Rumination management plan
Why does it happen?
The exact cause of rumination syndrome is still unknown. We do know that rumination is something you don't consciously choose to do.
It can sometimes begin with a 'trigger' which can make your gut very sensitive. This trigger might have been an illness you had, some bad news you may have had, or a big change in your life that might have caused you some stress.
Due to this 'trigger', your stomach muscles have learned to contract (squeeze) and cause some pressure which pushes the food/or liquid back up the food pipe (your oesophagus).
Even though the trigger event might be over, this reflex still stays like a learned habit.
My rumination management plan
There are 4 parts to help you manage your rumination these are:
- Part 1. Psychoeducation & Self-monitoring
- Part 2. Diaphragmatic breathing to prevent rumination from happening
- Part 3. Strategies to managing your urges and triggers to ruminate
- Part 4. Your plan to prevent rumination in the future
Tips for parents to help young people with rumination
Parents of young people with pain or physical symptoms often express how helpless they feel and how they wish there was something they could do to help their child, manage symptoms. Well research shows that there are a number of things parents can do to help!
1. Research shows that with time and helping your child engage in the strategies outlined above e.g. diaphragmatic breathing, physical activity that rumination will resolve. Many children with these problems do extremely well and have full, productive and happy lives.
2. We know that if parents pay attention to the rumination/vomiting that it can keep the symptoms going for longer. Instead, try to give your child attention when engaged in physical activity or talk to your child and see what fun activities you could do together.
3. Please know that it is okay and even preferable not to regularly ask your child about their pain/symptoms. Symptoms tend to worsen when children attend to it and improves when they are distracted from it.
4. Many families hold the idea that the treatment process will first involve resolution of the child’s symptoms and, second, resumption of normal activities. However from working with other children with these symptom e.g. pain, nausea, vomiting we know that these symptoms typically resolve only after the child has been engaging in her normal activities for some period of time.
5. Interventions that stabilize sleep are powerful because the circadian clock regulates all the components of the stress system, increases the child’s capacity to self-regulate. Talk to your child about leaving their phone downstairs or turned off at bedtime. A screen free, dark, cool room is best when helping your child to get a good night sleep.
6. Similarly, eating a healthy breakfast, lunch and dinner and two small snacks daily, helps regulate your child’s digestive system and prevents them getting overly hungry/stressed.
7. Talk to your child’s Year Head in school, let them know that your child has rumination syndrome and that they may need to use the bathroom more often. Check in to see how your child is getting on socially and academically. Is your child experiencing other stressors that can be resolved?
8. Listen to your child’s voice. Give them the choice as to which strategies to manage their pain they enjoy and therefore wants to prioritize. Creating a sense of ownership over the treatment programme helps your child to engage and gives them a sense of mastery and control.
9. Take time to self-care. It is stressful and worrying when your child is in pain or experiencing physical symptoms. Take time to do something you like, this can help to recharge your own batteries. Model to your child how you manage stress.
10. Use the supports available to you, your partner, a grandparent or your child’s favourite aunt, remember you are not alone when trying to support your child.