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|Title:||Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy?|
|Citation:||Alimentary Pharmacology & Therapeutics, 2007; 25(8):973-986|
|Publisher:||Blackwell Publishing Ltd|
|S. Haag, W. Senf, S. Tagay, M. Langkafel, U. Braun-Lang, A. Pietsch, G. Heuft, N. J. Talley and G. Holtmann|
|Abstract:||Aim: In a prospective randomized, controlled trial, to compare the long-term outcome of intensive medical therapy (with or without cognitive-behavioural or muscle relaxation therapy) vs. standard medical therapy in patients with refractory functional dyspepsia (FD), referred to a tertiary referral medical center. Methods: A total of 100 consecutive FD patients were allocated to a standardized symptom-oriented 4 month therapy (SMT, n = 24), intensive medical therapy (IMT, medical therapy with testing-for and targeting-of abnormalities of motor-and-sensory function, n = 28) or IMT plus psychological interventions (either progressive-muscle relaxation (IMT-MR, n = 20) or cognitive-behavioural therapy (IMT-CBT, n = 28). The symptom intensity (SI) and health-related quality-of-life (HRQoL) after 12 months were prespecified primary outcome parameters. Results: After 12 months, significantly greater improvement of SI occurred in patients with IMT-all (with or without psychological interventions) compared with SMT (P < 0.025 vs. IMT-all). IMT, IMT-MR and IMT-CBT alone also resulted in significantly better improvement of the primary outcome parameters (P all < 0.025 vs. SMT). HRQoL significantly improved in all groups with intensive medical therapy but not standard medical therapy. Differences between intensive medical therapy-all and standard medical therapy were not significant. Concomitant anxiety and depression was improved significantly by IMT-CBT (vs. SMT) but not other treatments. Conclusions: In FD patients with refractory symptoms, intensified medical management involving function testing and psychological intervention yields superior long-term-outcomes. Additional CBT may be effective for the control of concomitant anxiety and depression.|
|Description:||The definitive version is available at www.blackwell-synergy.com Article first published online: 12 FEB 2007|
|Rights:||© 2007 The Authors Journal compilation © 2007 Blackwell Publishing Ltd|
|Appears in Collections:||Medicine publications|
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