Introduction
Gastroesophageal reflux disorder is a condition that can be troubling due to the regurgitation of stomach acids into the esophagus. Frequent symptoms of heartburn and acid reflux can be a characteristic feature of the condition. It is a prevalent gastrointestinal disorder in most developing countries. Due to its detrimental effects on daily social activities, the emotional and physical well-being of affected individuals, and other factors, GERD plays a crucial role in the quality of life associated with health. The illness may also interfere with regular work and restful sleep.
What Is GERD?
A chronic condition where the acid from the stomach flows back into the esophagus is called GERD. The backflow of the acid (acid reflux) can irritate the lining of the esophagus. Heartburn is the most common symptom. Although it can be uncomfortable, occasional acid reflux is not an illness. However, some people constantly experience reflux. Prolonged acid reflux can seriously impair your quality of life and seriously harm your tissues. The primary signs and symptoms of GERD are heartburn, which is frequently described as a burning sensation in the chest, and regurgitating bitter or sour liquid into the mouth or throat. The incidence of GERD and its aftereffects, such as Barrett's esophagus and esophageal adenocarcinoma, is rising globally. The uncomfortable GERD symptoms can go beyond the typical primary symptoms of pyrosis and regurgitation.
How Are GERD and Mental Health Interlinked?
The gastrointestinal (GI) system and the brain might be closely related. For example, mental strain and distress can impact GI function and result in GI disorders. GI stress can also have an impact on one's mental and emotional health. Psychological factors can impact the severity of a functional GI condition, including GERD, by changing how pain is perceived due to activity on the gut-brain axis. Furthermore, psychological variables make treating functional gastrointestinal disorders more challenging and result in less favorable outcomes.
What Are the Studies Done to Show GERD and Mental Health Interlinked?
In their research, Li et al. hypothesize that GERD patients had more extensive psychological ranges of anxiety and despair than healthy people. Haug et al. discovered a clear connection between acid reflux and psychological issues. Patients with reflux esophagitis and non-erosive reflux illness scored higher on anxiety and depression scales than people in good health, according to Yang et al. Their distributions among the three categories show that patients with reflux esophagitis and non-erosive reflux illness experience moderate to severe anxiety and depression.
According to Bai et al., a cross-sectional study was done. About 2500 patients between the ages of 18 and 40 years participated in this study, which was carried out on younger participants. They diagnosed GERD using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG). The Frequency Scale for the Symptoms of GERD (FSSG) was created to assess the severity of GERD and its response to treatment.
Another study on the general population was conducted at the Gangnam Center of the Seoul National University Hospital Healthcare System. It was a retrospective, cross-sectional study with 1574 participants experiencing reflux symptoms. For the study, they gathered people who were young, middle-aged, and elderly. After undergoing esophagogastroduodenoscopy, the study participants were divided into three groups based on their symptoms.
Esophagogastroduodenoscopy is a diagnostic procedure where the healthcare professional can view the upper gastrointestinal tract till the duodenum). For anxiety and sadness, the Beck Sadness Inventory and the State-Trait Anxiety Inventory were utilized. The Beck Anxiety Inventory (BAI), which consists of 21 self-reported items on a four-point scale, is used to gauge how severe one's physical and cognitive anxiety symptoms have been over the previous week. According to their research, GERD patients experienced elevated levels of anxiety and sadness.
How Can Gerd Cause Depression and Anxiety?
Although the exact mechanism is unknown, worry may be a significant factor in the development of gastric reflux illness and aggravate acid reflux symptoms. According to several researchers, cholecystokinin (CCK), a brain neurotransmitter, has been linked to both pain and gastrointestinal diseases. CCK may also be a significant factor in the development of GERD in people with anxiety disorders. Several ideas suggest that worry causes an increase in stomach acid, slows digestion, and increases the tension in the muscles surrounding the stomach. Chronically high anxiety can raise the chance of developing functional gastrointestinal disorders, including functional dyspepsia and irritable bowel syndrome, by lowering the threshold for perceiving visceral sensations. Acute stress can make the esophagus more permeable, making it easier for stomach acid to reach the esophageal nociceptors (sensory neurons that detect pain).
Unlike the intensity of heartburn, higher anxiety levels in our study did not affect the severity of regurgitation symptoms. Regurgitation and heartburn are distinct symptoms. The latter involves feelings in the mouth and throat and is not painful, while the former is produced in the esophagus. Although the impact of anxiety on the perception of esophageal pain has been demonstrated in previous research, its influence on nonpainful throat symptoms remains unclear.
It was discovered that higher anxiety levels significantly impacted GERD patients' mental quality of life. Since elevated anxiety levels were linked to a rise in symptom severity, it is possible to speculate that elevated anxiety levels are also linked to a decline in the physical aspect of life quality. Patients are sometimes referred to as being hypersensitive to acid reflux when they have physiological acid exposure times, but there is a positive temporal correlation between reflux events and regurgitation and heartburn sensations. The number of reported symptoms and the intensity of GERD symptoms in these hypersensitive people are comparable. However, their esophageal acid exposure is lower than in patients with pathologic acid exposure. Furthermore, hypersensitive patients experience similar effects from GERD symptoms on their quality of life.
Conclusion
In conclusion, higher anxiety levels are linked to more severe GERD symptoms, including burning and pain in the retrosternum, but not regurgitation or an acidic aftertaste in the mouth. However, depression levels are not linked to increased GERD symptoms. Nevertheless, neither the number of reported symptoms during ambulatory reflux monitoring nor the number of felt reflux episodes are impacted by elevated anxiety levels in GERD patients. Similar anxiety levels, comparable reflux symptom severity, and comparable GERD symptoms' influence on quality of life are characteristics of GERD patients who are hypersensitive to acid reflux.
