Knowledge, Awareness, and Self-Reported Association Between Anxiety Symptoms and Gastroesophageal Reflux Disease in...

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder characterized by the reflux of gastric contents into the esophagus, causing symptoms such as heartburn, acid regurgitation, and extraesophageal manifestations. Psychological stress may worsen reflux symptoms by altering gastrointestinal motility, increasing esophageal sensitivity, and disrupting the brain-gut axis, while persistent reflux can negatively affect quality of life and contribute to psychological distress. Despite this evidence, public understanding of this relationship remains limited, particularly in Saudi Arabia.

This study aimed to assess the self-reported relationship between anxiety symptoms and GERD-related symptoms, evaluate public awareness regarding this relationship, and identify associated sociodemographic and lifestyle factors among participants in Jeddah, Saudi Arabia.

A cross-sectional study was conducted among adults residing in Jeddah using a convenience nonprobability sampling technique. The minimum required sample size was calculated using G*Power software (ver. 3.1 Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany; α = 0.05, power = 95%, effect size = 0.30, and five degrees of freedom), yielding a minimum of 220 participants. Data were collected through a bilingual (Arabic and English) self-administered questionnaire developed by the research team and reviewed by experts for face and content validity, as well as an electronic questionnaire distributed via social media. The survey assessed sociodemographic characteristics, lifestyle habits, reflux symptoms, anxiety-related factors, and knowledge of the self-reported association between anxiety symptoms and GERD. Data were analyzed using IBM Statistical Package for the Social Sciences, version 28.0 (IBM Corp., Armonk, NY; 2021). Descriptive statistics and chi-square tests were applied, with statistical significance set at p < 0.05.

A total of 388 participants were included in the study. Of these, 90 (23.2%) reported having been diagnosed with GERD by a healthcare professional, while 167 (43.0%) describe the proportion of participants who reported regularly experiencing anxiety symptoms. Heartburn was the most frequently reported symptom, with 226 cases (58.2%). A significant self-reported association was observed between GERD and age (p = 0.027), as well as between anxiety symptoms and several sociodemographic and lifestyle factors (p < 0.05). Participants demonstrated variable levels of knowledge regarding the relationship between anxiety and GERD.

The study found that self-reported anxiety symptoms and reflux-related symptoms were commonly reported among participants in Jeddah. A substantial proportion of participants also perceived worsening of reflux-related symptoms during periods of anxiety or stress. These findings reflect self-reported symptoms and perceptions and do not establish a clinical diagnosis of anxiety or anxiety-associated GERD or a causal relationship between the two conditions.