How to Recognize & Treat Rumination Eating Disorder
Stress negatively impacts the body in a variety of ways. It’s been linked to high blood pressure, depression, heart disease, muscle tension, and a broad spectrum of other health conditions that can wreak havoc on the human body. This is even more concerning when we consider that 77 percent of Americans say they’ve experienced moderate to high levels of stress in the last month.
Most of us have a relatively good understanding of the role stress plays in our overall health and wellness. But what we may not know is that stress manifests itself in unusual ways, such as an eating disorder called rumination syndrome.
This rare and lesser-known eating disorder is a serious, diagnosable medical condition that currently impacts approximately one percent of Americans (the majority of whom are female). And while stress isn’t the only reason a person might experience rumination eating disorder, it’s a major contributing factor, and it’s reason enough to learn about rumination syndrome and how the condition presents itself.
Here’s what you need to know about rumination eating disorder.
What is Rumination Disorder?
Rumination disorder, also known as rumination eating syndrome, is a medical condition that causes a person to regurgitate their food after they eat. So what is regurgitation exactly? It’s the act of “spitting up” food from the stomach into the mouth. The individual may swallow the food for a second time or they may vomit and be incapable of keeping a meal down. Typically, this process occurs after nearly every meal and continues for an extended period of time.
Rumination Eating Disorder Symptoms
Regurgitating food on a continuous basis leads to a number of physical symptoms. A few of the most notable include:
- Stomach Pain
Frequent vomiting will eventually damage the esophagus, as it exposes a person’s food passage to gastric acid (a naturally-occurring stomach liquid that breaks down our food). It also increases a person’s risk of developing stomach ulcers, heartburn, and gastroesophageal reflux disease (GERD) — all of which can be quite painful. If you’ve been throwing up undigested food and you’re experiencing unexplained abdominal pain, it’s possible you may have rumination disorder.
- Weight Loss
It goes without saying that our bodies can’t absorb an adequate amount of nutrients if the food we eat isn’t being properly digested. A lot of people with rumination eating disorder lose weight as it becomes more and more difficult to keep food down. Ultimately, the body becomes malnourished and it begins to utilize fat as an energy source, causing the person to shed weight even if they aren’t intentionally trying to do so.
- Dental Problems
The acid in our stomachs is strong enough to erode the enamel of our teeth. When a person repeatedly regurgitates their food, it exposes the teeth to digestive fluids that cause them to deteriorate over time. For this reason, people with rumination syndrome are more prone to cavities, enamel loss, and tooth decay.
Causes of Rumination Disorder
The first thing you need to know is that for people with this disorder, regurgitating isn’t voluntary. It’s a reflex that, although it may be a learned behavior initially, becomes uncontrollable over time.
Simply put? Those diagnosed with rumination syndrome can’t just stop regurgitating their food.
So what causes people to start burping up food? Here are the top contributing factors:
- Extreme Levels of Stress
High levels of stress that continue for a prolonged period of time can induce a rumination disorder. Stress often causes a person to lose their appetite. If the person continues to avoid food due to stress, they may struggle to regain a healthy eating routine and find themselves feeling nauseated after consuming food. This can cause vomiting or regurgitation which, in some cases, develops into a disordered eating pattern.
- Severe Prior Illness
There have been recorded cases of ruminating eating disorders being triggered by a severe illness, such as gastroenteritis or food poisoning. While sick, the person may develop an aversion to food, either because it makes them feel worse or because they were unable to eat for days and the thought of food makes them nauseous. Eventually, when the person tries to reintroduce food, they experience a mental repulsion and find themselves involuntarily regurgitating meals.
- Mental Health Conditions
Some mental illnesses, such as obsessive compulsive disorder, have been linked to rumination syndrome. Intrusive or obsessive thoughts can be incredibly difficult to ignore, and many people with OCD experience these thoughts in relation to food. They may experience intense fears of food contamination or they may need to maintain certain behavioral rituals with their food in order to consume it without issue. When these compulsive thoughts aren’t satisfied, the person might regurgitate or vomit involuntarily as a psychosomatic symptom of OCD.
Rumination Syndrome Diagnosis
If you’ve been researching “Why does food come back up after eating?” due to experiencing involuntary regurgitation or vomiting, you’ll likely want to be assessed for rumination eating disorder.
Here are some steps you can take to receive a medical diagnosis:
- Speak to Your Family Physician
If you have a family physician, it’s best to start by expressing your concerns to them, as they are most familiar with your medical history. Depending on your healthcare provider's level of expertise and comfort, they may decide to conduct a DSM-5 assessment themselves or they may refer to a specialist for a more comprehensive assessment. Either way, you’ll benefit from knowing your family physician is in the loop and aware of your concerns.
- Meet With a Registered Dietitian
Registered dietitians play an integral role in the treatment of eating disorders. They are highly-educated experts who specialize in the area of nutrition and since many individuals with eating disorders are malnourished, working with an RD can help them reestablish healthy eating habits and achieve optimal health. Plus, registered nutritionists can also conduct DSM-5 assessments to determine which eating disorder, if any, a patient might be experiencing.
- Document Your Symptoms
It’s always worthwhile to keep a detailed log of your symptoms. Jot down when you regurgitate or vomit. Note any thoughts or emotions you experienced just prior to regurgitating. Analyze whether or not specific foods trigger regurgitation more than others. It will be much easier to explain your concerns when a record of your symptoms.
Rumination Eating Disorder Treatment
Because rumination eating disorder is a habitual behavior due to stress, mental health, or other factors, the main form of treatment is behavioral therapy. This therapy can include diaphragmatic breathing and, in cases where mental illness is a factor, medication may be prescribed. Frequent rumination can cause damage to the esophagus, in which case patients will be prescribed proton pump inhibitors to protect the lining of the esophagus. Often, in addition to behavioral therapy, those diagnosed with rumination eating disorder are referred to registered dietitians for assistance developing a specialized nutrition plan.
Nourish is Here to Help
Are you concerned about burping up undigested food or feeling nauseous after you eat? We can help. Our network of registered nutritionists offer in-depth eating disorder treatment and customized nutrition plans. Connect with one of our experienced registered dietitians today!