[Coping with stress and personality structure in patients with and without stress-associated symptoms of gastroesophageal reflux]

Abstract

Background: Psychological aspects like stress, emotions or personality are known to affect the severity of symptoms of gastroesophageal reflux disease (GERD). The aim of the present study was to evaluate differences in coping with stress, structure of personality and also objective and subjective parameters of patients with or without a stress-related perception of symptoms in GERD.

Methods: 100 patients which underwent laparoscopic antireflux surgery at our department of surgery were included in this study. All patients answered questionnaires to evaluate their coping with stress (SVF), structure of personality (FPI-R) and quality of life (GILQI) pre- and postoperatively. Also data of physiological parameters like manometry, 24-hours pH monitoring, endoscopy and clinical history were included. Patients were divided into two groups: one with and one without a stress-related perception of symptoms.

Results: 46 out of 100 patients declared stress-related symptoms of reflux (group 1) and 54 out of 100 had no influence of stress to their reflux disease (group two). Those two groups showed significant differences (p < .05) in some coping strategies and their personality: Coping with stress (SVF): Trial to control the situations (18.3 vs. 13.1), trial to control reactions (18.2 vs. 13.3), requirement of social support (9.7 vs. 14.8), tendency to escape (7.7 vs. 13.9) and aggression (13.1 vs. 7.6); structure of personality (FPI-R): Standard of performance (10.8 vs. 7.2), stress (9.8 vs. 4.7) and physical discomfort (7.6 vs. 4.6). We also found significant (p < .05) differences in pre- and postoperative quality of life (GILQI: preoperative 86.3 vs. 98.5 points; postoperative 117.9 vs. 128.2 points) and the day-time of reflux perception. There were no differences in physiological parameters.

Conclusion: These findings point out that there are no physiological differences between the two groups with or without stress-related symptoms in GERD. But we found significant differences in psychological factors. Therefore we suggest that preoperative psychological interventions may optimize the subjective outcome after antireflux surgery in patients with a stress-related perception of symptoms.