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Vol. 45. Issue 2.
Pages 155-163 (February 2022)
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Vol. 45. Issue 2.
Pages 155-163 (February 2022)
Review
Rumination syndrome: Critical review
Síndrome de rumiación, revisión crítica
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...
Luis Gerardo Alcala-Gonzaleza,b, Xavier Serraa, Elizabeth Barbac,
Corresponding author
barba@clinic.cat

Corresponding author.
a Departmento de Gastroenterología, Vall d’Hebron Hospital Universitari, Vall d’Hebron, Barcelona, Spain
b Facultad de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
c Departamento de Gastroenterología, Unidad de Motilidad Digestiva, Hospital Clínic, Barcelona, Spain
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Table 1. Clinical characteristics of gastro-oesophageal reflux disease, gastroparesis, achalasia, cyclic vomiting and rumination.
Table 2. Diagnostic criteria for rumination syndrome according to the Rome IV and DSM-5 criteria.
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Abstract

Rumination syndrome is a functional disorder characterized by the involuntary regurgitation of recently swallowed food from the stomach into the mouth, from where it can be re-chewed or expelled. Clinically, it is characterized by repeated episodes of effortless food regurgitation. The most usual complaint is frequent vomiting. The physical mechanism that generates regurgitation events is dependent on an involuntary process that alters abdominal and thoracic pressures accompanied by a permissive oesophageal-gastric junction. The diagnosis of rumination syndrome is clinical, highlighting the importance of performing an exhaustive anamnesis on the characteristics of the symptoms. Complementary tests are used to corroborate the diagnosis or rule out organic pathology. Treatment is focused on behavioural therapies as the first line, reserving pharmacological and surgical therapies for refractory cases.

Keywords:
Vomiting
Regurgitation
Biofeedback
Chronic vomiting
Rumination syndrome
Rumination treatment
Functional disorder
Resumen

El síndrome de rumiación es un trastorno funcional caracterizado por la regurgitación involuntaria de los alimentos recientemente ingeridos desde el estómago hacia la boca, donde puede ser remasticada o expulsada. Desde el punto de vista clínico, se caracteriza por episodios repetidos de regurgitación de alimentos sin esfuerzo, siendo la queja habitual los vómitos frecuentes. El mecanismo físico que genera los eventos de regurgitación es depende de un proceso involuntario que altera las presiones abdominal y torácica acompañado de una unión esofágo-gástrica permisiva. El diagnóstico del síndrome de rumiación es clínico, destacando la importancia de realizar una anamnesis exhaustiva sobre las características de los síntomas. Las pruebas complementarias se utilizan para corroborar el diagnóstico o descartar otra patología orgánica. El tratamiento está enfocado a terapias conductuales como primera línea, reservando las terapias farmacológicas y quirúrgicas para casos refractarios.

Palabras clave:
Vómito
Regurgitación
Biofeedback
Vómitos crónicos
Síndrome de rumiación
Tratamiento de la rumiación
Trastorno funcional

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