A Clinical Case Study of Rumination and Emesis in an Adult Male with Intellectual Disability

• Main Author: DeLapp, Christina M.
• Other Authors: Smith, Richard G. (Richard Gordon), 1956-
• Format: Others
• Language: English
• Published: University of North Texas 2016
• Subjects: rumination; emesis; G/J tube; fluid analysis; behavioral psychology; Merycism > Treatment.; Enteral feeding.; Vomiting > Treatment.
• Online Access: https://digital.library.unt.edu/ark:/67531/metadc849785/

An evaluation of a series of interventions was conducted for an individual who engaged in life-threatening rumination and emesis. There is substantial research indicating that the delivery of peanut butter (Barton & Barton, 1985; Greene, Johnston, Rossi, Racal, Winston, & Barron, 1991) and/or chopped bread following meals (Thibadeau, Blew, Reedy, & Luiselli, 1999), chewing gum (Rhine & Tarbox, 2009), and satiation procedures (Dudley, Johnston, & Barnes, 2002; Lyons, Rue, Luiselli, & DiGennario, 2007; Rast, Johnston, Drum, & Conrin, 1981) can be effective treatments for rumination. In the current case, each of these interventions was found to be either ineffective or contraindicated based on the participant's fragile health status. Previous literature has shown that liquid delivery can affect rates of rumination in some clients (Barton & Barton, 1985,; Heering, Wilder, & Ladd, 2003). We examined how liquid affected the rate of rumination during and after meals. Based on the individual's medical condition, oral nutrition and fluids were discontinued indefinitely and a gastronomy-jejunostomy tube was used for nutrition. All rumination ceased when fluids and nutrition were delivered via the jejunostomy tube. Finally, a fluid analysis procedure was implemented in which the participant received small amounts of fluid while NPO. Color and flavor were manipulated systematically, and results suggested that flavor impacted the rate of rumination.