Multifaceted Biopsychosocial Treatment Improved Intractable Aerophagia Arising from Maladjustment at Work : A Case Study

Abstract

Here, we report a case of aerophagia in which the integration of an organic, multifaceted treatment approach led to an improvement in intractable gastrointestinal symptoms. A 27-year-old man complained of repetitive belching and abdominal bloating. After excluding the possibility of organic gastrointestinal disorders by clinical examination, he was diagnosed as aerophagia using RomeⅢ criteria. The patient was poorly responsive to standard treatment. We initiated a biopsychosocial treatment approach for this patient, because maladjustment at work was one of the background causative factors. From a biological perspective, we improved the patient’s pathophysiology of aerophagia by showing him videos and images of the associated biological changes, such as the changes in intestinal gas patterns that can be seen on abdominal x-ray. From a psychological perspective, we encouraged emotional expression and acceptance of his condition because this patient exhibited alexithymic tendencies. We explained the importance of spending time on personal hobbies and encouraged behavioral changes considering his over-adaptive tendencies. From a social perspective, we made environmental intervention to his workplace to account for the patient’s significantly low intellectual processing speed.