Psychosomatic Aspects and Treatment of Gastrointestinal Pathology

The frequency of instances of diseases of the digestive system has increased in recent years. The pattern of diseases changes: the pathology of the upper gastrointestinal tract (gastroesophageal reflux disease, gastritis, duodenitis) is the most prevalent. Gastroesophageal reflux disease (GERD) is one of the most common, recurrent and comorbid gastroenterological diseases, with a prevalence of 30% in Western Europe and 10% in East Asia in the adult population. Evaluation of quality of life (based on the SF 36 questionnaire and Hamilton's scale of Depression and anxiety) is widespread and can aid in the choice of effective treatment for patients with combined pathology. We analyzed SF-36 questionnaires of patients with GERD only and GERD in combination with thyroid pathology (hypothyroidism). Patients were divided into two groups: the first group - patients with GERD (20 persons); the second group - patients with GERD and hypothyroidism (20 persons). The quality of life of patients from the second group was revealed to be low for such indicators as "physical and mental components of health", "social functioning". The intensity of pain in both of the two groups significantly limits daily activities of patients. The physical component of health in patients with GERD is 48.82%, and in patients with comorbidity - 39.21% (p≤0.05). A significant difference in the mental health component was observed: in the first group - 39.7%, and in the second group - 30.18% (p≤0.05). Patients with GERD suffer not only symptoms associated with erosive-ulcerative, catarrhal and/or functional disorders of the distal esophagus, but also neurotic disorders. Depression, memory impairment, attention disorders are more common. Thyroid dysfunction manifests with the psychoendocrine syndrome (depressive and anxiety-phobic disorders), therefore the mental health component of the quality of life of patients with GERD and hypothyroidism decreases. Patients with combined pathology of GERD and thyroid dysfunction should be examined not only by a general practitioner, gastroenterologist, endocrinologist, cardiologist, but also by a psychotherapist because of pronounced somatogenic mental disorders. Treatment with antacids and drugs such as omeprazole, Cerucal, were less effective than when combined with psychotropic drugs: Sertraline 25-30 mg and hydroxyzine 12.5-25 mg per day.