After you eat, do you also feel like the food comes back up into your throat before it is fully digested? Without the nausea of vomiting, does it just come up a little bit, and you sometimes chew it again and swallow it? Or does it come out without you realizing it? This is a really annoying problem for some people. Today we are going to talk about this condition called Rumination Syndrome. Don't be afraid, the most important thing is to be aware of this.
What is Rumination Syndrome?
Simply put, Rumination Syndrome is when the food we eat comes back up from the stomach into the mouth before it is properly digested. In medicine, this is also called regurgitation. Some people chew and swallow the food that comes back up into the throat, while others spit it out. Most of the time, this happens right after eating, or within a few minutes.
The most important thing is that when this happens, you don't feel any pain or nausea like vomiting that comes with a stomach ache. It just feels like the food is coming up without much effort. Think of it like a small child does when they get some milk in their throat.
Another thing is that the food that comes to the throat like this often does not have a sour or bitter taste. The reason for this is that the food has not yet started to be digested properly with the stomach acid. That is, the food has not yet fully entered the digestive process.
This regurgitation of food into the throat, sometimes called ``regurgitation,'' can be a reflex action that occurs spontaneously and cannot be controlled. However, for some people, over time, this can become an intentional act or a habit. But the most important thing to remember is that this is not due to a stomach ache, a disease like gastritis, or any other serious stomach disease.
Who is more likely to develop this condition?
Doctors have long known that this condition, called Rumination Syndrome, occurs in young children and those with developmental disabilities. But in reality, it can affect anyone of any age . That means young children, young adults, and adults can all experience this condition.
Research has found that children and adults who are particularly stressed or anxious are at a higher risk of developing rumination syndrome. So, you are more likely to experience this when you are under a lot of stress, sadness, or anxiety .
What are the symptoms of this?
Okay, so how do we recognize this Rumination Syndrome? What are the symptoms of this? Let's see.
- The main symptom is frequent regurgitation of food, followed by rechewing or swallowing, or spitting it out. This usually happens after every meal.
- Stomach discomfort. Feeling full, bloating, and sometimes indigestion and stomach aches may occur.
- Dental problems. Bad breath and tooth decay can occur because food constantly gets stuck in the throat. This is because the food that comes from the stomach may contain some acid.
- Weight loss. Because the food you eat is not properly absorbed by your body, you may lose weight over time. This can especially affect the growth of children.
- Dry, chapped lips.
If your baby has this condition, they may do things like squirm and arch their back. (However, this symptom can also be a sign of gastroesophageal reflux, which is when stomach acid comes up into the throat, so it's a good idea to see a doctor.) Babies may also make a gurgling sound.
Why is this happening? What are the reasons?
The exact cause of Rumination Syndrome is not yet fully understood. However, doctors believe that it may occur when some people have mental health problems or experience stressful events in their lives. This means that it may be related to mental health .
Explained mechanically, as it happens inside our bodies, it could be something like this:
1. When we eat, the stomach expands, meaning it gets bigger.
2. Then, the abdominal pressure increases.
3. At the same time, the lower esophageal sphincter, which acts like a valve where our esophagus (the tube that carries food from the mouth to the stomach) connects to the stomach, relaxes.
When these events occur in succession, the undigested food in the stomach begins to ``regurgitate'' back up the esophagus, into the mouth.
How do doctors recognize this?
Okay, now let's see how a doctor diagnoses this, that is, how they decide "This is Rumination Syndrome."
In most cases, this can be diagnosed through a medical history and a physical exam by your doctor. In particular, if you have been regurgitating food for at least 3 months, but have not vomited, there is enough evidence to suggest that you may have Rumination Syndrome.
According to the medically accepted Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), for someone to be diagnosed with this condition, the following criteria must be met:
- Food continues to come up into the throat for at least a month. The food that comes up is chewed, swallowed, or expelled.
- This food regurgitation should not be caused by a gastrointestinal condition or another medical condition (for example, conditions called gastroesophageal reflux or pyloric stenosis).
- This eating disorder cannot occur alone with another eating disorder, such as anorexia nervosa, bulimia nervosa, binge eating disorder, or avoidant/ restrictive food intake disorder.
- If the eating disorder is co-occurring with another mental illness (such as an intellectual disability), the symptoms must be severe enough to warrant medical attention.
In addition, doctors may also perform certain tests to determine if another medical condition is causing these symptoms. For example:
- Gastric emptying test: This measures how long it takes for food to move from the stomach to the small intestine.
- Upper endoscopy: In this procedure, a doctor inserts a thin tube with a small camera called an endoscope down your throat to examine your esophagus and stomach. This can help check for any ulcers or other problems inside.
- X-rays: Pictures are taken of the inside of the esophagus and stomach.
What is the treatment?
Okay, so what are the treatments for Rumination Syndrome? Is this something that can't be cured? No.
The main and most effective treatment for this is ``behavioral therapy.'' Simply put, it is about changing your behavior to stop the food from coming down your throat. The behavioral therapy that doctors often prescribe for this is ``diaphragmatic breathing.'' Some people also call this ``belly breathing.''
What is diaphragmatic breathing?
The diaphragm is a large, dome-shaped muscle located between our chest and stomach. It is the main muscle that works when we breathe. Diaphragmatic breathing aims to relax your diaphragm, use it properly when breathing, and help strengthen it. This helps control the food that goes down your throat.
Here's how to do it:
1. Lie faceup on a flat surface (like the floor) or in bed. Bend your knees and place a pillow under your head. If you want, you can also place a pillow under your knees to support your legs.
2. Place one hand on your chest and the other hand slightly below your ribs, that is, on your stomach. This will help you feel your diaphragm moving and your stomach rising and falling as you breathe.
3. Now, breathe in through your nose. As you do so, the hand on your stomach should rise. That is, your stomach should expand. Try to keep the hand on your chest in one place as much as possible, without moving it. We teach this to young children, "Breathe in like an opera singer."
4. Next, purse your lips slightly (like blowing a whistle) and exhale through your mouth. As you do this, tighten your abdominal muscles and let them go in. This means that the hand on your stomach should go down. At this point, keep the hand on your chest as still as possible.
How often should I do this breathing exercise?
Do this exercise three to four times a day, for about 5 to 10 minutes at a time. It may be a little difficult at first, but it will become easier with practice. If you want to make this exercise a little more challenging, you can do it while holding something like a book on your stomach.
The most important thing is to practice this 'belly breathing' after every meal, or even when taking a bite of food, if necessary. This will help a lot to stop the food from going down your throat.
What complications can this cause?
If not treated properly, Rumination Syndrome can damage our esophagus (the tube that carries food from the mouth to the stomach). Because when stomach contents constantly come up, it's not good for the esophagus.
Apart from that, other complications can occur. They are:
- Shyness, the discomfort of being in society. This can also affect the mind.
- Lack of healthy nutrition. Because the body does not absorb food properly.
- Failure to grow properly. This can have a major impact on the growth of children, especially.
- Electrolyte imbalance in the body. That is, an imbalance in the types of salts needed by the body.
- Dehydration. Lack of water in the body.
- Aspiration of food into the windpipe or lungs. This is a bit dangerous because it can cause lung infections.
- Shortness of breath.
- Lung infections like pneumonia.
- In very rare, severe cases, even death can occur. (This is very rare, but it's good to be aware of it).
Are there ways to prevent this from happening?
Although it is difficult to say whether it can be completely prevented, the risk can probably be reduced. In particular, by learning more positive ways to deal with stressful situations, that is, by using ``positive coping strategies``, it is possible that the risk of developing Rumination Syndrome can be reduced to some extent. Maintaining good mental health is very important.
Can we live with this situation? What is the future?
Yes, many people live completely healthy, normal lives with Rumination Syndrome. If treated and managed properly, it usually doesn't have a major impact on your daily activities. So, don't be discouraged if you find out you have it.
When should I see a doctor?
If you or your child has symptoms of Rumination Syndrome, which is what we talked about earlier, especially if food is constantly coming up your throat, definitely see your family doctor or a pediatrician. That's the best thing to do. They can examine you properly and advise you on what's causing this and what to do.
What questions should you ask the doctor?
If you have this condition, you can ask questions like these when you see a doctor. This will help you gain a clearer understanding of this:
- "Doctor, how serious is this condition called Rumination Syndrome?"
- "What is the real reason for this?"
- "What treatment is right for me? What should I do?"
- "Is there any medicine for this? Or is it just breathing exercises?"
- "Will this affect my daily life?"
Finally, some things to remember (Take-Home Message)
Okay, we've talked a lot about Rumination Syndrome. Finally, here are some important things you need to remember:
Rumination Syndrome is a condition in which food comes back up into the throat shortly after eating, before it is digested. This is not vomiting. It can occur in people of any age, and can sometimes be associated with stress.
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If you have these symptoms , don't be embarrassed or afraid. See a doctor as soon as possible and get advice. Behavioral treatments like diaphragmatic breathing exercises can help control this to a great extent.
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Seeking proper medical advice and treatment is the best way to manage this condition. You are not alone, and there is help available.
` Rumination Syndrome, food coming up in the throat, regurgitation, digestive system, stress, diaphragmatic breathing, behavioral therapy
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