Published online Jun 30, 2019. doi: 10.13105/wjma.v7.i6.297
Peer-review started: April 23, 2019
First decision: May 24, 2019
Revised: May 31, 2019
Accepted: June 10, 2019
Article in press: June 10, 2019
Published online: June 30, 2019
Rumination syndrome (RS) is characterized by recurrent effortless postprandial regurgitation of recently ingested food from the stomach to the oral cavity and has been associated with quality of life impairment and malnutrition. There is a general lack of consensus on the most appropriate treatment options for RS.
To summarize the literature on treatment options for RS.
We conducted a systematic review according to PRISMA guidelines. We searched Medline (1946 to February 2019), EMBASE (1947 to February 2019), PsycINFO (1806 to February 2019) and Cochrane central register of controlled trials for articles discussing treatment options for adult patients (> 18 years) with RS. All relevant articles were accessed in full text. We extracted data on study designs, patient profiles, duration of symptoms, follow up periods, date, diagnostic criteria, interventions and outcomes. Risk of bias assessment was carried out independently by 3 reviewers via Cochrane Risk of Bias tool and Newcastle Ottawa Scale for randomized controlled trials and Cohort studies respectively.
Twelve articles were identified. A total of 254 patients were included in the analysis, with a mean age of 36.1 (range 18-89). 185 patients (72.8%) were females. 5 studies looked into behavioral therapies, primarily diaphragmatic breathing (DB) 2 studies looked at baclofen, 1 fundoplication and 1 supportive lifestyle changes. 3 studies looked at a combination of therapies involving pharmacological, behavioral and psychotherapies.
Although evidence for treatment options is still limited, the strongest evidence point towards the use of DB and Baclofen, and both should be considered depending on their availabilities.
Core tip: Rumination syndrome (RS) is a relatively common but underdiagnosed gastroenterological condition. Due to recent advances in research, we have decided to perform the first systematic review on treatment options for RS. Our results show that diaphragmatic breathing has the strongest data for efficacy in this condition.