婴幼儿功能性胃肠病

G2. Rumination Syndrome反刍综合征

Rumination is the habitual regurgitation of stomach contents into the mouth for the purpose of self-stimulation.Rumination has the following clinical presentations: infant rumination syndrome, rumination in neurologically impaired children and adults, and rumination in healthy older children and adults.反刍是指胃内容物习惯性的反流入口腔，以达到自

我消解的目的。除了婴幼儿反刍综合征，健康或神经系统受损的年长儿和成人均可发生反刍。

G2.Diagnostic Criteria for Rumination Syndrome反刍综合症的诊断标准Must include all of the following for at least 2 months:

必须满足以下所有条件，症状持续至少 2 个月：

1. Repetitive contractions of the abdominal muscles,diaphragm, and tongue腹肌、膈肌和舌肌的反复收缩。

2. Effortless regurgitation of gastric contents, which are either expelled from the mouth or rechewed and reswallowed

胃内容物不费力反流，再从口腔吐出或者重新咀嚼后再次咽下

3. Three or more of the following:满足以下3 项或以上：

a. Onset between 3 and 8 months发病年龄为3～8 月龄

b. Does not respond to management for gastroesophageal reflux disease and regurgitation按GERD 和反流治疗均无效；

c. Unaccompanied by signs of distress不伴有痛苦的表情

d. Does not occur during sleep and when the infant is interacting with individuals in the environment睡眠时或与周围其他人交流时不发作

Clinical evaluation. 临床评价：

Infant rumination syndrome is rare, and has received little attention in the literature. A recent questionnaire based study of 1447 mothers showed a prevalence of 1.9%. 婴幼儿反刍综合征比较少见，并且很少有文献报道。最近一项由1447 名母亲参与研究的调查问卷表明其患病率为 1.9%。Rumination historically has been considered a self-stimulatory behavior that arises in the context of longstanding social deprivation. In the limited published literature, maternal behavior may appear to be neglectful or slavishly attentive, but there is no enjoyment in holding the baby or sensitivity to the infant’s needs for comfort and satisfaction.反刍被认为是一种在长期得不到关怀情况下出现自我安慰的行为。母亲可能表现为忽视或盲目关注，她们在照顾孩子的过程中缺乏乐趣或对于婴幼儿对舒适和满意的要求缺乏敏感性。Observing the ruminative act is essential for diagnosis.However, such observations require time, patience, and stealth because rumination can cease as soon as the infant notices the observer. No tests are necessary for the diagnosis of infant rumination syndrome.观察反刍动作是诊断所必需的，但需要有足够的时间、耐心和隐蔽性，因为一旦婴幼儿发现有人在观察他时会立即停止反刍动作。婴幼儿反刍综合征的诊断不需要实验室检查。

Treatment. 治疗

Historically, infant rumination syndrome responded to empathetic and

responsive nurturing.Excessive and continuous loss of previously swallowed food may cause progressive malnutrition. Behavioral therapy is useful in eliminating rumination in highly motivated adults or children with neurologic impairment. 从历史上看，婴儿反刍综合症对充满感情的和有交流的养育方式有反应。过度或持续地呕吐之前已经吞咽的食物可引起进行性的营养不良。行为疗法有助于消除高积极性的成年人或患有神经障碍的儿童的反刍。There is no information on whether those techniques are useful in infant rumination syndrome. The most humane, developmentally appropriate, and comprehensive management aims at reversing the baby’s weight loss by eliminating its need for ruminative behavior. Treatment aims at helping the caregivers address their feelings toward the infant and to improve their ability to recognize and respond to the infant’s physical and emotional needs.目前还没有关于这些技术是否对婴儿反刍综合症有用的信息。最人道、最适宜发育和最全面的管理，旨在通过消除婴儿的反刍行为的需要来扭转其体重减轻。治疗的目的是帮助监护人员处理他们对婴儿的感觉，并提高他们的能力，认识和回应婴儿的生理和情感需求。