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Predictors of cognitive behavioural therapy success in managing supragastric belching

18 Aug 2019

In the management of supragastric belching (SGB) with cognitive behavioural therapy (CBT), factors such as number of SGB and hypervigilance score at baseline as well as proficiency during treatment help predict CBT outcomes, according to a study.

Researchers examined the medical records of 39 SGB patients who had completed the CBT protocol to determine factors associated with successful treatment and to assess symptoms 6–12 months after CBT completion. They used a visual analogue scale (VAS) score to measure changes in symptoms from pre- to post-treatment.

In the cohort, the median number of SGBs was 103 episodes. The median total number of reflux episodes was 49, of which 37 were acid reflux episodes. Total oesophageal acid exposure time was a median of 3.8 percent, with 17 patients (44 percent) having pathological acid exposure (>6 percent).

Significant predictors of CBT success included a lower number of SGBs (p<0.01) and lower hypervigilance score (p<0.04) prior to treatment initiation, and higher CBT proficiency score (acceptance of the explanation that SGB is a behavioural phenomenon, detection of a warning signal before belching, and adherence to the exercises treatment; p=0.001). Multiple regression analysis found that all three factors were independently associated with treatment outcome (p<0.01, p=0.01 and p<0.01, respectively).

Mean VAS score of 267 before CBT dropped to 151 soon after treatment initiation (p<0.001), with the effect persisting at 6–12 months follow-up (153).

The present data may aid in the detection of patients with SGB who are less likely to respond to CBT at diagnosis, the researchers said. In light of this, treatment outcome may be improved by modifying the CBT intensity and duration.

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