Psych CASC / OSCE · General adult psychiatry — feeding and eating disorders
Explain rumination disorder and diaphragmatic breathing to a patient — CASC communication station
MRCPsych/FRANZCP-style communication station: explain rumination mechanism, discrimination from BN/GORD, breathing training, baclofen as possible later adjunct, and safety-netting.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 28-year-old referred from gastroenterology after normal endoscopy and failed PPIs wants a clear explanation of why food 'comes back up,' how this differs from bulimia and from reflux, what diaphragmatic breathing involves, whether a tablet will fix it, and when to seek urgent care if weight falls.
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in a liaison / eating disorders clinic. [5]
Candidate instructions. Explain rumination disorder in plain language, how it differs from reflux and from bulimia nervosa, teach the rationale for diaphragmatic breathing, give a balanced answer on medication, and safety-net. Check understanding and invite questions. The examiner plays the patient. [1][2]
References5ShowHide
- [1]Halland M, Pandolfino J, Barba E Diagnosis and Treatment of Rumination Syndrome Clin Gastroenterol Hepatol, 2018.PMID 29902642
- [2]Halland M, Parthasarathy G, Bharucha AE, Katzka DA Diaphragmatic breathing for rumination syndrome: efficacy and mechanisms of action Neurogastroenterol Motil, 2016.PMID 26661735
- [3]Pauwels A, Broers C, Van Houtte B, et al. A Randomized Double-Blind, Placebo-Controlled, Cross-Over Study Using Baclofen in the Treatment of Rumination Syndrome Am J Gastroenterol, 2018.PMID 29206813
- [4]Barba E, Accarino A, Soldevilla A, Malagelada JR, Azpiroz F Randomized, Placebo-Controlled Trial of Biofeedback for the Treatment of Rumination Am J Gastroenterol, 2016.PMID 27185077
- [5]Crone C, Fochtmann LJ, Attia E, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Eating Disorders Am J Psychiatry, 2023.PMID 36722117