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Rethinking psychological treatment targets for pediatric rumination syndrome: Clinical implications from a case series analysis

Piña-Anastasiadis WA, Gloe LM, Johnson-Kwochka A, Kroon Van Diest AM, Lagges AM, Wagoner ST, Williams AE, Sparks BA et al.

JPGN reports, 2025

Abstract

Rumination syndrome (RS) is a common pediatric disorder of gut-brain interaction. However, a dearth of research on efficacious treatment to help guide clinical decision-making remains. Thus, relying on well-established treatment recommendations for other conditions with similar mechanisms or symptom profiles may be helpful; for example, conceptualizing RS treatment targets to address it as a "tic disorder of the gut" could be beneficial. To demonstrate the clinical utility of this conceptualization, we presented two cases that provide broad implications for treating pediatric RS. In both cases, akin to pediatric tic and related disorders, cognitive distress and physical discomfort were alleviated temporarily by rumination episodes. Thus, we recommend a targeted diagnostic assessment, including a functional analysis incorporating a transdiagnostic evaluation of symptoms. Close comanagement with specialty physicians and psychologists is also highly recommended. The patients represent complex yet standard cases seen in pediatric psychology outpatient clinics, suggesting the clinical utility of implications for psychologists and allied health professionals.

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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