Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy

摘要: SUMMARY Aim In a prospective randomized, controlled trial, to compare the long-term outcome of intensive medical therapy (with or without cognitive-behavioural muscle relaxation therapy) vs. standard in patients with refractory functional dyspepsia (FD), referred tertiary referral center. Methods A total 100 consecutive FD were allocated standardized symptom-oriented 4 month (SMT, n = 24), (IMT, testing-for and targeting-of abnormalities motor-and-sensory function, n = 28) IMT plus psychological interventions (either progressive-muscle (IMT-MR, n = 20) (IMT-CBT, n = 28). The symptom intensity (SI) health-related quality-of-life (HRQoL) after 12 months prespecified primary parameters. Results After 12 months, significantly greater improvement SI occurred IMT-all interventions) compared SMT (P < 0.025 IMT-all). IMT, IMT-MR IMT-CBT alone also resulted better parameters (P all < 0.025 SMT). HRQoL improved all groups but not therapy. Differences between therapy-all significant. Concomitant anxiety depression was by (vs. SMT) other treatments. Conclusions symptoms, intensified management involving function testing intervention yields superior long-term-outcomes. Additional CBT may be effective for control concomitant depression.