How to recognize and treat rumination syndrome.
Journal
Current opinion in gastroenterology
ISSN: 1531-7056
Titre abrégé: Curr Opin Gastroenterol
Pays: United States
ID NLM: 8506887
Informations de publication
Date de publication:
01 07 2023
01 07 2023
Historique:
medline:
7
6
2023
pubmed:
25
4
2023
entrez:
25
4
2023
Statut:
ppublish
Résumé
Rumination syndrome (RS) is a functional gastroduodenal disorder characterized by repeated effortless regurgitation or vomiting of recently ingested food without retching. RS generally has been considered a rare entity. However, it has been increasingly recognized that many RS patients are likely to be underdiagnosed. This review discusses how to recognize and manage RS patients in clinical practice. A recent epidemiological study that included over 50,000 individuals found that the prevalence of RS around the world is 3.1%. In patients with proton pump inhibitor (PPI)-refractory reflux symptoms, postprandial high-resolution manometry combined with impedance (HRM/Z) reveals that RS accounts for up to 20% of those cases. HRM/Z can be a gold standard for objective RS diagnosis. In addition, off-PPI 24-h impedance pH monitoring can suggest the possibility of RS when it reveals frequent postprandial, non-acid reflux with a high symptom index. Modulated cognitive behavioral therapy (CBT) targeting secondary psychological maintaining mechanisms almost eliminates regurgitation. The prevalence of RS is higher than generally thought. For patients suspected of RS, HRM/Z is useful to distinguish RS from gastroesophageal reflux disease. CBT can be a highly effective therapeutic option.
Identifiants
pubmed: 37097822
doi: 10.1097/MOG.0000000000000937
pii: 00001574-202307000-00014
doi:
Substances chimiques
Proton Pump Inhibitors
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
340-346Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
O’Brien MD, Bruce BK, Camilleri M. The rumination syndrome: clinical features rather than manometric diagnosis. Gastroenterology 1995; 108:1024–1029.
Sawada A, Guzman M, Nikaki K, et al. Identification of different phenotypes of esophageal reflux hypersensitivity and implications for treatment. Clin Gastroenterol Hepatol 2021; 19:690–698.e2.
Yadlapati R, Tye M, Roman S, et al. Postprandial high-resolution impedance manometry identifies mechanisms of nonresponse to proton pump inhibitors. Clin Gastroenterol Hepatol 2018; 16:211–218.e211.
Rogers B, Stratton P, Victor J, et al. Chronic regurgitation among persons with mental retardation: a need for combined medical and interdisciplinary strategies. Am J Ment Retard 1992; 96:522–527.
Josefsson A, Hreinsson JP, Simrén M, et al. Global prevalence and impact of rumination syndrome. Gastroenterology 2022; 162:731–742.e739.
Rajindrajith S, Devanarayana NM, Crispus Perera BJ. Rumination syndrome in children and adolescents: a school survey assessing prevalence and symptomatology. BMC Gastroenterol 2012; 12:163.
López-Colombo A, Morgan D, Bravo-González D, et al. The epidemiology of functional gastrointestinal disorders in Mexico: a population-based study. Gastroenterol Res Pract 2012; 2012:606174.
Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993; 38:1569–1580.
Devanarayana NM, Adhikari C, Pannala W, Rajindrajith S. Prevalence of functional gastrointestinal diseases in a cohort of Sri Lankan adolescents: comparison between Rome II and Rome III criteria. J Trop Pediatr 2011; 57:34–39.
Sagawa T, Okamura S, Kakizaki S, et al. Functional gastrointestinal disorders in adolescents and quality of school life. J Gastroenterol Hepatol 2013; 28:285–290.
Wang X, Luscombe GM, Boyd C, et al. Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria. World J Gastroenterol 2014; 20:16293–16299.
Fairburn CG, Cooper PJ. Rumination in bulimia nervosa. Br Med J (Clin Res Ed) 1984; 288:826–827.
Malik R, Srivastava A, Yachha SK, Poddar U. Chronic vomiting in children: a prospective study reveals rumination syndrome is an important etiology that is underdiagnosed and untreated. Indian J Gastroenterol 2020; 39:196–203.
Almansa C, Rey E, Sánchez RG, et al. Prevalence of functional gastrointestinal disorders in patients with fibromyalgia and the role of psychologic distress. Clin Gastroenterol Hepatol 2009; 7:438–445.
Soykan I, Chen J, Kendall BJ, McCallum RW. The rumination syndrome: clinical and manometric profile, therapy, and long-term outcome. Dig Dis Sci 1997; 42:1866–1872.
Schol J, Wauters L, Dickman R, et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J 2021; 9:287–306.
Huang IH, Schol J, Khatun R, et al. Worldwide prevalence and burden of gastroparesis-like symptoms as defined by the United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J 2022; 10:888–897.
Bredenoord AJ, Chial HJ, Camilleri M, et al. Gastric accommodation and emptying in evaluation of patients with upper gastrointestinal symptoms. Clin Gastroenterol Hepatol 2003; 1:264–272.
Hoshikawa Y, Fitzke H, Sweis R, et al. Rumination syndrome: assessment of vagal tone during and after meals and during diaphragmatic breathing. Neurogastroenterol Motil 2020; 32:e13873.
Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology 2016; 150:1380–1392.
Amarnath RP, Abell TL, Malagelada JR. The rumination syndrome in adults. A characteristic manometric pattern. Ann Intern Med 1986; 105:513–518.
Rommel N, Tack J, Arts J, et al. Rumination or belching-regurgitation? Differential diagnosis using oesophageal impedance-manometry. Neurogastroenterol Motil 2010; 22:e97–e104.
Kessing BF, Bredenoord AJ, Smout AJ. Objective manometric criteria for the rumination syndrome. Am J Gastroenterol 2014; 109:52–59.
Geysen H, Michielsen S, Rommel N, et al. The gastro-sphincteric pressure gradient: a new parameter to diagnose a rumination episode. Neurogastroenterol Motil 2021; 33:e14068.
Nakagawa K, Sawada A, Hoshikawa Y, et al. persistent postprandial regurgitation vs rumination in patients with refractory gastroesophageal reflux disease symptoms: identification of a distinct rumination pattern using ambulatory impedance-pH monitoring. Am J Gastroenterol 2019; 114:1248–1255.
Nikaki K, Rybak A, Nakagawa K, et al. Rumination syndrome in children presenting with refractory gastroesophageal reflux symptoms. J Pediatr Gastroenterol Nutr 2020; 70:330–335.
Taft TH, Triggs JR, Carlson DA, et al. Validation of the oesophageal hypervigilance and anxiety scale for chronic oesophageal disease. Aliment Pharmacol Ther 2018; 47:1270–1277.
Halland M, Ravi K, Nelson HA, et al. Baseline impedance measured during high-resolution esophageal impedance manometry in patients with rumination syndrome is as abnormal as in patients with GERD. J Clin Gastroenterol 2020; 54:28–34.
Barba E, Burri E, Accarino A, et al. Biofeedback-guided control of abdominothoracic muscular activity reduces regurgitation episodes in patients with rumination. Clin Gastroenterol Hepatol 2015; 13:100–106.e101.
Barba E, Accarino A, Soldevilla A, et al. Randomized, placebo-controlled trial of biofeedback for the treatment of rumination. Am J Gastroenterol 2016; 111:1007–1013.
Murray HB, Zhang F, Call CC, et al. Comprehensive cognitive-behavioral interventions augment diaphragmatic breathing for rumination syndrome: a proof-of-concept trial. Dig Dis Sci 2021; 66:3461–3469.
Chitkara DK, Van Tilburg M, Whitehead WE, Talley NJ. Teaching diaphragmatic breathing for rumination syndrome. Am J Gastroenterol 2006; 101:2449–2452.
Glasinovic E, Wynter E, Arguero J, et al. Treatment of supragastric belching with cognitive behavioral therapy improves quality of life and reduces acid gastroesophageal reflux. Am J Gastroenterol 2018; 113:539–547.
Halland M, Parthasarathy G, Bharucha AE, Katzka DA. Diaphragmatic breathing for rumination syndrome: efficacy and mechanisms of action. Neurogastroenterol Motil 2016; 28:384–391.
Robles A, Romero YA, Tatro E, et al. Outcomes of treating rumination syndrome with a tricyclic antidepressant and diaphragmatic breathing. Am J Med Sci 2020; 360:42–49.
Blondeau K, Boecxstaens V, Rommel N, et al. Baclofen improves symptoms and reduces postprandial flow events in patients with rumination and supragastric belching. Clin Gastroenterol Hepatol 2012; 10:379–384.
Pauwels A, Broers C, Van Houtte B, et al. A randomized double-blind, placebo-controlled, cross-over study using baclofen in the treatment of rumination syndrome. Am J Gastroenterol 2018; 113:97–104.
Koek GH, Sifrim D, Lerut T, et al. Effect of the GABA(B) agonist baclofen in patients with symptoms and duodeno-gastro-oesophageal reflux refractory to proton pump inhibitors. Gut 2003; 52:1397–1402.
Lidums I, Lehmann A, Checklin H, et al. Control of transient lower esophageal sphincter relaxations and reflux by the GABA(B) agonist baclofen in normal subjects. Gastroenterology 2000; 118:7–13.
Oelschlager BK, Chan MM, Eubanks TR, et al. Effective treatment of rumination with Nissen fundoplication. J Gastrointest Surg 2002; 6:638–644.
Cooper CJ, Otoukesh S, Mojtahedzadeh M, et al. Subtotal gastrectomy as “Last Resort” consideration in the management of refractory rumination syndrome. Gastroenterology Res 2014; 7:98–101.
Nikaki K, Sifrim D. Rumination syndrome “Real Prevalence”: a need to increase awareness, early recognition, and specific management. Gastroenterology 2022; 162:696–697.