Rumination syndrome, or merycism, is a chronic motility disorder characterized by effortless regurgitation of most meals following consumption, due to the involuntary contraction of the muscles around the abdomen. There is no retching, nausea, heartburn, odour, or abdominal pain associated with the regurgitation, as there is with typical vomiting, and the regurgitated food is undigested. The disorder has been historically documented as affecting only infants, young children, and people with cognitive disabilities (the prevalence is as high as 10% in institutionalized patients with various mental disabilities). It is increasingly being diagnosed in a greater number of otherwise healthy adolescents and adults, though there is a lack of awareness of the condition by doctors, patients and the general public. Rumination syndrome presents itself in a variety of ways, with especially high contrast existing between the presentation of the typical adult patient without a mental disability and the presentation of an adult with a mental disability. Like related gastrointestinal disorders, rumination can adversely affect normal functioning and the social lives of individuals. It has been linked with depression. Little comprehensive data regarding rumination syndrome in otherwise healthy individuals exists because most people are private about their illness and are often misdiagnosed due to the number of symptoms and the clinical similarities between rumination syndrome and other disorders of the stomach and esophagus, such as gastroparesis and bulimia nervosa. These symptoms include the acid-induced erosion of the esophagus and enamel, halitosis, malnutrition, severe weight loss and an unquenchable appetite.
Chemistry
Nafarelin is a GnRH analogue, or a synthetic analogue of GnRH. It is a decapeptide and is also known as [6-D-(2-naphthyl)alanine]-GnRH. Nafarelin is marketed for medical use in both its free base (nafarelin) and acetate salt (nafarelin acetate) forms. History
Nafarelin was introduced for medical use in 1990. Society and culture
Generic names
Nafarelin is the generic name of the drug and its INN and BAN, while nafaréline is its DCF and nafarelin acetate is its USAN, BANM, and JAN. It is also known by its former developmental code name RS-94991 or RS-94991-298. Brand names
The major brand names of nafarelin are Synarel and Synarela. It has also been marketed under a number of other brand names including Synrelin, Synrelina, Nafarelil 0.2%, and Nasanyl 0.2%. Availability
Nafarelin is available widely throughout the world, including in the United States, Canada, the United Kingdom, Ireland, other European countries, Australia, Israel, Argentina, Brazil, Mexico, and Japan. See also
Gonadotropin-releasing hormone receptor § Agonists

References
Further reading
Barbieri RL (February 1990). "Comparison of the pharmacology of nafarelin and danazol". Am. J. Obstet. Gynecol. 162 (2): 581–5. doi:10.1016/0002-9378(90)90436-B. PMID 2137975. Chrisp P, Goa KL (April 1990). "Nafarelin. A review of its pharmacodynamic and pharmacokinetic properties, and clinical potential in sex hormone-related conditions". Drugs. 39 (4): 523–51. doi:10.2165/00003495-199039040-00005. PMID 2140979. Burry KA (February 1992). "Nafarelin in the management of endometriosis: quality of life assessment". Am. J. Obstet. Gynecol. 166 (2): 735–9. doi:10.1016/0002-9378(92)91705-F. PMID 1531576. Minaguchi H, Wong JM, Snabes MC (June 2000). "Clinical use of nafarelin in the treatment of leiomyomas. A review of the literature". J Reprod Med.