Psychological Comorbidity Is Common With Functional Heartburn

Increased sensation to visceral stimuli and anxiety and depression play a major role in reflux hypersensitivity (RH), functional heartburn (FH), and nonerosive reflux disease (NERD), according to a recent study.

In their study, the researchers “aimed to assess markers of psychological comorbidity as well as gastro-esophageal reflux measurements in RH patients compared to controls and also in patients with FH and NERD versus controls.”

They conducted a study involving 304 patients attending a functional diagnostics center from 2016 to 2018 who underwent psychological assessment with validated questionnaires.

Overall, decreased visceral sensitivity index (VSI) of 57.8 ± 15.4 points was observed among RH patients (n = 45) compared with 85.7 ± 2.0 points in the control group (n = 31). A significant difference in VSI was observed between patients with FH (60.8 ± 23.3 points, n = 59) and NERD (61.9 ± 20.8 points, n = 67) compared with controls.

Hospital anxiety and depression score (HADS)was also significantly different between patients with RH (11.9 ± 6.0 points), FH (11.0 ± 7.4 points), and NERD (11.3 ± 8.9 points) as compared with controls (2.0 ± 1.4 pts).

“Increased sensation to visceral stimuli as well as anxiety and depression appears to play an important role not only in reflux hypersensitivity and functional heartburn as defined by Rome IV but also in NERD. These findings are in line with the disease concept of disorders of gut-brain interaction in which psychological comorbidities and visceral hypersensitivity play a major role,” the researchers concluded.

—Michael Potts

Reference:

Losa M, Manz SM, Schindler V, et al. Increased visceral sensitivity, elevated anxiety, and depression levels in patients with functional esophageal disorders and non-erosive reflux disease. Published online June 14, 2021. Neurogastroenterol Motil. https://doi.org/10.1111/nmo.14177