Persistent reflux symptoms cause anxiety, depression, and mental health and sleep disorders in gastroesophageal reflux disease patients

Abstract

Some patients with gastroesophageal reflux disease experience persistent reflux symptoms despite proton pump inhibitor therapy. These symptoms reduce their health-related quality of life. Our aims were to evaluate the relationship between proton pump inhibitor efficacy and health-related quality of life and to evaluate predictive factors affecting treatment response in Japanese patients. Using the gastroesophageal reflux disease questionnaire, 145 gastroesophageal reflux disease patients undergoing proton pump inhibitor therapy were evaluated and classified as responders or partial-responders. Their health-related quality of life was then evaluated using the 8-item Short Form Health Survey, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale questionnaires. Sixty-nine patients (47.6%) were partial responders. These patients had significantly lower scores than responders in 5/8 subscales and in the mental health component summary of the 8-item Short Form Health Survey. Partial responders had significantly higher Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale scores, including anxiety and depression scores, than those of responders. Non-erosive reflux disease and double proton pump inhibitor doses were predictive factors of partial responders. Persistent reflux symptoms, despite proton pump inhibitor therapy, caused mental health disorders, sleep disorders, and psychological distress in Japanese gastroesophageal reflux disease patients.

Prevalence and Correlates of Gastroesophageal Reflux Disease in Southern Iran: Pars Cohort Study

“…Previous studies showed bidirectional association between GERD and psychological problems such as anxiety, depression, sleep disturbance, and insomnia. 35 , 57 - 59 , In our results, positive history of anxiety (OR 1.24, 95% CI 1.11 - 1.40) and insomnia (OR 1.36, 95% CI 1.21 - 1.54) were significantly associated with GERD and frequent GERD.…”

Association Between Anxiety and Depression and Gastroesophageal Reflux Disease: Results From a Large Cross-sectional Study

“…Previous studies have shown that patients, particularly those with a poor response to PPIs, were more likely to show higher levels of anxiety and depression, and these partial PPI responders were most common in the NERD group among the subtypes of GERD. 38 Therefore, the relationship between anxiety, depression, and GERD involves a complex interplay of various mechanisms, and a multidisciplinary approach is needed to understand this relationship.…”

Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-types of Gastroesophageal Reflux Disease and Gastroesophageal Reflux Disease-related Disorders

“…8,[31][32][33] It has been demonstrated that the higher the level of anxiety and depression, the poorer, the effectiveness of acid-suppressing therapy, and thus psychological factors can be used as a predictor of anti-reflux treatment. [34][35][36] Therefore, patients with GERD with anxiety and depression were included in the present study. GERD-AD group was recruited according to the GerdQ, endoscopy, and Hamilton Anxiety and Depression Rating Scale, and the GERD-AD group did not overlap with other groups.…”

“…In turn, GERD can also increase the incidence of psychological disorders such as anxiety and depression. 7,8 Current diagnostic methods for GERD include symptom questionnaires and 24-hour pH monitoring, 9 high-resolution esophageal manometry, 10 endoscopy, radionuclide gastroesophageal reflux test, and proton pump inhibitor (PPI) diagnostic treatments. 11 Among them, 24-hour pH monitoring is the most commonly used method with a high specificity.…”