Rumination Syndrome

Neelima Bonthi, Magnus Halland, David A. Katzka

Research output: Chapter in Book/Report/Conference proceedingChapter


Rumination syndrome is a disorder in which patients involuntarily and effortlessly regurgitate and re-swallow gastric content during, and after, a meal. It is commonly confused with gastroesophageal reflux disease and may be errantly treated with proton pump inhibitors and even fundoplication. The pathophysiology appears to involve generation of high gastric pressures, perhaps from high intra-abdominal pressures, in the presence of reduced lower and upper esophageal sphincter pressures. This reversal of the normal pressure gradient facilitates retrograde propulsion of gastric content into the mouth. Although generally clinically defined, high-resolution esophageal manometry can be used to document these findings and prove the diagnosis if needed. Therapy relies on reversing these pressure phenomena, via diaphragmatic breathing, or using baclofen to increase LES pressure.

Original languageEnglish (US)
Title of host publicationEssential Medical Disorders of the Stomach and Small Intestine
Subtitle of host publicationA Clinical Casebook
PublisherSpringer International Publishing
Number of pages13
ISBN (Electronic)9783030011178
ISBN (Print)9783030011161
StatePublished - Jan 1 2019


  • Diaphragmatic breathing
  • Gastric pressure
  • Gastroesophageal reflux
  • Regurgitation
  • Rumination

ASJC Scopus subject areas

  • General Medicine


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