A March 2021 study is showing that gut disorders involving rumination often led to a misdiagnosis. The study, originally published by Massachusetts General Hospital (MGH) in Neurogastroenterology and discussed in the Jan. 3 edition of The Print, involved 242 patients seeing specialists due to GI issues.
Rumination & Symptoms
Rumination syndrome, a behavioral issue in which patients regurgitate food while eating and sitting upright, is classified as a disorder of the gut-brain interaction (DGBI), according to The Print.
“One reason rumination symptoms are missed is because they overlap with other DGBIs, such as functional dyspepsia (stomach pain or indigestion) or gastroparesis, which is when patients feel nauseous and full after eating just a small amount,” the article explains.
The study explains that the patient involved in the study reported seeing their GI specialist for reported symptoms of gastroparesis and dyspepsia. Researchers found that of the 242 patients involved, 12.8% (≈ 30 individuals) met the criteria for rumination syndrome. One of the main causes for the continuing misdiagnosis is an incorrect description of symptoms by patients, primarily as “reflux or vomiting.”
Additionally, nearly half of the patients (48.8%) reported “associated psychological impairment.” This impairment is described as patients experiencing discomfort in social situations due to their condition.
Research into demographics of involved patients showed little to no difference in occurrences of rumination based on race, gender, ethnicity, and more.
“There is little demographically that distinguishes these patients other than their tendency to regurgitate when eating,” Trisha Satya Pasricha, M.D., co-lead author of the study with Helen Burton Murray, M.D. said. “They are not more likely to have a history of an eating disorder or weight problems.”
One common factor that did link patients was the tendency to experience heartburn, especially during the daytime. Researchers recommended screening for heartburn and regurgitation to assist in identifying symptoms of rumination.
As rumination is a behavioral diagnosis, treatment plans have involved deep breathing. Two pilot trials have shown that this practice has significantly improved gastric reflux symptoms. Comprehensive cognitive behavioral therapy for rumination syndrome (CBT-RS) has also been recommended for treatment.