Biofeedback asistovaný tréning hlbokého dýchania pri refraktérnych poruchách interakcie čreva a mozgu – naše prvé skúsenosti, dojmy a návrhy pre ďalšiu klinickú prax

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Authors: Peter Lipták ¹; I. Tonhajzerová ²; Martin Ďuriček ¹; Z. Višňovcová ³; N. Ferencová ³; Diana Vážanová ¹; P. Bánovčin Jr. ¹
Authors‘ workplace: Clinic of Internal Medicine – Gastroenterology, Jessenius Faculty of Medicine in Martin, Comenius University, University Hospital in Martin ¹; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava ²; Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava ³
Published in: Gastroent Hepatol 2023; 77(4): 289-294
Category: Clinical and Experimental Gastroenterology: Original Article
doi: https://doi.org/10.48095/ccgh2023289

Overview

Úvod: Poruchy interakcie čreva a mozgu predstavujú skupinu širokého spektra chronických gastrointestinálnych ochorení s množstvom symptómov súvisiacich s poruchou špecifického orgánu. Neexistuje žiadny špecifický liek na DGBI a terapia je väčšinou zameraná na zmiernenie symptómov. Jednou z potenciálnych nových terapií na zmiernenie symptómov by mohol byť tréning hlbokého dýchania. Dostupné údaje naznačujú, že stimulácia hlbokého dýchania pomocou biofeedbacku môže viesť k zníženiu vnímania bolesti, dokonca aj viscerálnej bolesti pochádzajúcej z gastrointestinálneho traktu. Metódy: Ide o retrospektívnu analýzu klinických údajov získaných od pacientov, ktorí boli liečení nácvikom hlbokého dýchania pre refraktérny prípad ochorenia interakcie čreva a mozgu. DGBI bol diagnostikovaný na základe kritérií ROME IV. Pred tréningom bol pacientom dôkladne vysvetlený správny mechanizmus hlbokého brušného dýchania. Pacienti tiež vyplnili dotazníky STAI-X1, STAI-X2 na posúdenie úrovne ich úzkosti. Po úvodnom tréningu v ordinácii boli pacienti inštruovaní, aby pokračovali v domácom hlbokom brušnom dýchaní 3- až 5-krát týždenne. Účinok terapie bol hodnotený po jednom mesiaci. Výsledky: Pätnástim vhodným pacientom bol ponúknutý tréning hlbokého dýchania s pomocou biofeedbacku. Deväť pacientov sa dostavilo na kontrolu po 4 týždňoch, a preto sú zohľadnení v analýze. U piatich pacientov došlo k miernemu zmierneniu symptómov. U dvoch pacientov došlo k vymiznutiu symptómov a naopak dvaja pacienti neuviedli žiadnu zmenu symptómov. V úrovniach úzkosti neboli žiadne štatisticky významné zmeny. Záver: Tréning hlbokého dýchania na zmiernenie symptómov pri poruchách interakcie čreva a mozgu sa zdá byť sľubnou reklamou na terapiu. Vyplýva to z publikovaných štúdií a našich vlastných skúseností. Pred jednoznačnejším záverom sú však potrebné prísnejšie údaje.

Klíčová slova:

dyspepsia – globus – biofeedback – IBS – tréning hlbokého dýchania

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