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Rumination (chewing gum)
Last reviewed: 23.04.2024
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Rumination (chewing gum) is a rare but too serious form of chronic regurgitation: it can cause a delay in the growth and pace of the child's psycho-speech and motor development, especially in the second half of the first year of life.
Cases of the disease in adults are unknown, as patients themselves are rarely informed about it. The pathophysiology of this disorder is not fully understood. There are no reports on the possibility of reversion of peristalsis to rumination in humans. This disorder is probably an acquired, unsuccessful habit and can be part of an eating disorder. A person acquires the ability to open the lower sphincter of the esophagus and move the gastric contents into the esophagus and pharynx while increasing pressure in the stomach due to rhythmic contraction and relaxation of the diaphragm.
With gum, regurgitation, chewing and re-ingestion of food occurs without nausea, but on the contrary, as a definitely pleasant process for the child, eagerly repeated. Soon the chewing gum turns into a more or less fixed habitual neurosis. In order to regurgitate food, the child deeply thrusts his finger into the throat or sets the tongue in the form of a groove when the mouth is wide open.
[Causes of curing
It is believed that rumination is a special kind of repetitive self-stimulation and self-satisfaction with which the child compensates for the lack of appropriate external stimuli. In some cases, such children for a long time are deprived of calming tactile, visual or auditory sensations. At an older age, a psychological factor plays an important role in preserving the rumination (as well as the habit of sucking a finger or tongue). In this case, the relationship between the mother (more often), the father and the child is violated, which is mainly due to the inability of adults to adequately perform their parental functions.
In some cases, the basis of regurgitation and ruminatsiya lies dysfunction of the esophagus, severe gastroesophageal reflux. It should be noted that the primary violations of the motor function of the esophagus, causing disorders of peristalsis and dysphagia, in children are rare.
Lower esophageal sphincter prevents the transfer of gastric contents into the esophagus. If the function of this sphincter is broken, then the contents of the stomach move retrograde, causing loss of nutrients and, ultimately, malnutrition. However, in infants, there is no clear connection between the function of the sphincter and the severity of gastroesophageal reflux.
Long-term exposure to gastric juice on the mucous membrane of the lower esophagus can cause distal esophagitis (reflux-esophagitis) or chronic blood loss. With esophagus dyskinesia, especially with dysfunction of its upper sphincter, aspiration of gastric contents is possible, which can lead to a prolonged, persistent cough, attacks of bronchial asthma and in some cases the development of aspiration pneumonia.
Symptoms and diagnosis of rumination
Nausea, pain and dysphagia are not observed. At the time of stress, the patient may not control the rumination process. Observing this process for the first time, others can initiate the patient's treatment to the doctor. Patients suffering from regurgitation rarely lose weight.
Rumination is usually diagnosed when monitoring a patient. Psychosocial history helps to disclose the cause of emotional stress. Endoscopy of the upper gastrointestinal tract is necessary to exclude diseases that cause a mechanical obstruction or a Center diverticulum. Oesophageal manometry, as well as studies to assess passage on the esophagus, stomach and duodenum can be used to detect motor disorders.
Rumination Treatment
Therapy, as a rule, is supportive. Drug treatment is generally ineffective. To a positive effect can lead to psychotherapy in motivated patients (eg, relaxation, biological feedback). It may be helpful to consult a psychiatrist.