Treament of Rumination
Condition: Rumination Disorders
MeSH terms: Rumination Syndrome; Feeding and Eating Disorders of Childhood
Study type: Interventional

Summary: 
      Background. Rumination syndrome is characterized by effortless recurrent regurgitation of
      recently ingested food into the mouth, with consequent expulsion or re-chewing and
      swallowing. In a previous study we showed that rumination is produced by an unperceived,
      somatic response to food ingestion. We developed an original biofeedback technique based on
      electromyography-guided control of abdominothoracic muscular activity. In a randomized,
      placebo-controlled trial we demonstrated the superiority of biofeedback over placebo for the
      treatment of rumination. However, the technique is technically complex and unpractical.

      Aim. To prove the efficacy of a simplified biofeedback technique for the treatment of
      rumination. Selection criteria. Rumination after meal ingestion. Intervention. Patients will
      be randomized into biofeedback in placebo groups. Three sessions of either biofeedback or
      placebo intervention will be performed after ingestion of a probe meal during the first 3
      weeks of the 4 weeks intervention period.

      Biofeedback: patients will be taught to control abdominal and thoracic muscular activity by
      providing a visual display of the abdominal and thoracic perimeter; patients will be
      instructed to perform the same exercises before and after breakfast, lunch and dinner during
      the 4-week intervention period.

      Placebo: abdominal and thoracic perimeter will be recorded but not shown to the patient and a
      pill of placebo containing 0.5 g glucose will be administered; patients will be instructed to
      take a pill of placebo before breakfast, lunch and dinner during the 4-week intervention
      period.

      Primary Outcome Measure:

      Number of rumination events measured by electromyography in response to the challenge meal
      before and after treatment.

      Secondary Outcome Measures:

        -  Number of self perceived rumination events measured by questionnaires administered daily
           for 10 days will before and after treatment.

        -  Associated abdominal symptom measured by questionnaires administered daily for 10 days
           before and after treatment.

        -  Follow up: number of self perceived rumination events measured at 1, 3 and 6 months
           after treatment.
    


Intervention name(s): Biofeedback; Placebo
Intervention type(s): Behavioral; Dietary Supplement
Intervention description(s): Three sessions by biofeedback will be performed during the first 3 weeks of the intervention period. In each session patients will be taught to control abdominal and thoracic muscular activity by providing a visual display of the abdominal and thoracic perimeter; patients will be instructed to perform the same exercises before and after breakfast, lunch and dinner during the 4-week intervention period.; Three sessions will be performed during the first 3 weeks of the intervention period. In each session abdominal and thoracic perimeter will be recorded but not shown to the patient; patients will take a pill of placebo containing 0.5 g glucose and no specific instructions will be provided. Patients will be instructed to take a pill of placebo before breakfast, lunch and dinner during the 4-week intervention period.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment