The influence of co‐morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro‐oesophageal reflux disease

Abstract

SUMMARY BackgroundA subset of patients with gastro-oesophageal reflux disease (GERD) does not achieve complete symptom resolution with proton pump inhibitor (PPI) therapy. The factors which affect response to PPI therapy in GERD patients remain unclear.

Predictive Factors of Response to Proton Pump Inhibitors in Korean Patients With Gastroesophageal Reflux Disease

“…34 In the present study, the frequency of a history of psychotherapy or neuropsychiatric medication was significantly higher in the non-responder group. Nojkov et al 35 demonstrated that patients who responded poorly to PPI therapy were more likely to experience psychiatric distress. Psychological stress can aggravate sensitivity to esophageal pain by increasing the perception of esophageal stimuli.…”

Review article: gastro‐oesophageal reflux disease and psychological comorbidity

“…40,41 GERD patients who also had irritable bowel syndrome perceived their symptoms as more severe and tended not to achieve the same degree of improvement in GERD symptoms while treated with a PPI as those without irritable bowel syndrome. 41 Based on recent data about the contribution of psychological comorbidity to the PPI failure phenomenon, GERD patients who are not responsive to treatment should be evaluated for psychological comorbidity.…”

“…40 Consequently, it has been proposed that patients who did not respond to PPI therapy are more likely to have psychosocial comorbidity than those who were successfully treated with a PPI. Nojkov et al 41 provided the first evidence that response to PPI treatment may be associated with the level of psychological distress. The latter independently predicted worse GERD symptoms and quality of life before and after PPI treatment.…”

Psychological Comorbidity and Chronic Heartburn: Which Is the Chicken and Which Is the Egg?

“…High levels of anxiety and depression reduce the likelihood of achieving complete heartburn relief [18,19]. Moreover, the level of psychological distress is an independent predictor for poor response to PPI treatment [20].…”