scholarly journals Internet-Delivered Cognitive Behavioral Therapy for Children With Pain-Related Functional Gastrointestinal Disorders: Feasibility Study

2017 ◽  
Vol 4 (3) ◽  
pp. e32 ◽  
Author(s):  
Maria Lalouni ◽  
Brjánn Ljótsson ◽  
Marianne Bonnert ◽  
Erik Hedman-Lagerlöf ◽  
Jens Högström ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Disorders ◽  
School Absence ◽  
Abdominal Symptoms ◽  
Irritable Bowel ◽  
Anxiety Depression

Background Pain-related functional gastrointestinal disorders (P-FGIDs; eg, irritable bowel syndrome) are highly prevalent in children and associated with low quality of life, anxiety, and school absence. Treatment options are scarce, and there is a need for effective and accessible treatments. Internet-delivered cognitive behavior therapy (Internet-CBT) based on exposure exercises is effective for adult and adolescent irritable bowel syndrome, but it has not been evaluated for younger children. Objective The objective of this study was to assess acceptability, feasibility, and potential clinical efficacy of Internet-CBT for children with P-FGIDs. Methods This was a feasibility study with a within-group design. We included 31 children aged 8-12 years and diagnosed with P-FGID, according to the ROME III criteria. Mean duration of abdominal symptoms at baseline was 3.8 years (standard deviation [SD] 2.6). The treatment was therapist-guided and consisted of 10 weekly modules of exposure-based Internet-CBT. The children were instructed to provoke abdominal symptoms in a graded manner and to engage in previously avoided activities. The parents were taught to decrease their attention to their children’s pain behaviors and to reinforce and support their work with the exposures. Assessments included treatment satisfaction, subjective treatment effect, gastrointestinal symptoms, quality of life, pain intensity, anxiety, depression, and school absence. Data were collected at pretreatment, posttreatment, and 6-month follow-up. Means, standard errors (SEs), and Cohen d effect sizes were estimated based on multi-level linear mixed models. Results Most children 25/31 (81%) completed 9 or 10 of the 10 treatment modules. Almost all children, 28/31 (90%), reported that the treatment had helped them to deal more effectively with their symptoms, and 27/31 (87%) children declared that their symptoms had improved during the treatment. Assessments from the parents were in accordance with the children’s reports. No child or parent reported that the symptoms had worsened. We observed a large within-group effect size on the primary outcome measure, child-rated gastrointestinal symptoms from pretreatment to posttreatment (Cohen d=1.14, P<.001, 95% CI 0.69-1.61), and this effect size was maintained at 6-month follow-up (Cohen d=1.40, P<.001, 95% CI 1.04-1.81). We also observed significant improvements from pretreatment to posttreatment on a wide range of child- and parent-rated measures including quality of life, pain intensity, anxiety, depression, and school absence. All results remained stable or were further improved at 6-month follow-up. Conclusions This study shows that children with longstanding P-FGIDs, and their parents, perceive exposure-based Internet-CBT as a helpful and feasible treatment. The included children improved significantly despite a long duration of abdominal symptoms before the intervention. The treatment shows potential to be highly effective for P-FGIDs. The results need to be confirmed in a randomized controlled trial (RCT).

scholarly journals Impact of Opioid Consumption in Patients With Functional Gastrointestinal Disorders

2020 ◽  
Vol 11 ◽  
Author(s):  
Chloé Melchior ◽  
Charlotte Desprez ◽  
Fabien Wuestenberghs ◽  
Anne-Marie Leroi ◽  
Antoine Lemaire ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Opioid Consumption ◽  
University Hospital ◽  
Gastrointestinal Disorders ◽  
Gi Symptoms ◽  
Irritable Bowel

Objective: We aimed to determine the burden of opioid consumption in a cohort of patients with functional gastrointestinal disorders.Methods: All patients diagnosed with functional gastrointestinal disorders and referred to our university hospital were evaluated from 2013 to the beginning of 2019. Irritable bowel syndrome and functional dyspepsia diagnoses were determined according to Rome criteria and severity according to irritable bowel syndrome severity scoring system. Vomiting was quantified using a 5-point Likert scale, and constipation severity was measured using the Knowles-Eccersley-Scott-Symptom questionnaires. Quality of life was quantified by the GastroIntestinal Quality of Life Index. Patients were categorized as being treated on a chronic basis with either tramadol, step II opioids, step III opioids or as being opioid-free.Results: 2933 consecutive patients were included. In our cohort, 12.5% had only irritable bowel syndrome, 39.3% had only functional dyspepsia, 24.9% had a combination of both, and 23.4% had other functional gastrointestinal disorders. Among them, the consumption of tramadol, step II (tramadol excluded) and step III opioids was 1.8, 1.3 and 0.3 % respectively in 2013 and 4.3, 3.4 and 1.9% in 2018 (p &lt; 0.03). Opioid consumption was associated with increased vomiting (p = 0.0168), constipation (p &lt; 0.0001), symptom severity (p &lt; 0.001), more altered quality of life (p &lt; 0.0001) and higher depression score (p = 0.0045).Conclusion: In functional gastrointestinal disorders, opioid consumption has increased in the last years and is associated with more GI symptoms (vomiting, constipation and GI severity), higher depression and more altered quality of life.

scholarly journals Irritable bowel syndrome: towards an integrated approach

1999 ◽  
Vol 4 (1) ◽  
pp. 45-46 ◽  
Author(s):  
Anita D Stuart ◽  
H Gertie Pretorius ◽  
Lynette Van der Merwe
Keyword(s):  
North Carolina ◽  
Irritable Bowel Syndrome ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Integrated Approach ◽  
Gastrointestinal Disorders ◽  
University Of North Carolina ◽  
Irritable Bowel ◽  
The Impact

Functional Gastrointestinal Disorders are defined as chronic or recurrent gastrointestinal symptoms characterized by abdominal pain, constipation and/or diarrhoea (Tally, 1994; University of North Carolina, 1998). These disorders are of concern because of their high incidence, associated morbidity, expense and the impact of these disorders on people's quality of life. Drossman (1993, in University of North Carolina (UNC), 1998) found that of 5 400 U.S. households, 69% of people met the criteria for at least one of the functional gastrointestinal disorders which represents a 59% increase in the incidence of functional gastrointestinal disorders since 1983 (Drossman, in UNC, 1998; Drossman, 1983). In particular, Irritable Bowel Syndrome (IBS) sufferers account for 2,4 - 3,5 million visits to doctors annually. Furthermore, IBS sufferers spend $40 million annually on treatment for their condition. They also tend to have 3 to 4 times more disability days than other workers, which illustrates the debilitating effect of this disorder (Drossman, in UNC, 1998). It is therefore necessary that the etiology of IBS be researched, as well as the course and management of this debilitating disease. The studies presented in this series aimed to improve the understanding of the multiple agents that influence the development and course of IBS.

Frequency of Functional Gastrointestinal Disorders in Patients with Obesity and Association with Anxiety, Depression and Quality of Life

2017 ◽  
Vol 152 (5) ◽  
pp. S831
Author(s):  
Christian Alejandra Sarabia Aldana ◽  
Claudia A. Aguilar Serralde ◽  
Elia Hernández Labra ◽  
Ariel Pérez Mendoza ◽  
Monica R. Zavala-Solares
Keyword(s):  
Quality Of Life ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Disorders ◽  
Anxiety Depression

scholarly journals Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Quénéhervé ◽  
D. Drui ◽  
J. Blin ◽  
M. Péré ◽  
E. Coron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Adrenal Insufficiency ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Non Profit ◽  
Acute Adrenal Insufficiency ◽  
Irritable Bowel ◽  
Rome Iv

AbstractGastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.

scholarly journals Z-score neurofeedback, heart rate variability biofeedback, and brain coaching for older adults with memory concerns

2020 ◽  
pp. 1-29
Author(s):  
Kyle D. Meeuwsen ◽  
Kayleah M. Groeneveld ◽  
Linda A. Walker ◽  
Anna M. Mennenga ◽  
Rachel K. Tittle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Boot Camp ◽  
Relative Power ◽  
Z Score ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Memory Complaints ◽  
Anxiety Depression

Background: The three-month, multidomain Memory Boot Camp program incorporates z-score neurofeedback (NFB), heart rate variability (HRV) biofeedback, and one-on-one coaching to teach memory skills and encourage behavior change in diet, sleep, physical fitness, and stress reduction. Objective: This prospective trial evaluates the Memory Boot Camp program for adults ages 55 to 85 with symptoms of Mild Cognitive Impairment (MCI) and subjective memory complaints. Methods: Participants were evaluated via the Montreal Cognitive Assessment (MoCA), NeuroTrax Global Cognitive Index, measures of anxiety, depression, sleep, quality of life, quantitative electroencephalography (QEEG), and HRV parameters at four timepoints: baseline, pre-program, post-program, and follow-up. The trial included a three-month waiting period between baseline and pre-program, such that each participant acted as their own control, and follow-up took place six months after completion of the program. Results: Participants’ MoCA scores and self-reported measures of anxiety, depression, sleep quality, and quality of life improved after treatment, and these changes were maintained at follow-up. Physiological changes in HRV parameters after treatment were not significant, however, breathing rate and QEEG parameters were improved at post-program and maintained at follow-up. Finally, participants’ improvement in MoCA score over the treatment period was correlated with their improvement in two brain oscillation parameters targeted by the z-score NFB protocol: relative power of delta and relative power of theta. Conclusions: Trial results suggest that the Memory Boot Camp program is a promising treatment strategy for older adults with symptoms of MCI and subjective memory complaints.

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