Inpatient Treatment of Rumination Syndrome: Outcomes and Lessons Learned

This retrospective analysis describes adolescent patients seeking treatment for rumination syndrome (RS) in an inpatient medical setting. It is the first study to examine clinical outcomes of patients involved in such an intensive multidisciplinary program. The analysis also explores factors that may be related to patients’ progress in the program. A chart review was conducted of 55 adolescents admitted to our program with RS over the course of 5 years. At admission, none of the patients was able to keep down enough caloric content by mouth to maintain weight. Variables examined included demographics, aspects of their illness (e.g., somatic symptoms, duration of illness), and progress with regard to rumination and ability to retain oral intake. By the end of treatment (Mdn _{length of stay} = 9.0 days), 87% of patients were able to successfully retain at least 80% of their daily caloric requirement by mouth. Patients who were not able to achieve this goal were more likely to have a comorbid mental health disorder. Anxiety disorder and depression were the 2 most common diagnoses. This analysis demonstrates the effectiveness of an multidisciplinary inpatient approach in the treatment of RS in what is likely a group of patients with challenging clinical presentations. It also highlights the importance of evaluating mental health concerns and conceptualizing the disorder in terms of a biopsychosocial framework.