The aims of this study were to investigate thediagnostic studies necessary to identify ruminationsyndrome and the long-term therapeutic outcomes ofpatients with rumination syndrome. Sixteen patients with rumination were evaluated between 1989 and1995. Esophageal motility, gastric emptying, uppergastrointestinal motility, and electrogastrography ofall patients were reviewed; follow-up information about their current status was available from10 of the 16 patients. Duration of symptoms was 77.2months and the mean age was 28.5 years at the time ofdiagnosis. Esophageal and upper gastrointestinal motility, gastric emptying, andelectrogastrographic studies were all normal. Mean loweresophageal pressure was 12.7 mm Hg and three of the 16patients had a decreased pressure of less than 6 mm Hg.Ten patients were followed for a mean duration of31.2 months. Five of 10 patients used biofeedback andrelaxation techniques and reported subjectiveimprovement. Our results indicate that ruminationsyndrome is often confused with a gastric motilitydisorder and diagnosis is possible if one is aware ofthis condition. Although there is not a definitivemanagement protocol for this condition, reassurance and education of the patient and the family arecrucial first steps followed by behavioral andrelaxation programs.