1. Rumination Syndrome Mayo Clinic Proceedings
Allison Malcolm, M.B., B.S., Miriam B. Thumshirn, M.D., Michael Camilleri, M.D., Donald E. Williams, Ph.D. 
Mayo Clinic Proceedings 
Volume 72, Issue 7, Pages (July 1997)
DOI: /
Copyright © 1997 Mayo Foundation for Medical Education and Research Terms and Conditions

2. Fig. 1
Proposed pathophysiology of rumination. LES = lower esophageal sphincter.
Mayo Clinic Proceedings  , DOI: ( / )
Copyright © 1997 Mayo Foundation for Medical Education and Research Terms and Conditions

3. Fig. 2
Left, Twenty-four-hour pH study demonstrating acid in esophagus during meal, with no other episodes even when patient is supine, findings indicative of rumination. Note there is no associated pain. Right, Twenty-four-hour pH study demonstrating acid in esophagus predominantly when patient is supine, findings indicating gastroesophageal reflux. Note several episodes of pain are reported.
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Copyright © 1997 Mayo Foundation for Medical Education and Research Terms and Conditions

4. Fig. 3
Gastrointestinal manometry and esophageal pH in patient with rumination. Note concurrence of regurgitation (arrows) with decreases in intraesophageal pH and “R” or simultaneous waves consistent with increased intra-abdominal pressure, desc. = descending.
(From O'Brien and associates.14 By permission.)
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Copyright © 1997 Mayo Foundation for Medical Education and Research Terms and Conditions

5. Fig. 4
Clinical approach to adult with suspected rumination. Postive (+) findings on history or gastrointestinal manometry signify features characteristic of rumination.
Mayo Clinic Proceedings  , DOI: ( / )
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