Predictors of Response to a Behavioral Treatment in Patients with Chronic Gastric Motility Disorders

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2002 May 23

PMID 12018897

Citations 9

Authors

Hani Rashed

Teresa Cutts

Thomas Abell

Patricia Cowings

William Toscano

Dima Adl

Affiliations

Soon will be listed here.

Abstract

Chronic gastric motility disorders have proven intractable to most traditional therapies. Twenty-six patients with chronic nausea and vomiting were treated with a behavioral technique, autonomic training (AT) with directed imagery (verbal instructions), to help facilitate physiological control. After treatment, gastrointestinal symptoms decreased by >30% in 58% of the treated patients. We compared those improved patients to the 43% who did not improve significantly. No significant differences existed in baseline symptoms and autonomic measures between both groups. However, baseline measures of gastric emptying and autonomic function predicted treatment outcome. Patients who improved manifested mild to moderate delay in baseline gastric emptying measures. The percent of liquid gastric emptying at 60 mins and the sympathetic adrenergic measure of percent of change in the foot cutaneous blood flow in response to cold stress test predicted improvement in AT outcome, with clinical diagnostic values of 77% and 71%, respectively. We conclude that AT treatment can be efficacious in some patients with impaired gastric emptying and adrenergic dysfunction. More work is warranted to compare biofeedback therapy with gastric motility patients and controls in population-based studies.

Citing Articles

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Diabetic and Non-Diabetic Gastroparesis: A Retrospective Comparative Outcome Study From the Nationwide Inpatient Sample.

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Nausea and Vomiting in 2021: A Comprehensive Update.

Heckroth M, Luckett R, Moser C, Parajuli D, Abell T J Clin Gastroenterol. 2021; 55(4):279-299.

PMID: 33471485 PMC: 7933092. DOI: 10.1097/MCG.0000000000001485.

Psychological controversies in gastroparesis: A systematic review.

Woodhouse S, Hebbard G, Knowles S World J Gastroenterol. 2017; 23(7):1298-1309.

PMID: 28275310 PMC: 5323455. DOI: 10.3748/wjg.v23.i7.1298.

Autonomic Evaluation of Patients With Gastroparesis and Neurostimulation: Comparisons of Direct/Systemic and Indirect/Cardiac Measures.

Stocker A, Abell T, Rashed H, Kedar A, Boatright B, Chen J Gastroenterology Res. 2016; 9(1):10-16.

PMID: 27785318 PMC: 5051107. DOI: 10.14740/gr667w.

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