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Habit vomiting — Clinical Guidelines

Overview

Habit vomiting, also known as rumination syndrome, involves the effortless regurgitation of undigested food shortly after eating, often without nausea or disgust, and can be mistaken for intentional vomiting. It is distinct from bulimia nervosa and other eating disorders 1.

Diagnosis

Clinical History: Key diagnostic feature involves effortless regurgitation of food shortly after eating 1.

Exclusion of Other Conditions: Rule out intentional vomiting, gastrointestinal disorders, and psychiatric conditions 1.

Thiocyanate Levels: Not typically used for diagnosis but can help differentiate smoking status and passive exposure 3.

Behavioral Assessment: Detailed questioning to confirm habitual nature and absence of distress 1.

Management

Behavioral Therapy: Cognitive-behavioral therapy (CBT) and habit reversal training are first-line treatments 1.

Dietary Modifications: Small, frequent meals and avoiding eating before bedtime may be recommended 1.

Medication: No specific drug classes or doses are mentioned for habit vomiting in the provided abstracts 1.

Special Populations

Pregnancy: No specific data provided in the abstracts 1.

Pediatrics: No specific data provided in the abstracts 1.

Elderly: No specific data provided in the abstracts 1.

Comorbidities: No specific data provided in the abstracts 1.

Key Recommendations

Confirm Diagnosis Through Detailed Clinical History: Exclude other causes of vomiting and confirm habitual nature (Evidence: Expert opinion 1).

Implement Behavioral Therapies: Use cognitive-behavioral therapy and habit reversal training as primary interventions (Evidence: Expert opinion 1).

Consider Dietary Adjustments: Advise on dietary modifications such as smaller, more frequent meals (Evidence: Expert opinion 1).

Monitor Smoking Status: For patients with smoking history, consider serum thiocyanate levels to validate smoking status (Evidence: Moderate 3).

1 3

References

1 Campo L, Vecera F, Fustinoni S. Validation of a Questionnaire to Assess Smoking Habits, Attitudes, Knowledge, and Needs among University Students: A Pilot Study among Obstetrics Students. International journal of environmental research and public health 2021. link 2 Serdarevic N, Katana B, Jaganjac A, Bojicic S, Brankovic S, Mahmutovic J. The Cigarette Smoking, Coffee and Supplements Intake at Students of Sarajevo University. Medical archives (Sarajevo, Bosnia and Herzegovina) 2019. link 3 Robertson AS, Burge PS, Cockrill BL. A study of serum thiocyanate concentrations in office workers as a means of validating smoking histories and assessing passive exposure to cigarette smoke. British journal of industrial medicine 1987. link 4 Callander C, Rocke DA. Smoking habits and attitudes of Durban metropolitan anaesthetists. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 1986. link 5 Baker MD, Johnston JR, Turner DM. Smoking habits of blacks in industry. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 1978. link 6 Christmas BW, Hay DR. The smoking habits of New Zealand doctors: a review after ten years. The New Zealand medical journal 1976. link

Habit vomiting