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

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.