Delay in diagnosis is associated with decreased treatment effectiveness in children with rumination syndrome.

Jia, Margaret R.; Lu, Peter L.; Khoo, Janice S.; Sabella, Julia; Yang, Dennis M.; Puri, Neetu B.; Vaz, Karla; Yacob, Desale; Di Lorenzo, Carlo; Kroon Van Diest, Ashley M.

Objectives: Rumination syndrome (RS) is challenging to diagnose, which can lead to diagnostic delays. Our objective was to evaluate the length of time from RS symptom onset to diagnosis in patients referred to our institution and to examine whether this duration predicts treatment outcomes. Methods: We conducted a review of patients with RS evaluated at our institution. Data were collected from chart review and patient/family reported questionnaires. We evaluated the time from symptom onset to diagnosis over time and whether it was associated with symptom resolution. Results: We included 247 patients with RS (60% female, median age of 14 years, interquartile range [IQR]: 9–16 years). The median age at symptom onset was 11 years (IQR: 5–14 years) and median age at diagnosis was 13 years (IQR: 9–15 years) for a median duration of 1 year (IQR: 0–3 years) between symptom onset and diagnosis. Length of time between symptom onset and diagnosis did not change significantly at our institution from 2016 to 2022. Among the 164 children with outcome data, 47 (29%) met criteria for symptom resolution after treatment. A longer time to diagnosis was associated with a lower likelihood of symptom resolution after treatment (p = 0.01). Conclusion: In our experience, the time to RS diagnosis after symptom onset is shorter than previously described. A longer delay in diagnosis is associated with lower likelihood of symptom resolution after treatment, emphasizing the importance of a prompt recognition of rumination symptoms and a timely diagnosis. What is Known: Rumination syndrome can be challenging to diagnose, due to overlapping features with more common disorders, which often leads to a delay in diagnosis.Data on the length of time between symptom onset and diagnosis are limited, especially in pediatric populations. Previous studies showed an average number of years to diagnosis of 8 years in adults and 2–3 years in children and adolescents. What is New: Our institution's experience shows a shorter length of time to diagnosis than was previously reported.We found that patients who experience a longer delay in diagnosis are less likely to have symptom resolution after treatment.

PEDIATRICS; RUMINATION (Digestion); MERYCISM; ADOLESCENCE; CHILDREN

Journal of Pediatric Gastroenterology & Nutrition, 2024, Vol 79, Issue 4, p850

0277-2116

Academic Journal

10.1002/jpn3.12345