JS Khoo, D Yang et al. J Pediatr Gastroenterol Nutr. 2026;83:251–257. The rumination severity index: Development and evaluation of a scoring tool for rumination syndrome

Methods: 66 children with rumination syndrome (RS) completed the 7-item RumSI and PedsQL questionnaires between 2018 and 2023.

RumSI Scoring: Skipped meals, weight loss due to vomiting, and use of a feeding tube or parenteral nutrition were each dichotomized, with absence of the symptom assigned a score of zero for each item and presence of the symptom assigned a score of 1.5σ = 4, where σ is the standard deviation of the combined vomiting/re-swallowing score. Both skipped days of school and social activities in the past 60 days were grouped into categories of 0, 1–4, 5–9, 10–19, 20–39, and 40–60 and assigned integer values of zero to five. The overall RumSI score was calculated by summing the six individual components (vomiting/re-swallowing, skipped meals, weight loss, use of feeding tube or parenteral nutrition, skipped days of school, and skipped days of sports/social activities).

Key Findings:

• RumSI scores ranged from 0 to 26.5 (mean 10.6 ± 7.2) out of a total possible 28, with higher scores indicating worse rumination symptoms
• RumSI and PedsQL scores were significantly negatively correlated (r = −0.45, p < 0.001), with every 1-point increase in RumSI score associated with a 1.3-point decrease in PedsQL total score
• Higher RumSI scores were associated with co-morbid conditions including depression, functional dyspepsia, functional nausea/vomiting, gastroparesis, and postural orthostatic tachycardia syndrome

My take: Currently, the RumSI score would be cumbersome in clinical practice (in the absence of an embedded calculator). However, the questions on the RumSI are very useful and I already made a smartphrase to help capture this information on patients with suspected rumination. Also, the RumSI should be useful for research studies by offering a common scoring system to define and track disease burden.

Related blog posts:

• Impact of Testing (or No Testing) for Rumination Syndrome Outcomes
• Potential Bias with Interpreting Rumination Outcomes
• Potential Bias with Interpreting Rumination Outcomes
• Most Kids with Rumination Respond to Specialized Treatment
• Internet Survey: Lots of People Have Rumination
• Expert Advice for Diagnosis and Treatment of Rumination Syndrome
• High-resolution Esophageal Manometry for Rumination Syndrome.
• Costs of Rumination (You don’t have to be Vinny Gambini to make the diagnosis)
• Jose Garza: What’s New in Motility (Part 2)
• Jose Garza: What’s New in Motility (Part 1)