Psychotherapy in functional dyspepsia

Haug, Tone Tangen; Wilhelmsen, Ingvard; Svebak, Sven; Berstad, Arnold; Ursin, Holger

doi:10.1016/0022-3999(94)90026-4

Cited by 72 publications

(70 citation statements)

References 21 publications

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“…These patients had better total symptom scores, reduced symptom severity and improved QOL, and the symptoms of their comorbid psychiatric conditions (such as anxiety, depression and somatization) also improved 211,215 . It is not clear whether the improvements in psy chiatric symptoms are secondary to the alleviation of gastrointestinal symptoms or vice versa.…”

Section: Nature Reviewsmentioning

confidence: 92%

“…Psychotherapy. In contrast to IBS, psychotherapy has rarely been tested in functional dyspepsia and has not been shown to be effective: only four controlled trials [210][211][212][213] were published until 2002 and an updated 2011 Cochrane analysis was withdrawn for unknown reasons. Three additional trials [214][215][216] were performed since the first Cochrane review, and all seven trials together covered the entire spectrum of psychotherapy options, but each technique was tested only in a single, small study (TABLE 2).…”

Section: Pharmacological Treatment Of Epsmentioning

confidence: 99%

“…A lifetime history of abuse and current depression influence QOL, but their effect is mediated by somatization 132,230 . • At the end of treatment: significantly decreased self-recorded pain intensity and number of pain occasions in the treatment arm compared with the control arms • At 1-year follow-up: no differences between treatment and control Cognitive psychotherapy (Haug et al 211 ) Two arms, control (no treatment) and treatment (10 × 45-50-minute sessions) over 4 months (100; 14%)…”

Section: Quality Of Lifementioning

confidence: 99%

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Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

253

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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Section: Nature Reviewsmentioning

confidence: 92%

Section: Pharmacological Treatment Of Epsmentioning

confidence: 99%

Section: Quality Of Lifementioning

confidence: 99%

See 1 more Smart Citation

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

253

247

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“…Further study is needed on this issue. A randomized clinical trial showed that cognition behavior therapy was effective in patients with FD, but the sample size was relatively small [68], and other information on this issue is limited. A few cross-sectional and case-control studies have been conducted on the association between imbalance of the autonomic nervous system and the pathogenesis of FD [69,70].…”

Section: Treatmentmentioning

confidence: 99%

Evidence-based clinical practice guidelines for functional dyspepsia

et al. 2015

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General interest in functional gastrointestinal disorders is increasing among Japanese doctors as well as patients. This increase can be attributed to a number of factors, including recent increased interest in quality of life and advances in our understanding of the pathophysiology of gastrointestinal disease. Japan recently became the world's first country to list ''functional dyspepsia'' as a disease name for national insurance billing purposes. However, recognition and understanding of functional dyspepsia (FD) remain poor, and no standard treatment strategy has yet been established. Accordingly, the Japanese Society of Gastroenterology (JSGE) developed an evidence-based clinical practice guideline for FD, consisting of five sections: concept, definition, and epidemiology; pathophysiology; diagnosis; treatment; and prognosis and complications. This article summarizes the Japanese guideline, with particular focus on the treatment section. Once a patient is diagnosed with FD, the doctor should carefully explain the pathophysiology and benign nature of this condition, establish a good doctor-patient relationship, and then provide advice for daily living (diet and lifestyle modifications, explanations, and reassurance). The proposed pharmacological treatment is divided into two steps: initial treatment including an acid inhibitory drug (H2RA or PPI) or prokinetics, (strong recommendation); second-line treatment including anxiolytics, antidepressants, and Japanese traditional medicine (weak recommendation). H. pylori eradication, strongly recommended with a high evidence level, is positioned separately from other treatment flows. Conditions that do not respond to these treatment regimens are regarded as refractory FD. Patients will be further examined for other organic disorders or will be referred to specialists using other approaches such as psychosomatic treatment.

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“…Contudo, em estudo de base populacional (14) sobre transtornos gastrointestinais funcionais, utilizando o Critério de Roma I, foi encontrada associação entre DF e morbidade psicológica, sendo que neuroticismo, depressão, ansiedade e angústia somática mostraram-se preditores para DF. Por outro lado, estudo mais recente (11) aponta para um percentual signifi cativamente maior de deprimidos entre os pacientes com DF que procuraram atendimento médico, quando comparados àqueles que não o procuraram.…”

Section: Discussionunclassified

Dispepsia funcional e depressão como fator associado

Silva¹,

Pinheiro²,

Silva³

et al. 2006

Arq. Gastroenterol.

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RESUMO ARQGA/1254 INTRODUÇÃOA dispepsia divide-se em dois grandes grupos: um secundário, a doença orgânica, e outro denominado dispepsia funcional (DF). A dispepsia orgânica (DO) pode ser defi nida como a secundária a lesões específi cas, como úlcera péptica, esofagite, câncer gástrico e colelitíase. Assim, é um agrupamento de sintomas resultantes de distintas doenças, sendo estudada a partir das mesmas (21) .No que se refere ao diagnóstico da DF, a falta de uniformidade em relação à defi nição motivou a realização de reuniões de especialistas de diferentes países, sendo mais conhecidas as de Chicago, nos EUA, e de Cortina e Roma, na Itália. As conclusões do Consenso de Roma II foram publicadas em livro em 2000 (7) e representam o esforço da comunidade científi ca para, a partir das investigações realizadas nos últimos anos, sistematizar o conhecimento a respeito dos transtornos gastrointestinais funcionais.O Consenso de Roma II (32) recomenda que a DF seja diagnosticada quando, em pelo menos 12 semanas consecutivas ou não, nos últimos 12 meses, o paciente apresentar: 1. dor ou desconforto no abdome superior, de caráter persistente ou recurrente, com peso epigástrico pós-prandial e/ou saciedade precoce e/ou náuseas e/ou vômitos e/ou distensão abdominal; 2. ausência de doença orgânica que possa explicar os sintomas; 3. ausência de evidências de que a dispepsia é aliviada pela evacuação ou associada à alteração na freqüência ou na forma das fezes.Essa defi nição (31) pretende abranger não só os pacientes que apresentam sintomas sem explicação identifi cável pelos exames, mas também aqueles que apresentam alterações fi siopatológicas ou microbiológicas de relevância clínica incerta para explicar os sintomas como: gastrite por

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Psychotherapy in functional dyspepsia

Cited by 72 publications

References 21 publications

Functional dyspepsia

Functional dyspepsia

Evidence-based clinical practice guidelines for functional dyspepsia

Dispepsia funcional e depressão como fator associado

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