STRESS AND GASTROESOPHAGEAL REFLUX DISEASE

  • Dalbir S Sandhu Division of Gastroenterology and Hepatology, Department of Medicine MetroHealth Medical Center and Case Western Reserve University Cleveland, Ohio, USA
  • Ronnie Fass Division of Gastroenterology and Hepatology, Department of Medicine MetroHealth Medical Center and Case Western Reserve University Cleveland, Ohio, USA
Keywords: Stress, gastroesophageal reflux disease, esophageal hypersensitivity

Abstract

Gastroesophageal reflux disease (GERD) is one of the commonest conditions managed by clinicians. Regurgitation and heartburn are considered the cardinal symptoms of GERD. In recent decades, an increasing association has been noted between stress and GERD and our knowledge about the pathophysiology of this relationship is constantly evolving. Both acute and chronic stress can accentuate GERD related symptoms. Subjects exposed to chronic life stressors are more likely to complaint of GERD symptoms. Current data suggests that acute stress exacerbates GERD symptoms by enhancing the perceptual responses to intra-esophageal acid stimulivia central mechanisms without increasing the amount of acid reflux. This process is likely mediated by an increase in esophageal mucosal permeability. Treatment with proton pump inhibitors attenuates the effect of acute stress on esophageal perception thresholds for pain. However, the effect of anti-reflux therapy in patients experiencing chronic stress remains to be elucidated.

 

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References

Katz P.O., Gerson L.B., Vela M.F. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-28; quiz 29.

https://doi.org/10.1038/ajg.2012.444

Sandhu D.S., Fass R. Current Trends in the Management of Gastroesophageal Reflux Disease. Gut Liver. 2018;12(1):7-16.

https://doi.org/10.5009/gnl16615

Anderson N.B. Levels of analysis in health science. A framework for integrating sociobehavioral and biomedical research. Ann N Y Acad Sci. 1998;840:563-76.

https://doi.org/10.1111/j.1749-6632.1998.tb09595.x

Dallman M.F., Pecoraro N., Akana S.F., La Fleur S.E., Gomez F., Houshyar H., et al. Chronic stress and obesity: a new view of «comfort food». Proc Natl Acad Sci U S A. 2003;100(20):11696-701.

https://doi.org/10.1073/pnas.1934666100

Holtmann G., Kriebel R., Singer M.V. Mental stress and gastric acid secretion. Do personality traits influence the response? Dig Dis Sci. 1990;35(8):998-1007.

https://doi.org/10.1007/BF01537249

Rubin J., Nagler R., Spiro H.M., Pilot M.L. Measuring the effect of emotions on esophageal motility. Psychosom Med. 1962;24:170-6.

https://doi.org/10.1097/00006842-196203000-00007

Bradley L.A., Richter J.E., Pulliam T.J., Haile J.M., Scarinci I.C., Schan C.A., et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol. 1993;88(1):11-9.

Kulig M., Leodolter A., Vieth M., Schulte E., Jaspersen D., Labenz J., et al. Quality of life in relation to symptoms in patients with gastro-oesophageal reflux disease– an analysis based on the ProGERD initiative. Aliment Pharmacol Ther. 2003;18(8):767-76.

https://doi.org/10.1046/j.1365-2036.2003.01770.x

Naliboff B.D., Mayer M., Fass R., Fitzgerald L.Z,. Chang L., Bolus R., et al. The effect of life stress on symptoms of heartburn. Psychosom Med. 2004;66(3):426-34.

https://doi.org/10.1097/01.psy.0000124756.37520.84

Haruma K., Kinoshita Y., Sakamoto S., Sanada K., Hiroi S., Miwa H. Lifestyle factors and efficacy of lifestyle interventions in gastroesophageal reflux disease patients with functional dyspepsia: primary care perspectives from the LEGEND study. Intern Med. 2015;54(7):695-701.

https://doi.org/10.2169/internalmedicine.54.3056

A gallup survey on heartburn across America. . Princeton, NJ Gallup Organization Inc. 1988.

Kahrilas P.J., Gupta R.R. Mechanisms of acid reflux associated with cigarette smoking. Gut. 1990;31(1):4-10.

https://doi.org/10.1136/gut.31.1.4

Vitale G.C., Cheadle W.G., Patel B., Sadek S.A., Michel M.E., Cuschieri A. The effect of alcohol on nocturnal gastroesophageal reflux. JAMA. 1987;258(15):2077-9.

https://doi.org/10.1001/jama.1987.03400150069031

Shapiro M., Simantov R., Yair M., Leitman M., Blatt A., Scapa E., et al. Comparison of central and intraesophageal factors between gastroesophageal reflux disease (GERD) patients and those with GERD-related noncardiac chest pain. Dis Esophagus. 2012;25(8):702-8.

https://doi.org/10.1111/j.1442-2050.2011.01317.x

Mittal R.K., Stewart W.R., Ramahi M., Chen J., Tisdelle D. The effects of psychological stress on the esophagogastric junction pressure and swallow-induced relaxation. Gastroenterology. 1994;106(6):1477-84.

https://doi.org/10.1016/0016-5085(94)90400-6

Wright C.E., Ebrecht M., Mitchell R., Anggiansah A., Weinman J. The effect of psychological stress on symptom severity and perception in patients with gastro-oesophageal reflux. J Psychosom Res. 2005;59(6):415-24.

https://doi.org/10.1016/j.jpsychores.2005.05.012

Peterson W.L. The role of acid in upper gastrointestinal haemorrhage due to ulcer and stress-related mucosal damage. Aliment Pharmacol Ther. 1995;9 Suppl 1:43-6.

https://doi.org/10.1111/j.1365-2036.1995.tb00783.x

Song E.M., Jung H.K., Jung J.M. The association between reflux esophagitis and psychosocial stress. Dig Dis Sci. 2013;58(2):471-7.

https://doi.org/10.1007/s10620-012-2377-z

Holtmann G., Singer M.V., Kriebel R., Stacker K.H., Goebell H. Differential effects of acute mental stress on interdigestive secretion of gastric acid, pancreatic enzymes, and gastroduodenal motility. Dig Dis Sci. 1989;34(11):1701-7.

https://doi.org/10.1007/BF01540047

Fass R., Naliboff B.D., Fass S.S., Peleg N., Wendel C., Malagon I.B., et al. The effect of auditory stress on perception of intraesophageal acid in patients with gastroesophageal reflux disease. Gastroenterology. 2008;134(3):696-705.

https://doi.org/10.1053/j.gastro.2007.12.010

Sharma A., Van Oudenhove L., Paine P., Gregory L., Aziz Q. Anxiety increases acid-induced esophageal hyperalgesia. Psychosom Med. 2010;72(8):802-9.

https://doi.org/10.1097/PSY.0b013e3181f5c021

Schey R., Dickman R., Parthasarathy S., Quan S.F., Wendel C., Merchant J., et al. Sleep deprivation is hyperalgesic in patients with gastroesophageal reflux disease. Gastroenterology. 2007;133(6):1787-95.

https://doi.org/10.1053/j.gastro.2007.09.039

Poh C.H., Hershcovici T., Gasiorowska A., Navarro-Rodriguez T., Willis M.R., Powers J., et al. The effect of antireflux treatment on patients with gastroesophageal reflux disease undergoing a mental arithmetic stressor. Neurogastroenterol Motil. 2011;23(11):e489-96.

https://doi.org/10.1111/j.1365-2982.2011.01691.x

Boltin D., Boaz M., Aizic S., Sperber A., Fass R., Niv Y., et al. Psychological distress is not associated with treatment failure in patients with gastroesophageal reflux disease. J Psychosom Res. 2013;75(5):462-6.

https://doi.org/10.1016/j.jpsychores.2013.08.008

Heading R.C., Monnikes H., Tholen A., Schmitt H. Prediction of response to PPI therapy and factors influencing treatment outcome in patients with GORD: a prospective pragmatic trial using pantoprazole. BMC Gastroenterol. 2011;11:52.

https://doi.org/10.1186/1471-230X-11-52

Hemmink G.J., Bredenoord A.J., Weusten B.L., Timmer R., Smout A.J. Does acute psychological stress increase perception of oesophageal acid? Neurogastroenterol Motil. 2009;21(10):1055-e86.

https://doi.org/10.1111/j.1365-2982.2009.01327.x

Johnston B.T., McFarland R.J., Collins J.S., Love A.H. Effect of acute stress on oesophageal motility in patients with gastro-oesophageal reflux disease. Gut. 1996;38(4):492-7.

https://doi.org/10.1136/gut.38.4.492


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Published
2018-12-28
How to Cite
1.
Sandhu DS, Fass R. STRESS AND GASTROESOPHAGEAL REFLUX DISEASE. Proc Shevchenko Sci Soc Med Sci [Internet]. 2018Dec.28 [cited 2024Mar.29];54(2):10-5. Available from: https://mspsss.org.ua/index.php/journal/article/view/150