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Psychophysiological interactions in esophageal diseases
1Department of Gastroenterology, Cleveland Clinic Foundation, OH 44195, USA.
Seminars in Gastrointestinal Disease
|October 1, 1996
Summary
Psychological factors significantly impact esophageal diseases like globus sensation and reflux. Anxiety and depression are common, but treatments like relaxation therapy and psychotropic drugs can effectively manage symptoms and improve patient outcomes.
Area of Science:
- Gastroenterology
- Psychosomatic Medicine
- Esophageal Physiology
Background:
- Biopsychosocial factors are increasingly recognized in esophageal diseases.
- Globus sensation is linked to psychological distress, not sphincter dysfunction.
- Esophageal motility disorders can be triggered by physiological and psychological stressors.
Purpose of the Study:
- To explore the role of psychological factors in esophageal diseases.
- To investigate the relationship between anxiety, reflux symptoms, and acid exposure.
- To evaluate treatment approaches for patients with esophageal conditions and psychological comorbidities.
Main Methods:
- Patient interviews and psychological assessments.
- Esophageal manometry and pH monitoring.
- Balloon distention for visceral hypersensitivity testing.
Main Results:
- Globus sensation patients exhibit high somatic concern, anxiety, or depression.
- Anxiety exacerbates reported reflux symptoms, not actual acid reflux.
- Relaxation therapy reduces both reflux symptoms and acid exposure.
- Patients with unexplained chest pain show increased somatic concern, anxiety, depression, and visceral hypersensitivity.
Conclusions:
- Psychological distress is a key component of several esophageal diseases.
- Behavioral and psychotropic therapies are valuable in managing esophageal conditions.
- A multidisciplinary approach is essential for treating patients with complex esophageal symptoms.