Multidisciplinary behavioral therapy reduces rumination.
behavioral therapy
functional gastrointestinal disorders
gut‐brain interaction disorders
rumination syndrome
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
20 Sep 2024
20 Sep 2024
Historique:
revised:
04
08
2024
received:
04
06
2024
accepted:
10
09
2024
medline:
20
9
2024
pubmed:
20
9
2024
entrez:
20
9
2024
Statut:
aheadofprint
Résumé
Behavioral therapy has proved effective as rumination therapy. Our objective was to treat rumination patients using multidisciplinary behavioral therapy aimed at reducing ≥2 of the rumination score. All patients fulfilled Rome IV criteria for rumination and were referred to speech therapy for psychoeducation, diaphragmatic breathing exercises and guided eating, physiotherapy for exercises to relax the thoracic and abdominal muscles, and consultation with the psychologist and the dietitian. Symptoms, depression, anxiety, health-related quality of life (HRQoL), and functional capacity were evaluated by questionnaires (Rome IV, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), 15D, and World Health Organization Disability Assessment Schedule (WHODAS) 2.0) at baseline and at 6-month control. Esophageal manometry was performed at 6-month control. The study enrolled 11 patients (19-64 years, 10 female). Rumination score: 6.5 (5-8) at baseline, 4.0 (3-5) at the 6-month control, p = 0.005. BDI/8 (6-13), BAI/15 (8-29) at baseline; BDI/7 (4-8), BAI/15 (7-27) at the 6-month control, NS. 15D score: 0.800 at baseline, 0.845 at the 6-month control, NS. WHODAS 2.0 score: 15 (7-33) at baseline, 11 (7-26) at the 6-month control, NS. Rumination could be evoked in manometry in six of nine (67%) patients at 6-month control. Behavioral multidisciplinary therapy significantly reduces the self-assessed frequency of rumination. These patients have more depression, anxiety and a lower HRQoL compared to the normal population.
Sections du résumé
BACKGROUND
BACKGROUND
Behavioral therapy has proved effective as rumination therapy. Our objective was to treat rumination patients using multidisciplinary behavioral therapy aimed at reducing ≥2 of the rumination score.
METHODS
METHODS
All patients fulfilled Rome IV criteria for rumination and were referred to speech therapy for psychoeducation, diaphragmatic breathing exercises and guided eating, physiotherapy for exercises to relax the thoracic and abdominal muscles, and consultation with the psychologist and the dietitian. Symptoms, depression, anxiety, health-related quality of life (HRQoL), and functional capacity were evaluated by questionnaires (Rome IV, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), 15D, and World Health Organization Disability Assessment Schedule (WHODAS) 2.0) at baseline and at 6-month control. Esophageal manometry was performed at 6-month control.
KEY RESULTS
RESULTS
The study enrolled 11 patients (19-64 years, 10 female). Rumination score: 6.5 (5-8) at baseline, 4.0 (3-5) at the 6-month control, p = 0.005. BDI/8 (6-13), BAI/15 (8-29) at baseline; BDI/7 (4-8), BAI/15 (7-27) at the 6-month control, NS. 15D score: 0.800 at baseline, 0.845 at the 6-month control, NS. WHODAS 2.0 score: 15 (7-33) at baseline, 11 (7-26) at the 6-month control, NS. Rumination could be evoked in manometry in six of nine (67%) patients at 6-month control.
CONCLUSIONS AND INFERENCES
CONCLUSIONS
Behavioral multidisciplinary therapy significantly reduces the self-assessed frequency of rumination. These patients have more depression, anxiety and a lower HRQoL compared to the normal population.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14919Informations de copyright
© 2024 The Author(s). Neurogastroenterology & Motility published by John Wiley & Sons Ltd.
Références
Halland M, Pandolfino J, Barba E. Diagnosis and treatment of rumination syndrome. Clin Gastroenterol Hepatol. 2018;16:1549‐1555.
Murray HB, Juarascio AS, Di Lorenzo C, Drossman DA, Thomas JJ. Diagnosis and treatment of rumination syndrome: a critical review. Am J Gastroenterol. 2019;114:562‐578.
Drossman DA, Hasler WL. Rome IV‐functional GI disorders: disorders of gut‐brain interaction. Gastroenterology. 2016;150:1257‐1261.
Stelmach‐Lask L, Glebov‐Russinov I, Henik A. What Is High Rumination? Acta Psychol. 2024;14(248):104331. doi:10.1016/j.actpsy.2024.104331
Kessing BF, Bredenoord AJ, Smout AJ. Objective manometric criteria for the rumination syndrome. Am J Gastroenterol. 2014;109:52‐59.
Josefsson A, Hreinsson JP, Simrén M, et al. Global prevalence and impact of rumination syndrome. Gastroenterology. 2022;162:731‐742.
Haworth JJ, Treadway S, Hobson AR. The prevalence of rumination syndrome and rumination disorder: a systematic review and meta‐analysis. Neurogastroenterol Motil. 2024;2:e14793. doi:10.1111/nmo.14793
Wang X, Luscombe GM, Boyd C, Kellow J, Abraham S. Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria. World J Gastroenterol. 2014;20:16293‐16299.
Barba E, Burri E, Accarino A, et al. Biofeedback‐guided control of abdominothoracic muscular activity reduces regurgitation episodes in patients with rumination. Clin Gastroenterol Hepatol. 2015;13:100‐106.
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;111:1007‐1013.
Murray HB, Zhang F, Call CC, et al. Comprehensive cognitive‐behavioral interventions augment diaphragmatic breathing for rumination syndrome: a proof‐of‐concept trial. Dig Dis Sci. 2021;66:3461‐3469.
Punkkinen J, Nyyssönen M, Walamies M, et al. Behavioral therapy is superior to follow‐up without intervention in patients with supragastric belching‐a randomized study. Neurogastroenterol Motil. 2022;34(2):e14171. doi:10.1111/nmo.14171
Muurinen T, Walamies M. Rumination in a young woman. Duodecim. 2015;131:76‐79.
Basnayake C, Kamm MA, Stanley A, et al. Standard gastroenterologist versus multidisciplinary treatment for functional gastrointestinal disorders (MANTRA): an open‐label, single‐centre, randomised controlled trial. Lancet Gastroenterol Hepatol. 2020;5:890‐899.
Basnayake C, Kamm MA, Stanley A, et al. Long‐term outcome of multidisciplinary versus standard gastroenterologist Care for Functional Gastrointestinal Disorders: a randomized trial. Clin Gastroenterol Hepatol. 2022;20(9):2102‐2111.
Nyyssönen M, Stahl‐Railila M, Ruuska S, et al. Multidisciplinary behavioral therapy reduces rumination. Neurogastroenterol Motil. 2023;35(S2):38.
Palsson OS, Whitehead WE, van Tilburg MA, et al. Development and validation of the Rome IV diagnostic questionnaire for adults. Gastroenterology. 2016;150:1481‐1491.
Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck depression inventories ‐IA and ‐II in psychiatric outpatients. J Pers Assess. 1996;67:588‐597.
Leyfer OT, Ruberg JL, Woodruff‐Borden J. Examination of the utility of the Beck anxiety inventory and its factors as a screener for anxiety disorders. J Anxiety Disord. 2006;20:444‐458.
Sintonen H. The 15D instrument of health‐related quality of life: properties and applications. Ann Med. 2001;33:328‐336.
Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: an international systematic review. Disabil Rehabil. 2017;39:2347‐2380.
Keefer L, Ballou SK, Drossman DA, Ringstrom G, Elsenbruch S, Ljótsson B. A Rome working team report on brain‐gut behavior therapies for disorders of gut‐brain interaction. Gastroenterology. 2022;162:300‐315.
Koskinen S, Lundqvist A, Ristiluoma N, eds. Health, Functional Capacity and Welfare in Finland in 2011. National Institute for Health and Welfare (THL); 2012. Report 68/2012 (http://urn.fi/URN:ISBN:978‐952‐245‐769‐1)
Ritola V, Lipsanen JO, Pihlaja S, et al. Internet‐delivered cognitive behavioral therapy for generalized anxiety disorder in Nationwide routine care: effectiveness study. J Med Internet Res. 2022;24(3):e29384. doi:10.2196/29384
Markkula N, Suvisaari J. Prevalence, risk factors and prognosis of depressive disorders. Duodecim. 2017;133:275‐282.
Pirkola SP, Isometsä E, Suvisaari J, et al. DSM‐IV mood‐, anxiety‐ and alcohol use disorders and their comorbidity in the Finnish general population—results from the health 2000 study. Soc Psychiatry Psychiatr Epidemiol. 2005;40:1‐10.
Norén P, Karlsson J, Ohlsson‐Nevo E, Möller M, Hermansson L. Psychometric evaluation of the WHODAS 2.0 and prevalence of disability in a Swedish general population. J Patient Rep Outcomes. 2023;7:36.
Alanne S, Roine RP, Räsänen P, Vainiola T, Sintonen H. Estimating the minimum important change in the 15D scores. Qual Life Res. 2015;24:599‐606.
Oelschlager BK, Chan MM, Eubanks TR, Pope CE 2nd, Pellegrini CA. Effective treatment of rumination with Nissen fundoplication. J Gastrointest Surg. 2002;6:638‐644.
Courtois I, Cools F, Calsius J. Effectiveness of body awareness interventions in fibromyalgia and chronic fatigue syndrome: a systematic review and meta‐analysis. J Bodyw Mov Ther. 2015;19:35‐56.
Lozano‐Serra E, Andrés‐Perpiña S, Lázaro‐García L, Castro‐Fornieles J. Adolescent anorexia nervosa: cognitive performance after weight recovery. J Psychosom Res. 2014;76:6‐11.
Sawada A, Sifrim D. How to recognize and treat rumination syndrome. Curr Opin Gastroenterol. 2023;39:340‐346.