[Psycho-autonomic aspects in patients with gastroesophageal reflux disease, and functional esophageal disorders]

The subjects of the study were 79 patients (35 with functional esophageal disorders (FED), 24 with nonerosive reflux disease (NERD), and 20 with erosive reflux disease (ERD), who were selected on the basis of clinical complaints, 24-hour ph-study, and esophagogastroduodenoscopy. All the subjects were evaluated by means of clinical questionnaires and psychological tests: Beck depression test, Spielberg State-Trait Anxiety inventory (STAI), and Toronto alexithymia test (TAS). In FED and NERD patients vs. ERD patients the following abnormalities were observed more frequently: autonomic and functional somatic symptoms (apart from gastrointestinal tract (GIT) complaints) (p < 0.01), sleep disturbances (p < 0.01), fatigue (p < 0.01), eating behavior disorders (DEBQ) (p < 0.05), maternal overprotection in childhood (p < 0.05), psychophysioligical GIT reaction in childhood (p < 0.05), higher levels of state and trait anxiety (p < 0.05), and hypochondria (p < 0.05). The clinical symptom index (CSI) (the sum of stomach and bowel complaints to the sum of esophageal complaints ratio) was calculated. CSI in FED and NERD patients was 1.8, while CSI in ERD patients--0.1 (p < 0). Thus, compared to ERD patients, patients with FED and NERD were characterized by more pronounced emotional, motivational, and autonomic disorders. Besides, CSI demonstrated that the character of gastrointestinal dysfunction was more diffuse in NERD and FED and more local--in ERD patients.