instruction: hello doctor I am a teen and I believe I have ruination syndrome as 10 minutes after every meal I regurgitate the food I eat but it is not digested and tastes like the food I recently ate I often chew the food again and swallow but it is quite annoying and it happens for about 20 minutes before going away it started several years ago but I brushed it off thinking it was nothing what should I do and is there any treatment
output: hello I can understand you must be upset about your condition lasting so long you well described the symptoms and timings which are very important in your case the symptoms you mention can present for many years harmlessly and at the time this accompanies other eating disorders such as bulimia nervosa excessive eating and anorexia nervosa excessive fasting I want to hear from you do you have certain symptoms suggestive those disorders as well ruination is a functional disorder and it can resolve with time on its own but the one recommended therapy is diaphragmatic breathing you can learn how to perform this at home by watching some videos available on youtube secondly you can start the tablet ondansetron my thrice daily this medication will improve gastric accommodation to prevent the reflux of contents the diagnosis of ruination can be confirmed with gastroesophageal manometry with impedance which is a test to measure the change in pressure across the stomach and esophagus while you do this ruination this test is sometimes important because there are certain mickers which present in the same way but have a completely different approach I hope this helps ruination motility disorder of esophagus gastroesophageal manometry with impedance esophageal motility disorder ruination syndrome diaphragmatic breathing tablet ondansetron my thrice daily half an hour before meals follow up to provide more information to decide whether a gastroesophageal manometry is required at the moment