deficiencies | Because the food you eat is not properly absorbed by the body, you may lose weight and lack nutrients like vitamins and minerals. This can also cause stunted growth in children. |
| Dental problems | When food constantly reaches the throat, even a little stomach acid can dissolve the enamel of the teeth and cause tooth decay. Bad breath can also occur. |
| Damage to the esophagus | Frequent reflux of stomach acid into the throat can damage the tissues of the esophagus. |
| Dehydration and salt imbalance | Dehydration can occur because the body loses fluids and salts along with food. |
| Aspiration | If food particles that enter the throat accidentally enter the airway , it can cause suffocation or conditions such as pneumonia. |
| Social problems | This is a big problem. Due to this condition, a person may feel shy about eating with people, going to parties, or going out with friends. Therefore, they gradually try to distance themselves from society. |
How does a doctor diagnose this?
If you have these symptoms, be sure to see your doctor . The first thing your doctor will do is ask you a detailed question about your symptoms, such as how they started and when they occur.
After that, you may need to have some tests done to make sure there are no other serious medical conditions. For example:
- Upper endoscopy: A small tube with a camera is inserted through the mouth to examine the esophagus and stomach.
- Esophagram: A substance called barium is given to drink and an X-ray is taken to examine the swallowing process.
- Esophageal manometry test: A test that measures the function of the muscles in the esophagus.
- Gastric emptying study: A test that measures how long it takes for food to leave the stomach.
After confirming that there are no other problems with all of these, the doctor will be able to diagnose Rumination Syndrome by comparing it with your symptoms.
What are the treatments for this?
The best and most important treatment for this is behavioral therapy . That is, rather than medication, we control this condition by changing our behavior and the way we control our bodies.
This mainly teaches breathing exercises using the diaphragm (`diaphragmatic breathing`) . Let's see how to do this properly. This teaches our body to stop the process when food is about to enter the throat.
How to do the diaphragmatic breathing exercise:
1. First, lie down on the floor. Bend your knees and place a small pillow under your head.
2. Place one of your hands on the upper part of your chest. Place the other hand on your stomach, just below where your ribs end.
3. Now take a slow breath in through your nose. As you breathe in, try to keep the hand on your chest as still as possible and only lift the hand on your stomach. That is, inflate your stomach and breathe out.
4. Then, purse your lips slightly and exhale slowly, tightening your abdominal muscles. As you exhale, keep the hand on your chest still and feel your stomach go in.
This exercise should be practiced several times a day. It is especially important to do this after eating. If you use this breathing technique as soon as you feel food coming into your throat, you can stop that process.
In addition, there are other treatment methods:
- Biofeedback: A method of learning to control your body's activities (such as muscle contractions) by monitoring them on a screen using a machine.
- Cognitive behavioral therapy (CBT): Counseling helps change the mental problems and thought patterns that cause this condition.
- Medication: Sometimes, your doctor may prescribe medications like baclofen, which helps tighten the lower esophageal sphincter. However, this is not given to everyone.
When should I see a doctor?
This is very important. If you feel like you are choking after eating, and it's not just once or twice, but if it's happening all the time, please don't ignore it . Don't waste time thinking, "This is just something else." Because these conditions can worsen over time. Then it takes longer to treat.
Therefore, as soon as you notice any of these symptoms, see your family doctor and discuss this. The sooner you start treatment, the sooner you can recover.
Take-Home Message
- Rumination Syndrome is not vomiting. It is a spontaneous process that occurs without nausea or pain.
- The main reason for this is a bad habit that the body has learned. Things like stress can affect this.
- The best treatment for this is behavioral therapy, especially diaphragmatic breathing exercises.
- Although this condition is not life-threatening, it can damage teeth, gums, and cause nutritional deficiencies in the long term.
- If you have these symptoms, don't be shy or afraid, see a doctor right away and get advice. That's the best thing you can do.
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