Acid perception in gastro-oesophageal reflux disease is dependent on psychosocial factors

Abstract

Background: Our aim was to contrast the psychosocial profiles of patients with gastro-oesophageal reflux disease whose symptoms correlate well with acid reflux against those whose symptoms do not.

Methods: One hundred and one patients presenting with heartburn for the first time underwent oesophageal pH monitoring, and 82 (81%) experienced symptoms during the recording. On the basis of how well their symptoms correlated with acid reflux, patients were divided into symptom-positive and symptom-negative groups. These two groups were then compared on the basis of four questionnaires looking at different psychosocial factors.

Results: Symptom-negative patients displayed significantly higher levels of trait anxiety (44.5 versus 38.7; p < 0.05) and hysteria (5.6 versus 4.1; p < 0.05). The adequacy of their social support structures was significantly lower (6.2 versus 7.3; p < 0.05). No difference in daily hassles or uplifts was found.

Conclusion: Significant psychosocial differences are noted in patients with poor symptom-reflux correlation. These differences may help explain the aetiology of such patients' symptoms.