Outcomes of Treating Rumination Syndrome with a Tricyclic Antidepressant and Diaphragmatic Breathing.
Diaphragmatic breathing
Rumination syndrome
Tricyclic antidepressant
Journal
The American journal of the medical sciences
ISSN: 1538-2990
Titre abrégé: Am J Med Sci
Pays: United States
ID NLM: 0370506
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
07
01
2020
revised:
27
02
2020
accepted:
01
04
2020
pubmed:
10
5
2020
medline:
3
10
2020
entrez:
9
5
2020
Statut:
ppublish
Résumé
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless postprandial regurgitation and accompanied by gastric visceral hypersensitivity. Almost invariably, the onset of symptoms is preceded by a psychologically stressful situation, and anxiety is often an accompanying complaint. In this background of gastric visceral hypersensitivity, anxiety and psychological stress, we investigated the effectiveness of combining a tricyclic antidepressant (TCA) with diaphragmatic breathing/relaxation techniques for the treatment of rumination syndrome. Patients who fulfilled the Rome IV criteria for rumination syndrome received hands-on instructions and/or coaching on diaphragmatic breathing techniques, were given relaxing auditory media, started on a TCA, and completed a follow-up symptoms questionnaire after undergoing a minimum of 3 months of this therapy. A total of 44 patients, 35 women; mean age 40.4 (range 20-71) were identified. Mean time from onset of symptoms to diagnosis was 36.0 months (range 6-180). Weight loss ranged from 1.4 to 39.5 kg. Approximately 65.9% had a history of anxiety and/or depression, and a separate 65.9% reported the onset of symptoms were chronologically related to an inciting event and/or psychological stressor. After a mean follow-up period of 8.8 months, 90.9% of patients reported improvement in their symptoms, with a mean subjective improvement from baseline of 68.9%, and specifically, 45.5% of patients reported ≥80% improvement. Weight increased or stabilized in 80.6% of those initially reporting weight loss. The combination of a TCA with diaphragmatic breathing/relaxation techniques is an effective treatment modality for the management of rumination syndrome as it addresses the underlying factors identified in this entity.
Sections du résumé
BACKGROUND
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless postprandial regurgitation and accompanied by gastric visceral hypersensitivity. Almost invariably, the onset of symptoms is preceded by a psychologically stressful situation, and anxiety is often an accompanying complaint. In this background of gastric visceral hypersensitivity, anxiety and psychological stress, we investigated the effectiveness of combining a tricyclic antidepressant (TCA) with diaphragmatic breathing/relaxation techniques for the treatment of rumination syndrome.
MATERIALS AND METHODS
Patients who fulfilled the Rome IV criteria for rumination syndrome received hands-on instructions and/or coaching on diaphragmatic breathing techniques, were given relaxing auditory media, started on a TCA, and completed a follow-up symptoms questionnaire after undergoing a minimum of 3 months of this therapy.
RESULTS
A total of 44 patients, 35 women; mean age 40.4 (range 20-71) were identified. Mean time from onset of symptoms to diagnosis was 36.0 months (range 6-180). Weight loss ranged from 1.4 to 39.5 kg. Approximately 65.9% had a history of anxiety and/or depression, and a separate 65.9% reported the onset of symptoms were chronologically related to an inciting event and/or psychological stressor. After a mean follow-up period of 8.8 months, 90.9% of patients reported improvement in their symptoms, with a mean subjective improvement from baseline of 68.9%, and specifically, 45.5% of patients reported ≥80% improvement. Weight increased or stabilized in 80.6% of those initially reporting weight loss.
CONCLUSIONS
The combination of a TCA with diaphragmatic breathing/relaxation techniques is an effective treatment modality for the management of rumination syndrome as it addresses the underlying factors identified in this entity.
Identifiants
pubmed: 32381269
pii: S0002-9629(20)30120-8
doi: 10.1016/j.amjms.2020.04.003
pii:
doi:
Substances chimiques
Antidepressive Agents, Tricyclic
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
42-49Informations de copyright
Copyright © 2020. Published by Elsevier Inc.