Habitual rumination: a benign disorder

Nine patients who habitually ruminated after meals underwent clinical tests and psychological questioning. Barium meal radiography showed no abnormalities. In one patient oesophageal manometry detected an abnormally large gastric pressure wave 20 minutes after food. Although four patients had family psychiatric histories and three histories of overdose, anorexia nervosa, and mild reactive depression, none had any present serious psychiatric disorder. Behavioural therapy to reduce rumination was successful in one patient. Most patients responded to reassurance that the habit was harmless. Since the condition is a distinct clinical syndrome it may be recognised early with minimal investigations if doctors are aware of its existence.