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Poovipirom N, Ratta-Apha W, Maneerattanaporn M, Geeratragool T, Chuenprapai P, Leelakusolvong S. Treatment outcomes in patients with globus: A randomized control trial of psychoeducation, neuromodulators, and proton pump inhibitors. Neurogastroenterol Motil 2023; 35:e14500. [PMID: 36443929 DOI: 10.1111/nmo.14500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Globus is a persistent or intermittent nonpainful sensation of a lump or foreign body, which markedly affect patient's quality of life. Treatment options for globus are limited and unsatisfying. This study aims to compare the effects of cognitive-behavioral-theory-based psychoeducation (CBT), neuromodulators (NMD), and proton pump inhibitor (PPI) on treatment outcomes in patients with globus. METHODS Eligible patients were randomly received CBT, 0.5 mg flupenthixol and 10 mg melitracen; NMD, or omeprazole 20 mg; PPI, for 4 weeks. The primary endpoint was the reduction in symptom scores; Glasgow Edinburgh Throat Scale (GETS). The secondary endpoints included treatment efficacy on Reflux Symptom Index (RSI), Hospital Anxiety Depression Scale (HADS), and quality of life (QoL) based on a 36-item short-form health survey (SF-36). Treatment compliance and adverse effects were recorded. KEY RESULTS Forty patients were completed study. Baseline characteristics between the groups were comparable. By the end of treatment, both CBT and NMD provided greater reduction in GETS than PPI (CBT vs PPI; 6.46 ± 8.56 vs 0.21 ± 5.42; p = 0.031, NMD vs PPI; 6.92 ± 9.85 vs 0.21 ± 5.42; p = 0.036). The improvement of RSI, HADS, and SF-36 among the groups was similar. Neuromodulators caused more adverse events. CONCLUSIONS & INFERENCES Both CBT and NMD provided equally effective treatment and better than PPI in patients with globus determined by the reduction in GETS. The improvement in RSI, HADS, and QoL of the three groups was not different. Given less of adverse effect than NMD, CBT should be considered as a substantial treatment.
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Affiliation(s)
- Natthanan Poovipirom
- Division of Gastroenterology, Department of Internal Medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Monthira Maneerattanaporn
- Division of Gastroenterology, Department of Internal Medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanawat Geeratragool
- Division of Gastroenterology, Department of Internal Medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pritsana Chuenprapai
- Division of Gastroenterology, Department of Internal Medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somchai Leelakusolvong
- Division of Gastroenterology, Department of Internal Medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Huang Q, Zheng S, Cai T, Zhang S, Su Q, Wang F. Factors associated with mood disorders and the efficacy of the targeted treatment of functional dyspepsia: A randomized clinical trial. Front Med (Lausanne) 2022; 9:859661. [PMID: 35935797 PMCID: PMC9353185 DOI: 10.3389/fmed.2022.859661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPatients with functional dyspepsia (FD) are often accompanied by mood disorders (MDs). This study aimed to identify factors associated with MDs in patients with FD and evaluate the efficacy of targeted treatment plans.MethodsRelevant scales were used to assess MDs. Patients with FD having MDs and acid reflux were treated with flupentixol and melitracen (FM) and acid-suppressive therapy (AST) (histamine-2 receptor antagonists (H2RAs) (group A) or proton pump inhibitors (PPIs) (group B)), and those without acid reflux (group C) did not receive AST. Patients with FD without MDs were randomly administered H2RAs (group D) or PPIs (group E). The primary endpoints were factors associated with MDs and improvement in gastrointestinal (GI) symptoms and MDs in patients with FD.ResultsA total of 362 patients with FD were enrolled in this study. Patients with FD having high GI score and low education were found prone to MDs. At week 2, the remission rate of overall GI symptoms and depression was significantly higher in group B than that in groups A and C [GI: 72.72% (32/44) vs. 47.73% (21/44) and 72.72% (32/44) vs. 38.94% (44/113), all P < 0.05; depression: 72.22% (26/36) vs. 41.67% (15/36) and 72.22% (26/36) vs. 41.57% (37/89), all P < 0.05]. Furthermore, the remission rate of overall GI symptoms was significantly higher in group E than that in group D [60.29% (41/68) vs. 42.65% (29/68), P < 0.05]. At week 8, similar efficacies and adverse reactions were observed in these groups.ConclusionThe risk factors for MDs were high GI scores and low literacy rates. Thus, targeted treatment (FM+PPIs for patients with MDs; PPIs for patients without MDs) can improve the efficacy of patients with FD.Clinical trial registrationwww.chictr.org.cn, identifier ChiCTR2100053126.
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Affiliation(s)
- Qian Huang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China
| | - Shaopeng Zheng
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China
| | - Ting Cai
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China
| | - Suxin Zhang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China
| | - Qian Su
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China
| | - Fen Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China
- *Correspondence: Fen Wang
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Xu TT, Li L, Geng L, Zhou BD, Zhu SL. Peripheral and central pathophysiological changes in a new rat model of acid reflux combined with mental stress. Neurogastroenterol Motil 2022; 34:e14360. [PMID: 35352852 DOI: 10.1111/nmo.14360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Mental stress is an important risk factor for gastroesophageal reflux disease (GERD), which interacts with acid reflux and affects the efficacy of single acid suppression treatment. However, the specific mechanism remains elusive, and there is a lack of available models for further support. METHODS This study established a new compound model combining acid reflux and chronic unpredictable mild stress (CUMS) to observe potential peripheral and central pathophysiological changes. KEY RESULTS Rats in the compound model suffered from significant weight loss and manifested depression-like behaviours. In addition, the acid reflux was not aggravated despite the presence of mental stress, along with dilated intercellular space (DIS), increased expression of desmoglein-1 (DSG1) mRNA, and injury of the lower oesophageal mucosa. The balance between pro-inflammatory and anti-inflammatory factors was disrupted. In the hypothalamus of rats in the compound model, the expression of corticosterone-releasing factor (CRF) and its receptors, protein kinase A (PKA), and γ-aminobutyric acid (GABA) receptors were decreased. This might be related to the "escape" of stress, which weakened the suppressive effect on excitatory transmission to cope with the damage of pressure to the body. CONCLUSIONS & INFERENCES Mental stress and acid reflux affect GERD through peripheral and central aspects, which can result in the poor efficacy of acid inhibitors. This may provide a new direction for the treatment of GERD.
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Affiliation(s)
- Ting-Ting Xu
- Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li Li
- Shanghai Guanghua Hospital of Integrated Chinese and Western Medicine, Shanghai, China
| | - Lin Geng
- Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bing-Duo Zhou
- Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Sheng-Liang Zhu
- Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Wang QQ, Cheng L, Wu BY, Xu P, Qiu HY, Wang B, Yan XJ, Chen SL. Short-course antidepressant therapy reduces discontinuation syndrome while maintaining treatment efficacy in patients with refractory functional dyspepsia: A randomized controlled trial. Front Psychiatry 2022; 13:1063722. [PMID: 36569610 PMCID: PMC9772443 DOI: 10.3389/fpsyt.2022.1063722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Long-course (LC) antidepressants for the treatment of disorders of gut-brain interaction, such as refractory functional dyspepsia (rFD), pose patients at risk of antidepressant discontinuation syndrome (ADS). Short-course (SC) therapy of rapid-acting antidepressant may reduce discontinuation syndromes while maintaining efficacy for dyspeptic symptoms. However, the evidence-based research is lacking. This study aims to determine whether SC therapy with antidepressants could decrease the risk of ADS with comparable treatment efficacy to LC therapy in rFD. METHODS This randomized clinical trial with rFD patients was conducted at a tertiary hospital in China. Participants (N = 240) were randomly allocated to receive flupentixol-melitracen (FM) plus omeprazole therapy for 2 (SC group) or 4 (LC group) weeks, respectively. Scores for Leeds Dyspepsia Questionnaire (LDQ), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 for Depression (PHQ-9) were assessed at baseline and every 2 weeks, ending at 4 weeks after treatment. ADS was assessed after drug cessation. Medication possession ratio (MPR) for FM was calculated. RESULTS The severity and incidence of ADS of patients in SC group were significantly lower than those in LC group (0.60 ± 0.62 vs. 1.71 ± 1.58 and 3.64 vs. 39.45%; both P < 0.0001). The MPR values for FM were significantly higher in patients of SC group than in LC group (P < 0.0001). Scores for LDQ, GAD-7 and PHQ-9 decreased in patients of both groups, and the symptom improvement in SC group was comparable to that in LC group after treatment. CONCLUSIONS Compared to 4-week FM therapy, the 2-week FM therapy reduces the risk of ADS with non-inferior treatment efficacy in patients with rFD. CLINICAL TRIAL REGISTRATION Clinical trials.gov, identifier NCT05099913.
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Affiliation(s)
- Qian-Qian Wang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Cheng
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bi-Yu Wu
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ping Xu
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong-Yi Qiu
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Wang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiu-Juan Yan
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sheng-Liang Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Lan QL, Lin XX, Wang Y, Xu BB, Shu KY, Zhang XJ. The Relationship Between Upper Esophageal Sphincter Pressure and Psychological Status in Patients with Globus Sensation. Int J Gen Med 2021; 14:8805-8810. [PMID: 34858048 PMCID: PMC8630375 DOI: 10.2147/ijgm.s337165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To explore the correlation between changes in esophageal pressure and psychological status in patients with globus sensation. Methods A total of 40 patients with globus sensation who attended Wenzhou People’s Hospital between August 2020 and February 2021 were divided into two groups based on the results of esophageal manometry: a high-pressure group and a non-high-pressure group. The duration of disease, clinical symptom score, and self-rating anxiety scale (SAS) were compared between the two groups to determine the relationship between changes in esophageal pressure and psychological status. Results All the patients before treatment were divided into a high-pressure group (n = 14) and a non-high-pressure group (n = 26) according to whether the resting pressure of the upper esophageal sphincter (UES) was greater than 104 mmHg. The differences between the high-pressure group and non-high-pressure group in duration of disease, clinical symptom score, and SAS were statistically significant (all P < 0.05). Anxiety was present in 12 patients in the high-pressure group and two patients in the non-high-pressure group. The difference between the the high-pressure group and non-high-pressure group in the incidence of anxiety was statistically significant (χ2 = 21.04 and P < 0.001). Pearson correlation analysis of the association between esophageal pressure and anxiety resulted in R = 0.74 and P < 0.001. Conclusion Patients with globus sensation who develop anxiety were more likely to have high pressure in the upper esophageal sphincter.
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Affiliation(s)
- Qiao-Li Lan
- Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Medical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Xiao-Xiao Lin
- Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Medical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Ying Wang
- Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Medical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Bei-Bei Xu
- Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Medical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Ke-Yue Shu
- Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Medical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Xiao-Jin Zhang
- Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Medical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
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Hou M, Hu H, Jin C, Yu X. Efficacy and Safety of Esomeprazole for the Treatment of Reflux Symptoms in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2264-2274. [PMID: 34178733 PMCID: PMC8215048 DOI: 10.18502/ijph.v49i12.4807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: We investigated the efficacy of esomeprazole for the treatment of gastroesophageal reflux disease (GERD) in a meta-analysis of clinical trials results. Methods: Medline, Embase, PubMed and Web of Science databases were systematically searched for suitable studies, and double-blind, randomized controlled trials (RCTs) were involved. A meta-analysis of RCTs was performed to analyze the efficacy of esomeprazole on clinical outcomes that associated with the severity of GERD. Results: A total of 8 clinical trials were selected in our meta-analysis (N=4495, patients with GERD). Esomeprazole treatment yielded a significant improvement in clinical signs and symptoms of GERD compared to placebo group. Funnel plot and Egger test showed there was no significant bias in the publication. Cochrane collaboration tool and Jadad scale were used to indicate that all 8 RCTs were of high quality. The results of Galbraith radial plot showed that no study was the major source of heterogeneity. Esomeprazole treatment significantly decreased the relapse rates more than that of placebo group (RR = 0.729; 95% CI: 0.670 to 0.794; P<0.001). It seems to be lower rates of heartburn (RR = 0.747; 95%CI: 0.665–0.839; P <0.001) and epigastric pain (RR = 0.795; 95%CI: 0.679–0.932; P =0.005) in esomeprazole-treated group compared with the placebo group. Moreover, serious adverse events was less likely to happen after esomeprazole therapy (RR = 1.406, 95% CI: 1.030–1.918; P =0.032). Conclusion: Compared with the control group, esomeprazole is a promising therapeutic agent that improves the management of patients with GERD.
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Affiliation(s)
- Mingxing Hou
- Department of Gastroenterology Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010058, China
| | - Haiqing Hu
- Department of Gastroenterology and Hepatology Chinese PLA General Hospital, Beijing, 100853, China
| | - Chunlu Jin
- Department of Gastroenterology and Hepatology Chinese PLA General Hospital, Beijing, 100853, China
| | - Xuemei Yu
- Department of Gastroenterology and Hepatology Chinese PLA General Hospital, Beijing, 100853, China
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Effects of Osteopathic Visceral Treatment in Patients with Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101738. [PMID: 31635110 PMCID: PMC6832476 DOI: 10.3390/jcm8101738] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Osteopathic manual treatment has been recommended as a non-pharmacological therapy for Gastroesophageal Reflux Disease (GERD). However, to date, no study has supported the effectiveness of this intervention with respect to the symptoms of the disease. Our goal was to assess the effect of an osteopathic manual technique for the lower esophageal sphincter on GERD symptoms, cervical mobility and on the C4 spinous process pressure pain threshold (PPTs). METHODS A randomized, double-blind placebo-controlled trial was performed. Sixty subjects suffering from GERD participated in this study and were randomly assigned to either an experimental group (EG) (n = 29), who received the osteopathic technique for the lower esophageal sphincter, or to a control group (CG) (n = 31), who received a manual contact, which mimicked the osteopathic technique without exerting any therapeutic force. Randomization was computer-generated, with allocation concealed by sequentially numbered, opaque, sealed envelopes. The GerdQ questionnaire was used to assess symptom changes the week after intervention. Cervical Range of Motion (CROM) and algometer were used to evaluate cervical mobility and PPTs before and after both treatments. Before-after between groups comparison (t-test) was used for statistical analysis of the outcome, with two measurement points (GerdQ), while repeated-measures ANOVA was used for those outcomes with four measurement points (CROM and PPT). RESULTS The application of the osteopathic manual treatment in subjects with GERD produced a significant improvement in symptoms one week after the intervention (p = 0.005) with a between-groups difference of 1.49 points in GerdQ score (95% CI: 0.47-2.49). PPT C4 improved in the EG after the treatment (p = 0.034; η2 = 0.048) (between-groups difference 8.78 Newton/cm2; 95% CI: 0.48-17.09). CROM also increased in the EG compared to the CG (p < 0.001; η2 = 0.108) (between-groups difference 33.89 degrees; 95% CI: 15.17-52.61). CONCLUSIONS The manual osteopathic technique produces an improvement in GERD symptoms one week after treatment, cervical mobility, and PPTs. This may mean that osteopathic treatment is useful for improving symptoms of GERD.
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Li X, Ding F, Luo P, Yang J, Liu Z, Liu J, Zhang Y, Leng A, Wu K. Study on the Therapeutic Effects of Drug and Cognitive-Behavioral Therapy on Non-Erosive Reflux Disease Patients With Emotional Disorders. Front Psychiatry 2018; 9:115. [PMID: 29867593 PMCID: PMC5954135 DOI: 10.3389/fpsyt.2018.00115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/20/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the correlation between the incidence of non-erosive reflux disease (NERD) and mental and psychological factors, deepen the understanding of the pathogenesis of NERD and explore effective treatments. METHODS NERD patients with mood disorders who met the inclusion criteria were randomly divided into a drug treatment group, a psychotherapy group, and a psychotherapy combined with drug treatment group. Before and after treatment, the patients were retrospectively analyzed using the gastroesophageal reflux disease Questionnaire, Hamilton Depression Scale, Hamilton Anxiety Scale, and SF-36 Quality of Life Scale. RESULTS All three treatments were found to relieve patients' symptoms and improve their quality of life to some extent. The psychotherapy combined with drug treatment group showed the best overall curative effect. The Hamilton Depression and Anxiety Scale scores were significantly lower in the psychotherapy-alone group and psychotherapy combined with drug treatment group than in the drug treatment alone group at 4, 8, and 12 weeks (P < 0.05). CONCLUSION Medication, psychotherapy, and psychotherapy combined with medication can relieve clinical symptoms and improve quality of life to varying degrees in patients with NERD.
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Affiliation(s)
- Xiuhua Li
- Department of Gastroenterology, Yiyang Central Hospital, Yiyang, China
| | | | | | - Jing Yang
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Zhenhua Liu
- Department of Nephrology, Yiyang Central Hospital, Yiyang, China
| | - Jinwei Liu
- Department of Intensive Care Unit, Yiyang Central Hospital, Yiyang, China
| | - Yali Zhang
- Department of Gastroenterology, Yiyang Central Hospital, Yiyang, China
| | - Aimin Leng
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China
| | - Kuangming Wu
- Department of Gastroenterology, Yiyang Central Hospital, Yiyang, China
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Hosseini M, Salari R, Shariatmaghani S, Birjandi B, Salari M. Gastrointestinal symptoms associated with gastroesophageal reflux disease, and their relapses after treatment with proton pump inhibitors: A systematic review. Electron Physician 2017; 9:4597-4605. [PMID: 28848636 PMCID: PMC5557141 DOI: 10.19082/4597] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/25/2017] [Indexed: 12/12/2022] Open
Abstract
Gastroesophageal reflux disease (GERD) is a common functional gastrointestinal disorder with significant effects on the quality of life. The burden of GERD is soaring in Asia. Preventing symptom relapse is a therapeutic goal in GERD patients. Since proton pump inhibitors (PPI) are the first-line treatment of GERD, drug failure has become a major problem in the treatment procedure. We reviewed the literature in order to find articles related to comorbidities and symptoms affecting GERD from 1980 to 2015 via PubMed and Google Scholar using keywords such as ‘Gastroesophageal reflux disease’, ‘Gastrointestinal symptoms’ and Boolean operators (such as AND, OR, NOT). Due to the cost of PPI therapy and the high rate of GERD relapse after PPI therapy, demand for continuing this type of treatment is decreasing. Thus, we need to discover new approaches to treat the disease and also investigate the relationship between the treatment of GERD and its comorbidities and symptoms such as functional constipation.
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Affiliation(s)
- Mousalreza Hosseini
- M.D., Gastroenterologist, Assistant Professor, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roshanak Salari
- Ph.D. of Drug Control, Assistant Professor, Department of Traditional Persian Pharmacy, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Shariatmaghani
- M.D., Internist, Assistant Professor, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Batul Birjandi
- M.D., Internist, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Salari
- M.D., Internist, Assistant Professor, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Zhou XY, Chu CL. Importance of diagnosis and management of psychological disorders in patients with refractory gastroesophageal reflux disease. Shijie Huaren Xiaohua Zazhi 2017; 25:1-6. [DOI: 10.11569/wcjd.v25.i1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Psychological factors are closely related to the pathogenesis of gastroesophageal reflux disease, irritable bowel syndrome, functional dyspepsia, and other gastrointestinal diseases. It has been widely accepted that psychological factors play a very important role in refractory gastroesophageal reflux disease (RGERD). This article reviews the role of psychological factors in the epidemiology, pathogenesis, assessment, and management of RGERD.
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Wang YM, Wang DC, Shen RJ, Lu HH, Zhang XL. Clinical efficacy of flupentixol/melitracen combined with mosapride and rabeprazole for treatment of reflux esophagitis. Shijie Huaren Xiaohua Zazhi 2016; 24:2881-2885. [DOI: 10.11569/wcjd.v24.i18.2881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the clinical efficacy of flupentixol/melitracen combined with mosapride and rabeprazole in the treatment of reflux esophagitis.
METHODS: From January 2013 to 2016, 96 reflux esophagitis patients with anxiety or depression treated at our hospital were randomly divided into either an observation group or a control group, with 48 cases in each group. Both groups were treated with mosapride and rabeprazole, and the observation group was additionally given flupentixol/melitracen. The Hamilton Depression Scale (HAMD) score, Hamilton Anxiety Scale (HAMA) score, reflux esophagitis symptom scores, mucosal healing, and adverse reactions were compared between the two groups.
RESULTS: After treatment, HAMD score, HAMA score, and reflux esophagitis symptom scores were improved in both groups, and the improvement was significantly better in the observation group than in the control group (P < 0.05). After treatment, the mucosal healing rate was significantly higher in the observation group than in the control group (91.67% vs 77.09%, P < 0.05). The incidence of adverse reactions did not differ significantly between the observation group and control group (5.16% vs 6.24%, P > 0.05). Adverse reactions such as mild dizziness and insomnia disappeared spontaneously without special treatment.
CONCLUSION: Flupentixol/melitracen combined with mosapride and rabeprazole for reflux esophagitis patients with anxiety or depression can significantly improve anxiety and depressive symptoms and reflux esophagitis symptoms, and promote the healing of the mucosa.
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Wang L, Zhong Z, Hu J, Rong X, Liu J, Xiao S, Liu Z. Sertraline plus deanxit to treat patients with depression and anxiety in chronic somatic diseases: a randomized controlled trial. BMC Psychiatry 2015; 15:84. [PMID: 25879863 PMCID: PMC4403889 DOI: 10.1186/s12888-015-0449-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/19/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Patients in chronic somatic diseases are often accompanied with depression and anxiety, remission of which may be observed in the third or fourth week after applying common antidepressant medications. We investigate the efficacy and safety of sertraline plus deanxit on patients with depression and anxiety in chronic somatic diseases. METHODS 75 Patients who met the criteria were randomly assigned to deanxit group or placebo group: sertraline (75 mg/day) plus deanxit (one piece/day) (N = 38), or sertraline (75 mg/day) plus placebo (one piece/day) (N = 37) for 2 weeks, both groups received sertraline (75 mg/day) in the following 2 weeks. Changes from baseline to day 4, day 8, day 15, and day 29 in Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) total scores were the efficacy measures. Adverse events were monitored and registered systematically during the trial. RESULTS Response rates for HAM-D scores in deanxit group and placebo group were significantly different on day 8(55.26% ± 2.56% VS 24.32% ± 2.19%, p = 0.006) and day 15(78.95% ± 3.89% VS 40.54% ± 4.18%, p = 0.001), while no statistical differences were observed on day 4 and day 29. Respectively, response rates for HAM-A scores on day 4 (34.21% ± 2.21% VS 8.11% ± 1.37%, p = 0.006), day 8 (57.89% ± 3.56% VS 18.92% ± 2.68%, p = 0.001) and day 15 (78.95% ± 4.37% VS 43.24% ± 4.68%, p = 0.002), favoring the deanxit group. However, HAM-A scores were not remarkably different at the end point. The overall safety profile of both groups was favorable with no distinct differences. CONCLUSIONS The efficacy was exhibited in the deanxit group, with evidence for similar safety. The rapid onset of sertraline plus short-term deanxit indicated that it might be an inspiring strategy to manage depression and anxiety within the first two weeks in chronic somatic diseases.
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Affiliation(s)
- Limin Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, 510080, Guangzhou, Guangdong Province, P P China.
| | - Zhuoyuan Zhong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
| | - Jingyang Hu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
| | - Songhua Xiao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
| | - Zhonglin Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
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Wang YF, Liu J, Li R. Esomeprazole combined with Deanxit for treatment of non-erosive gastroesophageal reflux disease with depression in elderly patients: Efficacy and impact on quality of life. Shijie Huaren Xiaohua Zazhi 2015; 23:777-781. [DOI: 10.11569/wcjd.v23.i5.777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the efficacy of esomeprazole combined with Deanxit in the treatment of non-erosive gastrooesophageal reflux disease (NERD) with depression in elderly patients and their impact on quality of life.
METHODS: From January 2012 to December 2013, 82 elderly NERD outpatients with depression treated at our department were randomly assigned into either a control group or an observation group (n = 41 for each). Both groups received 20 mg esomeprazole orally before breakfast, and only the observation group received 20 mg Deanxit orally after breakfast for eight consecutive weeks. The gastroesophageal reflux disease (GERD) questionnaire was used to analyze the overall and individual symptom scores before and after treatment. The Hamilton depression scale (HAMD), Zung self-rating depression scale (SDS) and the Chinese version of SF-36 scale were employed to evaluate the improved status of depression and quality of life. Meanwhile, the adverse reactions during medication were recorded.
RESULTS: The total effective rate in the observation group was higher than that in the control group (92.7% vs 75.6%, P < 0.05). No significant difference was observed in symptoms, depression or quality of life before treatment between the two groups, but the above parameters were significantly better after treatment in both groups (P < 0.05). In comparison with the control group, the observation group had significantly decreased scores of overall and individual symptoms of the GERD questionnaire and HAMD and SDS scores, but increased scores of body and psychological related quality of life (P < 0.05). Adverse reactions were mild, and similar between the two groups (P > 0.05).
CONCLUSION: Esomeprazole combined with Deanxit has a better effect than esomeprazole alone in the treatment of elderly NERD with depression in terms of improved symptoms, quality of life and depression.
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