Esophageal hypervigilance is prevalent across gastroesophageal reflux disease presentations.
anxiety
behavioral medicine
gastroesophageal reflux
psychological stress
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
16
12
2020
received:
13
06
2020
accepted:
23
12
2020
pubmed:
13
1
2021
medline:
27
1
2022
entrez:
12
1
2021
Statut:
ppublish
Résumé
There is a need to identify factors outside of abnormal reflux that contribute to gastroesophageal reflux disease (GERD). Esophageal hypervigilance is a psychological process impacting symptom experience in esophageal disease. However, little is known about the presence of hypervigilance in GERD phenotypes, especially in those with abnormal acid exposure or symptom index scores. The primary aim was to assess differences in self-reported esophageal hypervigilance across different GERD presentations. The secondary aim was to evaluate esophageal hypervigilance as a predictor of symptom severity. We conducted retrospective data analyses on a cohort of adult patients with reflux symptoms that underwent 96-hour wireless pH monitoring from 9/2015 to 9/2017. Patients were stratified into groups based on the number of days they exhibited positive acid exposure time (AET; 0 days, 1-2 days, 3+ days), and symptom index scores (SI; 0 days, 1-day, 2+ days). Esophageal hypervigilance and anxiety, and symptom frequency and severity were assessed between groups. A total of 123 AET cases and 116 SI cases were included for analysis. Esophageal hypervigilance and anxiety scores did not significantly differ based on the number of days of positive AET (p = 0.311) or SI (p = 0.118). Symptom severity and perceived symptom frequency differed between groups. Hypervigilance significantly predicted symptom severity, when controlling for symptom-specific anxiety. Esophageal hypervigilance is persistent across patients with reflux, irrespective of acid burden and symptom index, and significantly predicts symptom severity. Hypervigilance should be considered as an independent factor contributing to esophageal symptom perception.
Sections du résumé
BACKGROUND
There is a need to identify factors outside of abnormal reflux that contribute to gastroesophageal reflux disease (GERD). Esophageal hypervigilance is a psychological process impacting symptom experience in esophageal disease. However, little is known about the presence of hypervigilance in GERD phenotypes, especially in those with abnormal acid exposure or symptom index scores. The primary aim was to assess differences in self-reported esophageal hypervigilance across different GERD presentations. The secondary aim was to evaluate esophageal hypervigilance as a predictor of symptom severity.
METHODS
We conducted retrospective data analyses on a cohort of adult patients with reflux symptoms that underwent 96-hour wireless pH monitoring from 9/2015 to 9/2017. Patients were stratified into groups based on the number of days they exhibited positive acid exposure time (AET; 0 days, 1-2 days, 3+ days), and symptom index scores (SI; 0 days, 1-day, 2+ days). Esophageal hypervigilance and anxiety, and symptom frequency and severity were assessed between groups.
KEY RESULTS
A total of 123 AET cases and 116 SI cases were included for analysis. Esophageal hypervigilance and anxiety scores did not significantly differ based on the number of days of positive AET (p = 0.311) or SI (p = 0.118). Symptom severity and perceived symptom frequency differed between groups. Hypervigilance significantly predicted symptom severity, when controlling for symptom-specific anxiety.
CONCLUSIONS
Esophageal hypervigilance is persistent across patients with reflux, irrespective of acid burden and symptom index, and significantly predicts symptom severity. Hypervigilance should be considered as an independent factor contributing to esophageal symptom perception.
Identifiants
pubmed: 33432708
doi: 10.1111/nmo.14081
pmc: PMC8272741
mid: NIHMS1663713
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14081Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK092217
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK101363
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Dis Esophagus. 2015 Jul;28(5):428-36
pubmed: 26174953
Clin Gastroenterol Hepatol. 2020 Apr;18(4):767-776
pubmed: 31319183
J Neurogastroenterol Motil. 2017 Jan 30;23(1):72-79
pubmed: 28049863
Dis Esophagus. 2016 Jul;29(5):490-6
pubmed: 25824436
Aliment Pharmacol Ther. 2009 Nov 15;30(10):1030-8
pubmed: 19737151
Am J Gastroenterol. 2020 Mar;115(3):367-375
pubmed: 31990697
Neurogastroenterol Motil. 2015 Nov;27(11):1667-74
pubmed: 26337396
Clin Gastroenterol Hepatol. 2007 Dec;5(12):1392-8
pubmed: 17936081
Gastroenterology. 2018 Jan;154(2):277-288
pubmed: 29037470
Aliment Pharmacol Ther. 2018 May;47(9):1270-1277
pubmed: 29528128
Dis Esophagus. 2019 Mar 1;32(3):
pubmed: 30124795
J Neurogastroenterol Motil. 2018 Oct 1;24(4):593-602
pubmed: 30347938
Dig Dis Sci. 2014 Oct;59(10):2488-96
pubmed: 24811245
Neurogastroenterol Motil. 2017 Oct;29(10):1-15
pubmed: 28370768
Curr Gastroenterol Rep. 2018 Jun 9;20(7):34
pubmed: 29886565
J Pain. 2017 Oct;18(10):1197-1208
pubmed: 28533182
J Anxiety Disord. 2014 Mar;28(2):241-5
pubmed: 24507631
Br J Health Psychol. 2011 Feb;16(Pt 1):47-60
pubmed: 21226783
Psychosom Med. 2016 Feb-Mar;78(2):248-58
pubmed: 26575858
Gastroenterology. 2008 Mar;134(3):696-705
pubmed: 18206149
J Pain Res. 2018 Feb 19;11:395-405
pubmed: 29497330
Clin Gastroenterol Hepatol. 2012 Dec;10(12):1360-6
pubmed: 22813439
Am J Gastroenterol. 2018 Jan;113(1):31-38
pubmed: 28895583
Pain. 2003 Feb;101(3):299-306
pubmed: 12583873
Aliment Pharmacol Ther. 2010 Sep;32(6):720-37
pubmed: 20662774
Gut. 2007 Sep;56(9):1191-7
pubmed: 17272649
Dig Dis Sci. 2017 Apr;62(4):823-825
pubmed: 28205110
Neurogastroenterol Motil. 2015 Sep;27(9):1195-201
pubmed: 26303047
Am J Clin Hypn. 2015 Jul;58(1):22-33
pubmed: 26046715
Clin Gastroenterol Hepatol. 2015 Jun;13(6):1089-95.e1
pubmed: 25496817