Rumination is an upper gastrointestinal (GI) disorder characterized by the frequent regurgitation of recently ingested food. Very little is understood about the nature and treatment of this disorder. The act of regurgitation in rumination involves the opening of the upper esophageal sphincter and the muscular contraction of the abdomins rectus. Behavioral treatment of these symptoms is the clinical intervention of choice; however, only uncontrolled case documentation exists to support its effectiveness. However, an effective behavioral mechanism may be relaxation of the muscles. From a behavioral standpoint, muscular relaxation is incompatible with the necessary muscular contraction for rumination. To date, single case documentation and few designed single case studies have examined the clinical effectiveness of behavioral interventions for GI rumination. In the current study, the investigators seek to examine the effectiveness of two behavioral relaxation interventions for GI rumination through a treatment as usual paradigm (proposed N = 20). Our primary goals are to examine the clinical effectiveness of these interventions in symptom reduction at 1- and 3-month follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
13
Patients in this arm will be provided training in diaphragmatic breathing, taught its application in habit-reversal paradigm (to use after eating food and if urge to ruminate).
Progressive passive muscle relaxation
Mayo Clinic in Rochester
Rochester, Minnesota, United States
Rumination Frequency assessed using Rome III Criteria
Study participants will be treated with diaphragmatic breathing in one arm and muscle relaxation in the other arm. Outcome measure is: Rome III Study Questions Q8: In the last week, how often did food come back up into your mouth? Q10: When food came back up into your mouth, did it usually stay in your mouth for a while before you swallowed it or spit it out?
Time frame: 1 month after intervention
Rumination frequency assessed using Rome III Criteria
Study participants will be treated with diaphragmatic breathing in one arm and muscle relaxation in the other arm. Outcome measure is: Rome III Study Questions Q8: In the last week, how often did food come back up into your mouth? Q10: When food came back up into your mouth, did it usually stay in your mouth for a while before you swallowed it or spit it out?
Time frame: 3 months after intervention
Heath Care Utilization
How many healthcare visits would you estimate were related to rumination since you started the intervention?
Time frame: 1 month after intervention
Short Health Anxiety Inventory (SHAI)
Measure of degree to which intervention has impacted health concerns/anxiety. The SHAI is a validated measure
Time frame: 1 month post intervention
Sheehan Disability Scale (SDS)
This is a measure of the impact of symptoms on Work, Family, and Social life. Uses a 10 point scale --with categories of mild,moderate severe
Time frame: 1 month after intervention
Treatment adherence
Following question will be posed: Did you engage in the intervention as you were instructed at your training session? The responses will be categorized for themes.
Time frame: 1 month after intervention
Heath Care Utilization
How many healthcare visits would you estimate were related to rumination since you started the intervention?
Time frame: 3 month after intervention
Short Health Anxiety Inventory (SHAI)
Measure of degree to which intervention has impacted health concerns/anxiety. The SHAI is a validated measure
Time frame: 3 months post intervention
Sheehan Disability Scale (SDS)
This is a measure of the impact of symptoms on Work, Family, and Social life. Uses a 10 point scale --with categories of mild,moderate severe
Time frame: 3 months after intervention
Treatment adherence
Following question will be posed: Did you engage in the intervention as you were instructed at your training session? The responses will be categorized for themes.
Time frame: 3 months after intervention
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