<prompt> Answer this question truthfullyWhat does the term rumination disorder mean?  <response>: <reason> Rumination syndrome should be differentiated from other diseases that cause chronic nausea and vomiting. The differentials include the following: Disorder Clinical features Laboratory findings Chronic nausea Vomiting Diarrhea Retching Lethargy Social withdrawal Photophobia Epigastric painburning Lanugo hair Hypogonadism Russels sign Body mass index normal range: 18.5 to 24.9 Complete blood count CBC Electrolyte imabalance Lipase and amylase levels Gastric scintigraphy Ambulatory esophageal pH and impedance testing Gastroparesis within 1 hour of eating - - - - - - Anemia Normal maybe elevated if chronic renal failure is the cause of gastroparesis- usually less than threefold Periodic measurement of radiolabeled solid meal: Grade 1 mild, 11-20 retention at 4 h Grade 2 moderate, 21-35 retention at 4 h Grade 3 severe, 36-50 retention at 4 h Grade 4 very severe, 50 retention at 4 h Impedance testing antroduodenal manometery: Loss of normal fasting migratory motor complexes MMCs and reduced postprandial antral contractions and, in some cases pylorospasm Anorexia nervosa - - - - Leukocytosis, anemia Increased Gastric emptying may be delayed but may become normal as feeding recommences short lived Esophageal pH: May be decreased if patient develops gastroesophageal reflux disease Bulimia nervosa - - - Normal Leukocytosis, anemia Increased Gastric emptying delayed for a longer duration as compared to anorexia nervosa Esophageal pH: May be decreased if patient develops gastroesophageal reflux disease Rumination syndrome Regurgitation more common- within minutes of meal intake - - - - Normal Normal Delayed gastric emptying Esophageal pH: Fall in esophageal pH immediately after reguritation occurs while patient is awake and erect; this is in contrast to GERD, where reflux occurs diurnally and supine position Impedance testing: Increased intra- abdominal pressure leading to regurgitation of gastric contents Tall R waves Functional dyspepsia - - - - - - - Normal Normal Increased especially lipase Delayed gastric emptying Esophageal pH: May be decreased if patient develops reflux Cyclic vomiting syndrome - - - - - - - Leukocytosis, anemia Increased alongwith increased lactic acid - in cases of concomitant mitochondrial disease Rapid or normal Esophageal pH: Decreased Pancreatitis - - - - - Normal Leukocytosis Increased Not indicated Esophageal pH: Normal Gastric outlet obstruction within 1 hour of eating - - - - - - - - Leukocytosis Increased in cases of pancreatic disease Delayed gastric emptying Esophageal pH: Increased Esophageal manometery: High manoraetric score 