The Acceptance, Commitment and COgnitive RemeDiation (ACCORD) Study: Can a Brief Online Cognitive Intervention Improve Outcomes in Patients With Esophageal Disease?

Background: Cognitive and psychological inflexibility are two mental processes that influence how a person interprets and responds to esophageal symptoms. Patients with greater mental inflexibility are at risk for poorer outcomes. Brain-gut behavioral therapies (BGBT) are effective adjunctive treatments in many digestive diseases, with potential to improve mental flexibility.

The psychobiological model of disorders of gut-brain interaction: introduction of a novel, integrated, and testable model.

Psychogastroenterology encompasses both basic mechanistic research, which identifies psychological mechanisms (eg, fear-learning) that contribute to disorders of gut-brain interaction (DGBIs), and clinical applied research, which evaluates the efficacy of gut-brain behavioural therapies in DGBIs. However, progress in the field is hindered by inadequate communication between these areas, such that mechanistic processes are rarely translated into clinical targets, and interventions are developed with an incomplete understanding of the potential mechanisms by which they work or for whom they work. To bridge this translational gap, we propose the psychobiological model of DGBIs-an integrated and testable model that illustrates how psychological mechanisms central to DGBIs interact with each other and with biological processes along the gut-brain axis.

DIAGNOSTIC AND MANAGEMENT REVIEW OF GASTRIC AND SUPRAGASTRIC BELCHING, AEROPHAGIA, AND RUMINATION SYNDROME.

Supragastric belching and rumination syndrome are distressing and potentially debilitating gastrointestinal disorders. Though related, these conditions are distinct from aerophagia and excessive gastric belching. While diagnostic standards and effective treatment strategies are emerging, formal guideline directed treatment and validated measurement tools to demonstrate efficacy of interventions are lacking.

The San Diego Consensus for Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease.

Introduction: The term laryngopharyngeal reflux (LPR) is frequently applied to aerodigestive symptoms despite lack of objective reflux evidence. The aim of this initiative was to develop a modern care paradigm for LPR supported by otolaryngology and gastroenterology disciplines.

Methods: A 28-member international interdisciplinary working group developed practical statements within the following domains: definition/terminology, initial diagnostic evaluation, reflux monitoring, therapeutic trials, behavioral factors and therapy, and risk stratification.

Associations between the Anxiety Sensitivity Index-3 subscales and eating pathology.

Objective: While prior research has found links between anxiety sensitivity (AS) and eating disorder (ED) symptoms, there has been limited research exploring how specific aspects of AS are related to specific dimensions of eating pathology. To inform candidate targets of specific aspects of AS in future interventions, the current study identified associations between AS and ED constructs in a sample of individuals with elevated eating pathology.

Method:  = 382 undergraduate students (89.

Review Article: Rome Foundation Working Team Report: Consensus Statement on the Design and Conduct of Behavioural Clinical Trials for Disorders of Gut-Brain Interaction.

Background: Brain-gut behaviour therapies (BGBT) have gained widespread acceptance as therapeutic modalities for the management of disorders of gut-brain interaction (DGBI). However, existing treatment evaluation methods in the medical field fail to capture the specific elements of scientific rigour unique to behavioural trial evaluation.

Aims: To offer the first consensus on the development and testing of BGBT in DGBI.

Positive affect longitudinally buffers the negative effect of health anxiety on gastrointestinal symptoms.

People with significant health anxiety may experience brain-gut dysregulation, leading to increased visceral sensitivity and greater gastrointestinal (GI) symptoms. Positive affect (PA), on the other hand, may serve as a protective characteristic, buffering the negative impact of health anxiety on GI symptoms. This study investigated interrelationships between health anxiety, PA, and GI symptoms.

A primer for the gastroenterology provider on psychosocial assessment of patients with disorders of gut-brain interaction.

Background: GI-specific psychological factors are important contributors to patients' symptom experience and quality of life across all disorders of gut-brain interaction (DGBI). Clinicians' ability to recognize the role of these psychological factors is essential for formulating a biopsychosocial case conceptualization and informing treatment decisions.

Purpose: This article will familiarize gastroenterology providers with conceptualizing the role of GI-specific psychological factors in DGBI and provides stepwise, practical guidance for how to assess these during clinical encounters in a time-efficient manner.

The role of hypervigilance in chronic esophageal diseases: a scoping review.

Background: Hypervigilance has emerged as an important construct in esophageal symptom reporting, but a review of the literature does not currently exist. This scoping review aimed to generate a comprehensive overview of the literature on hypervigilance in esophageal diseases and summarize the evidence for each esophageal disease.

Methods: Guided by the Joanna Briggs Institute scoping review methodology, articles that were peer-reviewed original studies, published in English, and included adult patients with at least one esophageal disease were included.

Pain is a cardinal symptom cutting across Rome IV anatomical categories in disorders of gut-brain interaction: A network-based approach.

Introduction: Disorders of gut-brain interaction (DGBI) are symptom-based disorders categorized by anatomic location but have high overlap and heterogeneity. Viewing DGBI symptoms on a spectrum (i.e.

Predictors of Symptoms Trajectories in Newly Diagnosed Ulcerative Colitis: A 3-Year Follow-up Cohort Study.

Background And Aims: Psychological symptoms are associated with poorer ulcerative colitis [UC]-related outcomes. However, the majority of research is cross-sectional. We aimed to identify subgroups based on the longitudinal evolution of GI symptom levels and health-related quality of life [HRQoL], and to disentangle the directionality of effects between GI symptom levels and psychological distress.

Disease Acceptance, but not Perceived Control, is Uniquely Associated with Inflammatory Bowel Disease-related Disability.

Background And Aims: Disability, an important aspect of disease burden in patients with inflammatory bowel disease [IBD], has been suggested as a valuable clinical endpoint. We aimed to investigate how disease acceptance and perceived control, two psychological predictors of subjective health, are associated with IBD-related disability.

Methods: In this cross-sectional study, adult IBD patients from the University Hospitals Leuven received a survey with questions about clinical and demographic characteristics, disease acceptance and perceived control [Subjective Health Experience model questionnaire], and IBD-related disability [IBD Disk].

Validation of a measure of hypervigilance and anxiety about gastrointestinal symptoms for individuals with elevated eating pathology.

Gastrointestinal symptoms are common within eating disorders and gastrointestinal-specific anxiety is a posited maintenance factor. The present study sought to validate a modified version of an existing measure of gastrointestinal-specific anxiety and hypervigilance in a sample with elevated eating pathology. Esophageal-specific terms in the Esophageal Hypervigilance and Anxiety Scale were modified to measure any gastrointestinal symptoms as a general measure of gastrointestinal-specific anxiety and hypervigilance.

Psychological Processes, Not Physiological Parameters, Are Most Important Contributors to Symptom Severity in Patients With Refractory Heartburn/Regurgitation Symptoms.

Background & Aims: Physiological and psychological factors have been found to influence esophageal symptom reporting. We aimed to evaluate which of these factors are associated with 3 reflux symptom severity outcomes (ie, Total Reflux, Heartburn, and Sleep Disturbance) through a traditional statistical and a complementary machine-learning approach.

Methods: Consecutive adult patients with refractory heartburn/regurgitation symptoms underwent standard 24-hour pH-impedance monitoring and completed questionnaires assessing past and current gastrointestinal and psychological health.

Psychological symptoms do not discriminate between reflux phenotypes along the organic-functional refractory GERD spectrum.

Objective: Historically, psychological processes are associated with disorders at the functional end of the gastro-oesophageal reflux disease (GERD) spectrum. However, recent research suggests that psychological symptoms are relevant across the GERD spectrum. We aim to investigate whether psychological symptoms are associated with reflux phenotype (True GERD, Borderline GERD, reflux hypersensitivity, functional heartburn) along the GERD spectrum in a cohort of refractory reflux patients.

Assessment of Post-traumatic Stress Disorder Among Objective Esophageal Motility and Reflux Phenotypes in Symptomatic Veterans.

Prior research suggests post-traumatic stress disorder (PTSD) is associated with the development of esophageal symptoms. We aimed to evaluate the prevalence of PTSD in veterans with esophageal symptoms, and assess for differences in objective esophageal motility and reflux classifications. Consecutive veterans reporting esophageal symptoms (e.

Validation in French of the Brief Esophageal Dysphagia Questionnaire in Patients Referred For Esophageal Manometry.

A brief esophageal dysphagia questionnaire (BEDQ) was recently developed in English to evaluate frequency and intensity of dysphagia. Our aim was to validate this questionnaire in French in a cohort of patients referred for esophageal manometry. Patients referred for esophageal high resolution manometry were offered to fill out different questionnaires including Eckart score, GERDQ score and BEDQ.

Validation of the French version of the esophageal hypervigilance and anxiety scale.

Introduction: An esophageal hypervigilance and anxiety scale (EHAS) was developed in English to assess the psychological process in patients with esophageal disorders. The aim of the current study was to validate this scale in French.

Patients And Methods: Patients referred for esophageal high resolution manometry (HRM) were offered to fill out different questionnaires including EHAS, Eckart score and gastro-esophageal reflux disease-questionnaire (GERDQ) score.

Esophageal hypervigilance is prevalent across gastroesophageal reflux disease presentations.

Background: There is a need to identify factors outside of abnormal reflux that contribute to gastroesophageal reflux disease (GERD). Esophageal hypervigilance is a psychological process impacting symptom experience in esophageal disease. However, little is known about the presence of hypervigilance in GERD phenotypes, especially in those with abnormal acid exposure or symptom index scores.

Validation of the Short-Form Esophageal Hypervigilance and Anxiety Scale.

Background & Aims: Esophageal hypervigilance and anxiety are emerging as important drivers of dysphagia symptoms and reduced quality of life across esophageal diagnoses. The esophageal hypervigilance and anxiety scale (EHAS) is a validated measure of these cognitive-affective processes. However, its length may preclude it from use in clinical practice.