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Certain factors may influence behavioral therapy response in supragastric belching
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Several factors, including lower hypervigilance, are associated with better outcomes of cognitive behavioral therapy in patients with supragastric belching, according to study results.
Daniel Sifrim, MD, PhD, of Barts and The London School of Medicine and Dentistry Queen Mary University of London in the United Kingdom, and colleagues wrote previous studies have shown that CBT reduces symptoms and improves quality of life in about 50% of patients with supragastric belching (SGB). However, identifying factors associated with CBT success is important because of limited access to the therapy.
“Such treatment is not readily available in many institutions world-wide,” they wrote. “It could be, therefore, clinically relevant and useful to be able to identify, beforehand, those patients who are more likely to respond to CBT.”
Researchers analyzed data from medical records of 39 patients who had previously completed CBT for SGB. They assessed the percent change in symptoms from before to after treatment using a visual analogue scale and determined the association between pre- and during-treatment factors and symptomatic outcomes.
The pre-CBT visual analogue scale score was 267 ± 79, which decreased to 151 ± 88 at the end of therapy. Investigators found that the effect persisted at 6 to 12 months of follow-up (153 ± 82).
Sifrim and colleagues found that patients with a lower number of SGBs (P < .01) and lower hypervigilance score (P < .04) before treatment had better outcomes. In their assessment of during-treatment factors, they found that a higher CBT proficiency score — based on acceptance of SGB as a behavioral phenomenon, detection of a warning signal before belching and adherence to the exercises of treatment — was associated with a better outcome (P = .001).
“The number of SGBs, hypervigilance score and CBT proficiency were factors that influenced treatment outcome,” Sifrim and colleagues concluded. “This result suggested that clinicians could detect patients with SGB who are less likely to respond to CBT at diagnosis. Based on this information, it is possible to modify the CBT intensity and duration to improve outcome.” – by Alex Young
Disclosures: Sifrim reports receiving research grants from Alfa Sigma Italy, Jinshan Technology China and Reckitt Benckiser UK. The other authors report no relevant financial disclosures.
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