title: A personalized systems medicine approach to refractory rumination.
abstract: OBJECTIVE
  As with many functional disorders, rumination syndrome poses a great dilemma when approached via standard of care. This case report illustrates how rumination syndrome may be effectively approached using the systems medicine.
  
  
  METHODS
  The patient's treatment involved two distinctively different treatment cycles. Initially she was treated in an academic tertiary inpatient and outpatient multidisciplinary program with a primary symptom-based focus with little improvement. She subsequently sought care at a systems-based integrative medicine clinic within an academic family medicine centre, which identified the inciting events, diagnosed the current pathology and developed a stepwise treatment plan.
  
  
  RESULTS
  The patient is now rumination free.
  
  
  CONCLUSIONS
  Chronic or refractory diseases, especially when regarded as 'functional' may be approached by a systems medicine methodology, which allows physicians to fine-tune the vast amount of specific pieces of knowledge to achieve an integrated approach to managing the whole person.
authors.affiliation: Department of Family Medicine, Center for Integrative Medicine, Ohio State University Medical Center, Columbus, Ohio 43221, USA. anup.kanodia@osumc.edu
authors.forename: Anup K
authors.initials: AK
authors.lastname: Kanodia
authors.forename: Inah
authors.initials: I
authors.lastname: Kim
authors.forename: Joachim P
authors.initials: JP
authors.lastname: Sturmberg
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003109:Colonic Diseases, Functional / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D004035:Diet Therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D057285:Precision Medicine / Q000379:methods*; D049490:Systems Biology
chemical_list: D005765:Gastrointestinal Agents