СТРЕС І ГАСТРОЕЗОФАГЕАЛЬНА РЕФЛЮКСНА ХВОРОБА

Dalbir Sandhu,Ronnie Fass

doi:10.25040/ntsh2018.02.010

Abstract

Gastroesophageal reflux disease (GERD) is one of the commonest conditions managed by clinicians. Regurgitation and heartburn are considered the cardinal symptoms of GERD. In recent decades, an increasing association has been noted between stress and GERD and our knowledge about the pathophysiology of this relationship is constantly evolving. Both acute and chronic stress can accentuate GERD related symptoms. Subjects exposed to chronic life stressors are more likely to complaint of GERD symptoms. Current data suggests that acute stress exacerbates GERD symptoms by enhancing the perceptual responses to intra-esophageal acid stimulivia central mechanisms without increasing the amount of acid reflux. This process is likely mediated by an increase in esophageal mucosal permeability. Treatment with proton pump inhibitors attenuates the effect of acute stress on esophageal perception thresholds for pain. However, the effect of anti-reflux therapy in patients experiencing chronic stress remains to be elucidated.

Highlights

Gastroesophageal reflux disease (GERD) is defined as symptoms or complications resulting from the reflux of gastric contents into the esophagus or beyond, into the oropharynx, larynx and pulmonary system [1]
Auditory stress hanced perceptual response to intra-esophageal acid exposure compared to healthy subjects
Objective parameters of acid reflux remained unchanged. These subjects’ reflux ratings remained at high levels during all stress periods, whereas subjects in all other experimental conditions reported decreased reflux symptoms across periods. These results suggested that reflux patients who are chronically anxious and exposed to prolonged stress may perceive low intensity esophageal stimuli as painful reflux symptoms [7]

Summary

Introduction

Gastroesophageal reflux disease (GERD) is defined as symptoms or complications resulting from the reflux of gastric contents into the esophagus or beyond, into the oropharynx, larynx and pulmonary system [1]. The authors proposed increased level and frequency of esophageal acid exposure, inhibition of gastric emptying of acid, or stress-induced esophageal hypersensitivity as potential mechanisms of worsening heartburn symptoms in subjects with stress. Stress and intra-esophageal acid exposure One of the early proposed mechanism on how stress leads or exacerbates GERD related symptoms was increase in gastroesophageal reflux.

Results

Conclusion