Rumination Disorder
Rumination disorder involves repeated regurgitation of food after eating. Food returns to the mouth without the usual nausea or involuntary vomiting response and may be re-chewed, swallowed again or expelled.
Regurgitation is not the same as vomiting
The pattern usually begins soon after a meal and may occur daily or several times each week at any age. It often lacks nausea, disgust and forceful retching. Some people experience it as almost automatic, while others recognise the first sensation.
The problem can be hidden through coughing, covering the mouth or avoiding meals with others. Weight loss, poor growth, dehydration, dental erosion, oesophageal irritation and respiratory complications may occur when the pattern is frequent or severe.
Medical assessment comes first
- Regurgitation repeats for at least one month and food may be re-chewed, swallowed again or expelled.
- Gastro-oesophageal reflux, gastroparesis, obstruction and other gastrointestinal or medical causes are investigated before diagnosis.
- The pattern does not occur exclusively during anorexia nervosa, bulimia nervosa, binge-eating disorder or ARFID.
- When intellectual disability or another developmental or mental condition is present, a separate diagnosis is used only when rumination needs specific clinical treatment.
Treatment and nutrition support
Diaphragmatic breathing before, during and after meals can act as a competing response to regurgitation and is taught by a trained clinician. Biofeedback or cognitive-behavioural strategies may help identify early sensations, triggers and avoidance.
Medical and dietetic monitoring covers weight, growth, hydration and nutrition. Coexisting gastrointestinal disease, anxiety or eating disorder is treated alongside the rumination-specific plan. For infants and people who need care, calm meals, supervision and caregiver training replace blame or pressure.
When to seek help
Request medical assessment when regurgitation continues for weeks, occurs after most meals or accompanies weight loss, poor growth, pain, swallowing difficulty or social avoidance. In infants, early paediatric review is essential. A short meal-and-symptom diary may help but does not replace examination.