Mind-body connection: GERD and psychological distress
An immense amount of research exists to support the mind-body connection. One such study has recently emerged and was presented at a meeting of the American College of Gastoenterology. According to William Chey, M.D., and colleagues at the University of Michigan at Ann Arbor, patients that have GERD, also known as treatment-resistant gastroespophageal reflux disease, may not be responding to acid-suppressive therapy with PPI’s due to psychological distress.
According to the study, approximately 40% of patients with GERD have psychological distress as well. The study focused on 101 patients who endured esophagogastroduodenoscopy as well as health related surveys. The following is an excerpt of an article from Medpage Today that reviews the study in-depth:
To determine the prevalence of comorbid psychological distress and assess its impact on response to PPI therapy, Dr. Chey and colleagues studied 101 patients who underwent esophagogastroduodenoscopy for evaluation of persistent heartburn. Testing revealed that 67 patients had nonerosive reflux disease and 34 had erosive esophagitis.
At enrollment each patient completed health-related surveys designed to assess GERD symptoms and severity, quality of life, and psychological status. Patients with a score greater than 63 on the Brief Symptom Inventory were defined as having psychological distress.
“A BSI of 63 actually defines significant psychological distress,” said Dr. Chey. “We set the bar pretty high. These patients were significantly distressed.”
All patients received treatment with open-label rabeprazole (Aciphex) 20 mg/d. After eight weeks of PPI therapy, the health-related surveys were administered again.
Overall, 39% of the patients had comorbid psychological distress. The prevalence of concomitant psychological symptomatology did not differ between patients with nonerosive or erosive disease, said Dr. Chey. Although some of the patients were on antidepressants, most had not been diagnosed with psychological disorders.