Rumination Syndrome: Diagnostic & Management Challenges in an Eating Disorders Unit

Royal College of Psychiatrists (2021 stated that, “referrals to eating disorders inpatient settings and emergency admissions to acute hospitals have increased by a fifth and waiting times have doubled since the pandemic”. The pandemic has led to significant delays in accessing mental health services.

Rumination syndrome (RS) is a rare syndrome which can be easily missed in clinical practice and lacks clear treatment guidelines.

The report will focus on clinical presentation, diagnosis, treatment and available literature on Rumination Syndrome.

We present a report of a 16 year old girl presented with regurgitations without retching or gagging preceded by a sensation of pressure in her oesophagus and abdomen. She was investigated extensively; a diagnosis of Rumination Syndrome was confirmed. She was admitted to specialist eating disorders following deterioration in her presentation.

Rumination Syndrome can cause significant impairment, including medical complications. Treatment involves managing physical health complications and psychological interventions.

Rumination syndrome is understudied, and often, patients with Rumination Syndrome go undetected and untreated. Diagnosis can often be delayed because of a lack of clinician knowledge and patients can experience protracted symptoms without appropriate treatment.

Dr Ayesha Umair & Dr Gore Muchemenye

Dr Ayesha Umair is an Associate Speciality Doctor with special interest in inpatient psychiatry and Eating Disorders. Currently, working on Wedgewood Eating Disorder Unit, Huntercombe Hospital Stafford.

She has more than 2 years experience in managing complex eating disorder patients and treating rare eating disorders syndromes like ARFID, rumination syndrome and pervasive refusal disorder along with other common co-morbid conditions likes depressions, anxiety, obsessive compulsive disorder and autism.

Dr Gore Muchemenye, MBChB, MRCPsych, MSc (Clinical Neuropsychiatry), is a consultant psychiatrist with special interests in inpatient psychiatry, neuropsychiatry and rare eating disorder syndromes. He also has a special interest in substance misuse psychiatry and has completed a dissertation as part of his MSc in clinical Neuropsychiatry entitled ‘’Neuropsychiatric manifestations of Legal Highs’’.

He also works as an expert witness and has bond solon Expert Witness Certificate in Civil, Criminal and Family Law. Dr Muchemenye is a consultant psychiatrist for Wedgewood Eating Disorder Unit, Huntercombe Hospital. Stafford.

Dr Muchemenye is on the GMC Specialist Register is approved under S12 (2) of the Mental Health Act and is an Approved Clinician.