The secondary rumination syndrome

Objective: To describe a case of rumination syndrome. The rumination syndrome in humans is characterized, manometrically, by straining-induced intra-abdominal pressure peaks which precede the episodes of regurgitation. Patient: A 26-year-old woman with rumination syndrome suspected on the basis of her symptoms. Methods: A 24-h ambulatory study was performed to simultaneously monitor oesophageal pH (five levels), oesophageal pressure and intragastric pressure. Results: All episodes of regurgitation were associated with abdominal pressure peaks. However, spontaneous gastro-oesophageal reflux rather than rumination appeared to be the primary event, followed by abdominal straining which propelled the refluxed material further upwards in the oesophagus. Conclusions: The term secondary rumination is proposed to describe the abnormality observed in this patient.