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The Rumination Syndrome in Adults: A Characteristic Manometric Pattern

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Grant support: In part by grant AM-26428 from the National Institutes of Health. Dr. Abell is a Visiting Scientist.

▸Requests for reprints should be addressed to Juan-R. Malagelada, M.D.; Gastroenterology Unit, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Rochester, Minnesota

©1986 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1986;105(4):513-518. doi:10.7326/0003-4819-105-4-513
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The rumination syndrome is defined as a process in which a person chews regurgitated gastric contents and then either partially ejects or swallows them. We report 12 cases of rumination in which the clinical diagnosis was supported by esophageal and gastrointestinal motility studies. These patients showed a characteristic pressure spike-wave pattern that was associated with regurgitation and was recorded simultaneously at all manometric sites. These spike waves increased significantly in frequency (p < 0.001) and amplitude (p < 0.04) during the postprandial period. The underlying gastrointestinal motility was normal except for a small decrease in postprandial antral motility index, with mean ( ±SE) values of 13.2 ±0.3 for patients compared with 14.2 ±0.3 for eight healthy adult controls (p < 0.03). Nine patients had significant personality disturbances, including six whose scores on the Minnesota Multiphasic Personality Inventory for hypochondriasis and depression were significantly above the reference population (p < 0.02). The rumination syndrome should be considered in adult patients with long-standing postprandial vomiting. The manometric pattern is characteristic.







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