# Talk:Rumination syndrome

There's been a certain video going around the internet that features a girl who has an... "ability" to do exactly what this article is describing. Maybe that girl has this syndrome. If you know what I'm talking about, great, let's discuss. If not, forget you even read this. ShihoMiyano (talk) 23:03, 14 July 2010 (UTC)

I'm sorry to have to say it, but this article looks like a mess.  Why is it peppered with parenthetical comments such as "(unsubstantiated theory/hypothesis)," "(necessarily)," "(personal experience)?"  NONE of this belongs within the body of the article.  The text should not serve as a critique of itself.  Issues that are disputed or questioned should be discussed here on the discussion page, OR the text should be edited so that it is SUBSTANTIATED by cited sources, and NOT BASED ON PERSONAL EXPERIENCE that would amount to Original Research.  I don't know what is, or what isn't substatiated, I don't know whose supposed "personal experience" is being referenced, and I know nothing about the subject.  I came to read and learn from the article, and stumbled into a catastrophe of qualifications and skepticism.  Someone please clean this up. zadignose (talk) 18:38, 20 July 2008 (UTC)

Okay, I've removed much of the material which was unsourced and heavily dependent on qualifying parenthetical comments.  I've also removed statments whose factual nature has been in question at least since being tagged last December.  It looks cleaner and simpler now.  Add back only what can be credited to a reliable source. zadignose (talk) 05:49, 24 July 2008 (UTC)
Unfortunately for an article of this nature, personal experience IS neccessary. This is a condition that practically every doctor on the planet ignores in favour of a diagnosis of Bulimia. My girlfriend suffers from a variety of this syndrome, and I will be adding my personal research. It is just as valid, important, contributing, and truthful as an article off the web (If anything, it's more truthful) - Floydian 01:19, 28 May 2009 (UTC)

I have rewritten this article based upon an information sheet I have from the Mayo Clinic in Rochester, Minnesota. The article has been divided into categories, and proper information has been added.
Some information is of my own research. While I am not a licenced doctor, I have witnessed my significant other suffer with this for several years now. Every doctor is so quick to prove their intelligence as a doctor that rather than listening and looking deeper, they dismiss it as bulimia. There is little, if any, accurate information on non-infant non-handicapped sufferers available.
Qualified or not, my "original research" is based on a sufferer, and may be of great assistance to other sufferers. I will fight to retain what I have added. - Floydian (talk) 02:39, 28 May 2009 (UTC)

Your qualifications are irrelevant.  Wikipedia's mandatory policy, WP:No original research, is at issue.  You may not include your own original research because it is not WP:Verifiable, even if it is 100% true.  Wikipedia includes what is "verifiable, not True™".  WhatamIdoing (talk) 15:27, 9 June 2009 (UTC)
Everything is or will be backed up. The adjectives I use and the way things are described may be based on my accounts, but the facts will all be backed up.  —Preceding unsigned comment added by Floydian (talk • contribs) 07:18, 11 June 2009 (UTC)

By what? Wikipedia is made from unbiased accounts from reliable sources. Whether your account is truthful or not doesn't matter if it cannot be verified. ShihoMiyano (talk) 22:23, 14 July 2010 (UTC)

Since this condition does have an actual name, I have decided to move it to a page titled Rumination Syndrome, to adknowledge that fact. To list it as Rumination (eating disorder) is to simply say that the symptom of rumination is an eating disorder, when the actual condition is far more complicated. —Preceding unsigned comment added by Floydian (talk • contribs) 22:32, 8 June 2009

Please do not blank the WPMED assessments just because you're working on the article.  The importance of this rare syndrome (to WPMED as a whole) won't change, even if the article is perfect; the quality can be reassessed on request by leaving a note at WP:MEDA.  Thanks, WhatamIdoing (talk) 15:25, 9 June 2009 (UTC).

Rare because nobody comes forward and because it's so underdiagnosed. - Floydian (talk) 18:05, 9 June 2009 (UTC)

This is a checklist for myself. Others need not worry unless they are brave and want to tackle the challenge :)

Will cross out as completed -- ʄɭoʏɗiaɲ τ ¢ 03:40, 26 June 2009 (UTC)
As someone who "suffers" from Rumination "Syndrome," I'd like an explanation of why, exactly, it is considered a disease.  It seems more like a physical skill that not everyone possesses, like wiggling one's ears or touching one's nose with one's tongue.  I've had Rumination Syndrome for probably ten years, and my teeth enamel is in fine shape.  Also, since I developed this ability, I rarely have heartburn.  I read and reread the article, and I couldn't find anything beyond the tooth-enamel thing that would classify this as a disease.  (In my case, it hasn't affected my weight at all.)  —Preceding unsigned comment added by Serop2 (talk • contribs) 18:09, 29 September 2010 (UTC) 

It's not a disease. Diseases are caused by pathogens. Rumination is a disorder, as those with it are unable to eat as intended. I'm not sure if I mistakenly labelled it as a disease or not (as far as I remember it only mentions disorder). Tooth enamel was merely stated in a study. In my case there is no damage to the enamel either. Actually, now  that you mention it, my significant other has never experienced heartburn in the past several years.
You should fix also on line 4 the sentence that is missing a subject and a capital letter in the beginning.  — Preceding unsigned comment added by 216.252.88.138 (talk) 17:25, 14 February 2012 (UTC) 

However, my intention here is recognition by getting it on the main page, which means sticking to the "facts" published in the one or two studies done on this disorder, unfortunately. - ʄɭoʏɗiaɲ τ ¢ 20:09, 29 September 2010 (UTC)

I felt it necessary to strongly emphasize the lack of awareness of this disorder whatsoever within the public or medical community. Every paper cited in that string contains some mention of the fact that there is very little knowledge of the disorder and very little awareness of it. There are only two places in North America that treat the disorder, and not many more that have ever heard of it. These citations back up the usage of the word "severely." - ʄɭoʏɗiaɲ τ ¢ 17:42, 10 August 2009 (UTC)

Hello.
I am a member of WikiProject Medicine, a Wikipedia wide project that maintains and improves articles that fall under the scope of medicine. Since your article is already under has our tag, I have now reassessed it to make sure if is in the right WikiProject. Upon reassessment of the article, I'd like to make a few points, as shown below:

Reassess article with class and importance factors
Reassessed tags for correct placements
Your article is very clearly written..I would suggest trying out for GA in the very near future!
Leave a message on my talk page if you have any questions. I'm glad this article could fall within our scope, and I hope to see it grow large! Many thanks! Renaissancee (talk) 17:18, 16 August 2009 (UTC)

Could you give use exact numbers rather than severely under-diagnosed Doc James (talk · contribs · email) 00:36, 7 September 2009 (UTC)

No. There are no numbers because there's only one place in North America that treats it, and they have no way of knowing how much more prevalent the condition is. They probably won't for a while because the condition is by and large ignored by doctors, who consider it (get this) benign (which is probably because the pharmaceutical companies can't make money off selling a breathing technique, but that's just my humble opinion there). - ʄɭoʏɗiaɲ τ ¢ 01:39, 7 September 2009 (UTC)
So if there are no exact numbers, how can it be definitively stated that it is "severely under-diagnosed?"  Sounds like speculation.  — Preceding unsigned comment added by 162.6.97.20 (talk) 12:16, 12 January 2012 (UTC)
It would be if the sources used in the article didn't state it verbatim. I believe it's in Papadoupolis et al. - ʄɭoʏɗiaɲ τ ¢ 12:53, 12 January 2012 (UTC)

This review is transcluded from Talk:Rumination syndrome/GA1. The edit link for this section can be used to add comments to the review.
I'll be conducting the GA review.  Strombollii (talk) 03:55, 7 September 2009 (UTC)

Awesome... I've literally been checking the GAR page twice a day since I nominated this. Hope you enjoy reading it. I've managed to find most of the sourced journal entries online freely. If you have any questions you may as well direct them straight to me since nobody else has really contributed to this one beyond minor fixes. Cheers - ʄɭoʏɗiaɲ τ ¢ 05:09, 7 September 2009 (UTC)
I'll do my best to get it up speedily.  Strombollii (talk) 15:17, 7 September 2009 (UTC)
Just a few stylistic concerns:

Why the bulleted list under Diagnosis?
Citations in the lead: Not a huge deal, and very subjective, but are they necessary?  The lead should simply state facts that are substantiated and cited within the article itself.  Ergo, citations within the introduction should be unnecessary. With that said, they're also not prohibited under WP: MOS or WP:MEDMOS.
External links section needs descriptions. (from PR)
Reference 13 needs to be formatted. (from PR)
Link for 13 is also broken, can't access data.
Strombollii (talk) 01:09, 8 September 2009 (UTC)

If you don't mind me asking, what do you mean by "from PR"?
I'll fix the others up next time I'm on. I think some of the citations (Particularly the ones for "severely under-diagnosed") are necessary to back up claims that some may see as NPOV otherwise - ʄɭoʏɗiaɲ τ ¢ 02:15, 8 September 2009 (UTC)
Sorry, "from PR" was more for me, meaning "from Peer Review".  And if you can find a source that explicitly states that it is under-diagnosed, then you don't actually need such a huge list.  Strombollii (talk) 03:40, 8 September 2009 (UTC)
K, ref 13 is formatted... Not sure why you can't access it though, as it comes up fine for me on several different computers. As for the lead thing, all the citations explicitly state that it is "under diagnosed". None of them use the word 'severely', so I have justified that choice in wording with the countless journals that say "Its under diagnosed, doctors needs more awareness of this, and the general public needs more awareness of this." If I can keep 'severely' without that many citations than I'll remove the citations from the lead all-together. - ʄɭoʏɗiaɲ τ ¢ 18:49, 8 September 2009 (UTC)
It's probably my awful wifi here at school.  Sorry about that.  But I have misgivings using a term such a "severely", which is blatantly subjective.  There's no problem with saying that the disease is under-diagnosed or rarely seen as a result of lack of knowledge (given, of course, that said statements are echoed in the literature); but to derive "severely" from a multitude of papers that do not, in fact, say "severely," is a violation of WP: NPOV. Strombollii (talk) 21:19, 8 September 2009 (UTC)
I doubt any respected medical journal would ever use the word severely. If they use other words that mean essentially the same thing, can I use severely?.. Cause most of the words in the article aren't word-for-word the words used the journals (Since most of them contain terminology that are at a level above your average readers comprehension). - ʄɭoʏɗiaɲ τ ¢ 00:02, 9 September 2009 (UTC)
But if no respected medical journal would use the word "severely", why should it be used on Wikipedia?  It's subjective.  Strombollii (talk) 00:33, 9 September 2009 (UTC)
I see what you mean by that... A couple studies use the word "very", while some others state things such as "under-recognized condition" and "[there is] insufficient awareness [of the syndrome]". Could you perhaps suggest an alternative wording? - ʄɭoʏɗiaɲ τ ¢ 00:48, 9 September 2009 (UTC)
Maybe just state that it's an under-recognized or under-diagnosed condition? Strombollii (talk) 01:16, 9 September 2009 (UTC)
K. Severely is out, and under-recognised has been added as a new sentence in the lead. I also took ut most of the citations from the lead... The few that remain are all in that group of 7. Aside from the first 2 of those 7, they are only referenced at that point of the article and so I will soon find spots to use them and move them down. External links have had descriptions added to them (Which you may wish to truncate or such because I wasn't sure what would be an acceptable description) - ʄɭoʏɗiaɲ τ ¢ 01:39, 9 September 2009 (UTC)
GA review – see WP:WIAGA for criteria

Is it reasonably well written
A. Prose quality: Y

B. MoS compliance: Y

Is it factually accurate and verifiable?
A. References to sources: Y

B. Citation of reliable sources where necessary: Y
So many citations in the lead are a bit unnecessary, but it's not explicitly prohibited by WP: MEDMOS, so it's a bit of a moot point.

C. No original research: Y

Is it broad in its coverage?
A. Major aspects: Y

B. Focused: Y

Is it neutral?
Fair representation without bias: Y

Is it stable?
No edit wars, etc: Y

Does it contain images to illustrate the topic?
A. Images are copyright tagged, and non-free images have fair use rationales: Y

B. Images are provided where possible and appropriate, with suitable captions: Y

Images could be larger, so that graphs and data can be more easily accessed.
More images would also be nice, but that's not a GA requirement.  For an FA attempt, an anatomical diagram should be included.
Overall:
Pass or Fail: 

Awesome!! next up is FA. I think I will be very hard pressed to find an anatomical diagram... Might be able to make one but there's litting information regarding that. I'm guessing that fixing the diagnosis paragraph would also be a requirement, but I'll be doing that shortly anyways. Thank you very much : )  - ʄɭoʏɗiaɲ τ ¢ 16:43, 10 September 2009 (UTC)
Just thought I'd let you know, since I don't know what it needs to fix it, the GA Review template on the talk page says "Error: Invalid date" - ʄɭoʏɗiaɲ τ ¢ 16:48, 10 September 2009 (UTC)

Hi, I saw the note on WT:MED about how you're thinking of taking this to FAC soon and requesting input.  Looks good, well referenced and refs are of high quality.  But I do have a few suggestions:

Occasionally too technical and fancy language--opt for the simplest way of saying something to make the article readable by the widest audience.  e.g. amongst -> among, postprandially -> after eating, ingested -> eaten.
Definitely on this one. I've heard a few times that the medical terminology is daunting... Though I disagree with which ones need dumbing down. Postprandially seems to flow better in many cases and is wikilinked at its first occurrence to wiktionary, and changing ingested to eaten in most cases reads very very strange (This vomiting occurs several hours after the meal is eaten vs. This vomiting occurs several hours after the meal is ingested).
Well, in that example you could just say "...after the meal."  That would reduce the wording (redundant and unnecessary wording is a common thing to get trouble for at FAC, and you can expect the reader to figure out what the patient does to the meal).  Check out User:Tony1/How to improve your writing for more on that.   delldot ∇. 05:22, 12 September 2009 (UTC)
Say what the disorder is in the first sentence.  Leave the epidemiolgy info in the first and second sentences till later in the para.  If the third sentence info is presented first (maybe pared down), the current first, second and fourth sentences will flow better together.
Done... My grammar is absolutely terrible, so you may wish to look over the change
Looks good! delldot ∇. 05:32, 12 September 2009 (UTC)
Some material needs to be better referenced or more loyal to given references.  e.g. no mention of some of the diagnostic criteria in the list ref'd to ref 8 ([1]).  e.g. no mention of belching.  That ref says 'is usually not...nausea', this article says 'is not'.
Will add more references. There are two or three different nosologies that give slightly different criteria.
Done. The reason for this is that I used a direct reference to a picture contained in another reference (ref 1, J of Postgrad). The criteria picture used very absolute wording, but the prose in the accompanying article explained the nuances. Regardless, I've sourced each point.
This sentence is out of place and should be integrated into the previous para discussing success of the technique: Patients who successfully use the technique often notice an immediate change in health for the better.
Done
This sentence is also out of place and probably doesn't belong in Treatment: Past studies of rumination syndrome have described it as benign.[17] However, more recent studies have described otherwise.
Agreed. I couldn't decide which section it fit in, but after hearing it is 'benign' from a doctor at the mayo clinic, it really needs to be somewhere in there that it is not a benign condition (Tell them to live with vomiting every meal and call it benign). Any suggested location that would flow better?
Possibly in the lead after Like most eating disorders, rumination can adversely affect normal functioning and the social lives of afflicted individuals.  (or before.)  Normally you wouldn't put info in the lead that's not in the body, but this may be an exception since it's such a simple point about the general nature of the condition.  Since there's no classification section, there's not really a place for discussion of what this condition is.  The closest thing is Diagnosis, but I don't see anywhere in there where this sentence would flow with the rest of it.  delldot ∇. 05:32, 12 September 2009 (UTC)
Done
Awkward: can lead to the child becoming malnourished.  How about can lead to malnutrition?  or can cause the child to become...?
Done
Turn the ref in the caption for the epidemiology image into a footnote like the other refs.
Done
I can't see the numbers in the epidemiology image. Any way you could enlarge the numbers so I can see them without leaving the article?
I can try...There's a lot of numbers and it may look really terrible, but I'll see what I can do.
Can you provide PMIDs for the journal refs?  (Search the article title in pubmed, then copy the number at the bottom of the abstract)
Will do. Done.
That's all I got for now. delldot ∇. 18:17, 11 September 2009 (UTC)

Cool. I've already made most of the changes already. Some I will do shortly, and others I left a comment for. Thanks - ʄɭoʏɗiaɲ τ ¢ 19:01, 11 September 2009 (UTC)
Alrighty. Pretty much done minus some small changes left to be done to Diagnosis (the list), and the request you made on the picture. I put the nomination through since I'll probably have a month if it's backlogged like GAN. - ʄɭoʏɗiaɲ τ ¢ 16:21, 13 September 2009 (UTC)

Also per your request at WT:MED:

More visuals; maybe a pic of the upper GI tract with relevant landmarks highlighted, or a pic of Barrett's esophagus if applicable, something. Or several somethings.
Don't rely so heavily on your first two sources, even it they're awesome.
In the FA review, I'm being told to use it more in place of older sources. The papadopolus source is a review of all the studies before then (2007) ʄɭoʏɗiaɲ τ ¢
I don't think this is that big of a problem.  If not much is written on this, of course you're going to rely heavily on a few sources.  Obviously, try to get as diverse sources as you can, but don't opt for a poorer source just to avoid citing a better one "too much".  delldot ∇. 18:21, 14 September 2009 (UTC)
Cite your basis for calling it under-diagnosed clearly, because that's easily and often said about many conditions but hard to prove sometimes.
Every single source says that is under diagnosed and needs more awareness amongst doctors and the public. ʄɭoʏɗiaɲ τ ¢
The sentence in the DDx section that says Bulimia nervosa and gastroparesis are especially prevalent among the misdiagnosis of rumination is confusing to me... it sounds like you're saying a disease is incorrectly diagnosed as rumination, when in fact it should be BN or GP, but I think you probably mean the opposite.
Finally I would also condense the intro substantially, but that's just my personal stylistic preference. Kudos and keep up the good work. - Draeco (talk) 06:19, 14 September 2009 (UTC)

Thanks for the suggestions. A few of them I'm torn on because different editors are telling me the opposite, not to use studies from the late 90's when the 2007 review can be used. Never thought of the whole barretts esophagus thing... Good idea. Thank you - ʄɭoʏɗiaɲ τ ¢ 15:36, 14 September 2009 (UTC)
I haven't read through the whole talk page to see if it's been discussed, but have you considered changing the In other animals heading to something shorter?  Not exactly sure what you'd do here, but it just sounds sort of awkward.  Strombollii (talk) 15:33, 1 October 2009 (UTC)

Agreed. In Animals sounds much better, but In other animals is the heading given at WP:MEDMOS - ʄɭoʏɗiaɲ τ ¢ 15:55, 1 October 2009 (UTC)

If anyone is able to retrieve the full text to Rumination documented by using combined multichannel intraluminal impedance and manometry, I have a feeling it may contain a diagram, or information useful in drawing a diagram of the actual regurgitation process. - ʄɭoʏɗiaɲ τ ¢ 09:01, 13 September 2009 (UTC)

What's the PMID? Strombollii (talk) 21:09, 13 September 2009 (UTC)
Wait, wait. Nevermind. Will look later. Strombollii (talk) 21:13, 13 September 2009 (UTC)
Sorry, meant to link directly to the pubmed entry. It's fixed. - ʄɭoʏɗiaɲ τ ¢ 21:22, 13 September 2009 (UTC)
Haha yeah, I had found it.  But it's a journal that I don't have access to here at school.  Sorry.  Strombollii (talk) 23:17, 13 September 2009 (UTC)

I've gone over all the citations to bring them closer to what WP:MEDMOS#Citing medical sources calls for. Now they are rid of the redundant accessdates on journals, most have linked finding aids (pmid, doi, issn, etc) although this still needs more work. I'll invoke citation bot and see what develops next. LeadSongDog come howl 19:35, 30 September 2009 (UTC)

Please keep the first names and full page numbers. There are a few doctors that are related in family, and share last names. The full numbers for pages aren't forbidden by medmos. Lastly, the spacing after the "{{citation" line helps keep the references clear cut from the text. It doesn't effect the appearance of the article so I'd appreciate them being kept in place. I made the edits to restore these but kept the other changes you made. - ʄɭoʏɗiaɲ τ ¢ 20:19, 30 September 2009 (UTC)
First names are normally not used on medical articles. I would only use them where there are two authors with the same lastname and initial. The contracted page numbers are also normal. See WP:MEDMOS#Citing medical sources. It's all based on the Uniform Requirements for Manuscripts Submitted to Biomedical Journals, which are reflected in virtually all relevant journals and bibliographic indices, particularly Pubmed.LeadSongDog come howl 20:23, 30 September 2009 (UTC)
The medmos only provides a single example that happens to use that, but doesn't address the issue. While consistency is certainly my main focus, including as much information as possible is my second, and appealing to Joe "the moron" Public is third. It really comes down to a somewhat unwritten guideline, so can they be left for now? - ʄɭoʏɗiaɲ τ ¢ 21:32, 30 September 2009 (UTC)
You may find this to be more complete. If you want to get it to FA status, have a look at Category:FA-Class medicine articles, paying particular attention to ones that recently were promoted. Cheers.LeadSongDog come howl 22:13, 30 September 2009 (UTC)

I find it easy to accidentally bring up recently swallowed icecream, would that be an example of regurgitation or more likely just incomplete swallowing? (I suspect I have a hiatal hernia)
Also, is there a term for being able to easily inhale air into the stomach (not just swallowing air)?  —Preceding unsigned comment added by 75.73.70.113 (talk) 02:14, 9 February 2011 (UTC) 
Those tend to be disorders of the glottis or cardia, the two sphincters in the esophagus which keep food in the stomach and cause the urge to burp. Usually those who can bring stuff up have some conscious degree of control over both. I'd be surprised if you couldn't do it with other liquids if your tried.
I have no idea if there is a medical term for this, but those sphincters are where you'd want to start your research. - ʄɭoʏɗiaɲ τ ¢ 22:50, 4 March 2011 (UTC)

Hi there - can I ask if there is a reason why there is no differential or discussion on how this disease compares to, and differs from, Achalasia. Just to give you a quick quote (from Wikipedia): "Achalasia is characterized by difficulty swallowing, regurgitation, and sometimes chest pain." and further "The main symptoms of achalasia are dysphagia (difficulty in swallowing), regurgitation of undigested food, chest pain behind the sternum, and weight loss."  — Preceding unsigned comment added by 190.2.142.226 (talk) 18:42, 30 January 2013 (UTC) 

Seems confusion here... Lesion 10:22, 10 April 2014 (UTC)

The vomit is odourless, but halitosis is a common result of everything. - Floydian τ ¢ 13:43, 10 April 2014 (UTC)
Ah, thanks for that clarification. Maybe the halitosis is the result of increased bacterial activity in the retentive surface created by (o)esophageal erosions... Lesion 14:34, 10 April 2014 (UTC)
I'm totally not qualified medically to know (I only wrote this article because my s.o. at the time was afflicted by it, only to be told again and again by pompous non-curious doctors that she was doing it to herself; regardless she didn't have any halitosis)... but I'd hazard to guess that it's either destroying helpful bacteria or regurgitating odour-causing bacteria. - Floydian τ ¢ 22:08, 10 April 2014 (UTC)

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