BMJ  2006;333:133 (15 July), doi:10.1136/bmj.333.7559.133

Practice

Interactive case report

A 22 year old man with persistent regurgitation and vomiting: case outcome

¹ Oesophageal Laboratory, St Thomas' Hospital, London SE1 7EH, ² Department of Gastroenterology, St Thomas' Hospital

The first 150 words of the full text of this article appear below.

Four weeks ago we presented the case of Mr Neville, a 22 year old student with persistent severe epigastric pain and regurgitation and vomiting after meals (BMJ 2006;332: 1438, 17 June[Free Full Text]). Aggressive treatment with acid suppression, prokinetics, and anti-emetics was not effective, and his symptoms led to life threatening weight loss over five months in hospital (BMJ 2006;332: 1496, 24 June[Free Full Text]).

Clinical observation suggested he had rumination syndrome, and this was confirmed by physiological measurements. In this condition food is returned to the mouth from the stomach by voluntary, although subconscious, contraction of the abdominal wall; the ruminant is then spat out or swallowed again. The information provided by manometry and impedance measurements was useful in convincing Mr Neville that the problem was under his control. The contractions of the abdominal wall underlying rumination episodes were brought to . . . [Full text of this article]

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