• Person eats, swallows, and then regurgitates food back into the mouth where it is chewed and swallowed again. Process may be repeated several times or for several hours per episode.

• Rumination may be voluntary or involuntary.

• Ruminators report that regurgitated material does not taste bitter, and that it is returned to the mouth with a gentle burp, not violent gagging or retching and not even nausea. Person may enjoy the process, making stopping it very difficult.

• Consequences range from minor inconveniences to life threatening crises. They include bad breath, indigestion, chapped lips and chin; damage to dental enamel and tissues in the mouth; inhaling of food (can cause pneumonia); weight loss and failure to grow (children); electrolyte imbalance and dehydration (similar to consequences of bulimia, and in some cases, likewise fatal).

• Rumination is a not uncommon problem in infants. It usually stops as the child grows older and matures, but medical consultation should be sought to minimize consequences. Because adult ruminators are secretive, we do not know how many there are.

• Rumination is also found in people with profound mental and emotional impairments, where it can last for years.

• Not much is known about rumination. Attempts to explain it span the continuum from problems in the psyche to pathology in body structure or function. Rumination is sometimes a factor in anxiety disorders or depression, two problems that frequently accompany the more typical eating disorders.

One of the best reviews of rumination syndrome can be found at e-medicine.com, although the page emphasizes medical and physical factors over psychological and emotional issues. If you are concerned about rumination, we recommend a thorough workup by both a gastroenterologist and a psychiatrist. After that information has been developed, a custom-tailored treatment plan can be developed.