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

BMJ 2006; 333 doi: (Published 13 July 2006) Cite this as: BMJ 2006;333:133
  1. Mark Fox, specialist registrar (,
  2. Alasdair Young, senior house officer2,
  3. Roy Anggiansah, physiologist1,
  4. Angela Anggiansah, director1,
  5. Jeremy Sanderson, consultant2
  1. 1 Oesophageal Laboratory, St Thomas' Hospital, London SE1 7EH,
  2. 2 Department of Gastroenterology, St Thomas' Hospital
  1. Correspondence to: M Fox
  • Accepted 5 January 2006

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). 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).

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 …

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