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The upper gastrointestinal tract, common conditions, and recommended treatments
Published in Simon R. Knowles, Laurie Keefer, Antonina A. Mikocka-Walus, Psychogastroenterology for Adults, 2019
Rumination syndrome refers to repetitive, effortless postprandial regurgitation of gastric contents that are either reswallowed or spat out. There is usually no (or minimal) nausea and no retching which distinguishes rumination from vomiting and the food brought up is not acidic, which distinguishes rumination from gastrooesophageal reflux. Rumination is caused by contraction of the abdominal muscles which increases intra-abdominal pressure and overcomes the lower oesophageal sphincter, causing food to rise through the oesophagus to the mouth. Although the muscles involved in increasing intra-abdominal pressure are under voluntary control, this contraction is habitual, and the patient is unaware. Diagnosis can be made on the characteristic clinical features and can be confirmed by measuring the pressures in the stomach and oesophagus during an episode. Treatment focusses on education as to the mechanism of the symptoms, behavioural interventions with abdominal wall relaxation, and diaphragmatic breathing. For more information about rumination syndrome see [30].
Global prevalence and international perspective of paediatric gastrointestinal disorders
Published in Clarissa Martin, Terence Dovey, Angela Southall, Clarissa Martin, Paediatric Gastrointestinal Disorders, 2019
Shaman Rajindrajith, Niranga Devanarayana, Marc Benninga
Rumination syndrome is defined as effortless, repetitive, painless regurgitation of partially digested food into the mouth soon after the meal, which is subsequently re-chewed and re-swallowed or, in the alternative, expelled (Rasquin et al., 2006). Rumination syndrome is thought to be common in children who are neurologically handicapped with developmental abnormalities and learning difficulties (Chatoor et al., 1984; Rogers et al., 1992). In clinical settings, rumination syndrome is frequently misdiagnosed as gastro-oesophageal reflux, gastroparesis and recurrent vomiting. These misconceptions and misdiagnoses and poor awareness among clinicians have led to underdiagnosis of this important and sometimes disabling disease in children. However, recent data show its increasing prevalence among otherwise healthy people with normal cognitive function (Khan et al., 2000; Lee et al., 2007).
Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician
Published in European Journal of General Practice, 2018
Zekeriya Akturk, Ali Bilal Ulas, Atila Eroglu
Although a relatively rare condition, ZD should be easily recognized in primary care conditions due to its distinctive history and presentation, in particular when there are both digestive as well as respiratory symptoms, as in this case. There is a need for a high index of suspicion for ZD in patients with dysphagia, cough, and aspiration [17]. Affecting more than 20% of the population [15], GERD is a much more common gastrointestinal condition. Hence, it is no surprise that this patient was initially treated as such a case. Even Rumination syndrome [18] should be kept in mind for patients complaining of regurgitating undigested food.