Eructation Treated with Single-Session CBT: A Case Illustration
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Eructation Treated with Single‑Session CBT: A Case Illustration Anne Mary Montero1 · Sean Jones1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Chronic gastrointestinal disorders are disruptive to patients physically and psychologically, and benefit from multidisciplinary care, including targeted psychological interventions. This case study details a case of a 42-year-old Caucasian female with idiopathic eructation, who was identified as having psychological contributors to her 3-year history of GI symptoms. Following extensive medical testing, she was diagnosed with excessive, likely supragastric belching and referred for psychological care. She noted initial reticence to psychological approaches but was offered psychoeducation and CBT interventions targeting eructation disorder and anxiety. Although the patient paused treatment after only a single session of psychological contact (including assessment and brief intervention), her GI symptoms effectively resolved with application of anxiolytic breathing, psychoeducation, and other cognitive behavioral techniques, suggesting rapid efficacy of CBT interventions, when diligently applied. Keywords Eructation · Burping · CBT · Anxiolytic breathing · Diaphragmatic breathing · Anxiety
Introduction Chronic gastrointestinal disorders and liver diseases are linked to significantly high health care utilization rates and costs, as well as notable disease burden (Peery et al., 2015). For example, in 2010, abdominal pain was the number one gastrointestinal symptom to prompt an ambulatory visit, accounting for more than 27 million visits a year for pain alone (Peery et al., 2015). A two-way arrow can be conceptualized between GI symptoms and psychological distress, with patterns of at least symptom exacerbation if not precipitation of both physical and emotional upset (Fichna & Storr, 2012). For example, with high healthcare utilization rates, it is not surprising to learn that comorbid mental health disorders, such as major depressive disorder
Electronic supplementary material The online version of this article (doi:https://doi.org/10.1007/s10880-020-09697-6) contains supplementary material, which is available to authorized users. * Anne Mary Montero [email protected] 1
Digestive and Liver Disorders Division, Department of Medicine and Psychology, Indiana University Health, 10300 N. Illinois Street, Suite 1100, Indianapolis, IN 46032, USA
and generalized anxiety disorder, are exceedingly prevalent among gastroenterology patients (Whitehead, Palsson, & Jones, 2002). Further, not only are various types of trauma and abuse experiences unfortunately considered to be risk factors contributing to irritable bowel syndrome and other disorders of gut–brain interaction (Chitkara, van Tilburg, Blois-Martin, & Whitehead, 2008), but even more broadly, daily life stress can exacerbate gastrointestinal symptoms as well (Whitehead, Burnett, Cook, & Taub, 1996). It is considered to be best practice that gastroenterologists regularly assess pati
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