Rumination Syndrome in Adolescents: Clinical and Psychiatric Correlates From a Case Series

Abstract

Introduction

Rumination Syndrome (RS) lies at the intersection of gastrointestinal and psychiatric disorders but remains poorly recognized within Child and Adolescent Psychiatry. Although benign in nature, RS can cause marked psychological distress and functional impairment.

Objective

To describe the clinical presentation and mental health comorbidities of adolescents with suspected RS in an outpatient setting.

Methods

Eight adolescents (13–16 years) referred to a specialized Pediatric Clinic for Nutritional Disorders between January 2022 and July 2024 were reviewed. Data were extracted from clinical records focusing on psychiatric comorbidities and diagnostic differentiation.

Results

All patients were female (mean age 15.4 years). Symptom duration before referral ranged from 1 month to 4 years, with weight loss between 2–25 kg (BMI 14.5–20.5 kg/m²). RS was confirmed in six patients; five presented comorbid eating disorders. Interventions combining medical and psychological care reduced symptoms in most cases. One patient was diagnosed with an organic cause (ovarian anaplastic lymphoma).

Conclusions

RS in adolescence is often misdiagnosed or mistaken for an eating disorder. Awareness of its behavioral and psychological dimensions is crucial in mental health practice. This series supports the need for joint pediatric–psychiatric assessment and early behavioral intervention in RS.

Plain Language Summary

Rumination Syndrome is a condition where food comes back up from the stomach soon after eating. Although it may look like vomiting, it happens automatically and is not done on purpose. The problem can cause distress, embarrassment, and weight loss, and is often confused with reflux or vomiting. This study looked at eight teenage girls who were referred to a pediatric clinic because of repeated regurgitation after meals. Six of them were diagnosed with Rumination Syndrome. Most also had emotional or psychiatric difficulties, such as anxiety, depression, or eating disorders like anorexia and bulimia. In one case, an organic medical illness was discovered. The findings show that Rumination Syndrome can have both physical and emotional components. Because the symptoms resemble other disorders, diagnosis is often delayed. Understanding how stress and emotions can affect the stomach is important for effective treatment. This study highlights the need for cooperation between pediatricians and mental health professionals when assessing teenagers with gastrointestinal complaints.