This Common Gut Disorder Can Feel Like Acid Reflux—So It’s Often Misdiagnosed

Spicy foods, red meat, and alcohol can all lead to uncomfortable indigestion or acid reflux. But for a group of people, these symptoms happen more severely and with every meal, making it difficult to enjoy happy hours with friends or share dinners with family.

A study published in the journal Neurogastroenterology and Motility, says patients who regurgitate their food regularly may be suffering from a behavioral gut condition called rumination. While it may be the first time you’ve heard of the disorder, researchers from Massachusetts General Hospital (MGH) say it’s actually quite common, but often misdiagnosed.

What is rumination syndrome?  

According to the study, “rumination syndrome involves effortless, repeated regurgitation, and can overlap with other upper gastrointestinal (GI) disorders, including gastroparesis.” 

It occurs when patients spit up their food about 10 minutes after they’ve swallowed it. This is different from vomit since the food has not been fully digested. 

Rumination is considered a disorder of the gut-brain interaction (DGBI), making it a learned response. While it’s not entirely clear why it happens, researchers suggest it’s a response to pain or discomfort in the stomach. 

Because it’s similar to the act of vomiting, many patients unknowingly describe their symptoms as vomit or reflux. Other symptoms, like feeling full quickly, tightness in the abdomen, nausea, and unwanted or unintentional weight loss, are similar to symptoms of stomach pain, indigestion, and gastroparesis. This can cause the disorder to go undiagnosed or misdiagnosed for long periods of time, the researchers say. 

To better understand the syndrome, researchers looked at 242 patients with gastrointestinal symptoms similar to rumination. Of those volunteers, more than 12% qualified for a rumination diagnosis, and nearly half of that group said the condition impacted their social lives. 

“This condition causes a lot of embarrassment and may stop people from eating with others,” co-author of the study, Trisha Satya Pasricha, M.D., says in a news release. “It is not well understood, and is often mistaken for other disorders.”

The condition can affect pretty much anyone. “There is little demographically that distinguishes these patients other than their tendency to regurgitate when eating,” Pasricha says. “They are not more likely to have a history of an eating disorder or weight problems,” she adds. They were, however, more likely to experience heartburn during the day. 

How to manage rumination, naturally. 

Since rumination syndrome is a behavioral habit loop, studies have shown that practicing deep, diaphragmatic breathing, may be helpful in managing the response

On top of breathwork, researchers say comprehensive cognitive behavioral therapy (CBT) specific to rumination syndrome may also be effective. This form of therapy helps people unlearn habit loops and replace them with more beneficial thought processes and responses. 

While rumination is a learned behavior, it’s not a voluntary one. The behavioral gut disorder is a response to discomfort in the stomach, that leads to an impulse response in the brain. Recognizing the symptoms and distinguishing them from other GI disorders can help people avoid a misdiagnosis, and start getting the treatment they need. 

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