Rome IV Diagnostic Criteria for Rumination Syndrome
Official Rome IV criteria for the diagnosis of rumination syndrome.
Use in patients with symptoms suggestive of rumination syndrome, such as persistent or recurrent regurgitation of recently ingested food into the mouth with subsequent spitting or remastication and swallowing, for at least the past 6 months.
Patients with any of the following features must be evaluated clinically for other diagnoses even though rumination syndrome may be present:
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Signs or symptoms of GI bleeding.
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Unexplained iron deficiency anemia.
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Heartburn.
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Esophageal reflux/regurgitation.
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Unintentional weight loss.
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Palpable abdominal mass or lymphadenopathy on exam.
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Family history of gastric cancer and no recent upper endoscopy.
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Dysphagia.
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Persistent vomiting.
If diagnostic criteria are not met (negative):
Symptoms are unlikely to be caused by rumination syndrome. Consider further assessment for other diseases, or a different functional GI disorder.
If meets diagnosis (positive):
Likely diagnosis of rumination syndrome.
Management of rumination syndrome may include:
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Diaphragmatic breathing.
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Proton pump inhibitors.
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Neuromodulators (e.g. low dose tricyclic antidepressants).
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Baclofen.
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This calculator should only be used in patients after appropriate organic, systemic, and metabolic causes have been ruled out after careful investigation.
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Note: patients with rumination syndrome may have evidence of pathologic GERD on diagnostic testing.