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Rumination Disorder

By Evelyn Attia, MD, Professor of Psychiatry;Professor of Clinical Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute;Weill Cornell Medical College, New York Presbyterian Hospital ; B. Timothy Walsh, MD, Ruane Professor of Psychiatry;Founding Director, Eating Disorders Research Unit, College of Physicians and Surgeons, Columbia University;New York State Psychiatric Institute

Rumination is regurgitation of food after eating. Regurgitation may be voluntary.

People with this disorder repeatedly regurgitate food after eating, typically every day. People may rechew the regurgitated food and then spit it out or swallow it again.

The disorder may occur in infants, children, adolescents or adults.

Unlike vomiting, which is forceful, involuntary (not under the person's control), and typically caused by a disorder, regurgitation is not forceful and may be voluntary. However, people may report that they cannot stop themselves from doing it.

Some people are aware that the behavior is socially unacceptable and try to disguise it by putting their hand over their mouth or coughing. Some avoid eating with other people and do not eat before a social activity or work so that they do not regurgitate in public. Some people limit how much they eat. People who spit out the regurgitated material or who greatly limit how much they eat may lose weight or develop nutritional deficiencies.


  • A doctor's evaluation

Doctors usually diagnose the disorder by observing the person regurgitate food. If they suspect rumination disorder, doctors evaluate nutritional status to check for weight loss and nutritional deficiencies (see Overview of Nutrition : Evaluation of Nutritional Status).


  • Behavioral modification

Behavioral modification techniques, including treatments that use cognitive-behavioral strategies, may be helpful.