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The effect of life stress on symptoms of heartburn.

Abstract

OBJECTIVE

Psychosocial stressors have been associated with exacerbations of symptoms in functional and inflammatory disorders of the gastrointestinal tract. The present longitudinal study tests the general hypothesis that life stressors can exacerbate symptoms in patients with chronic heartburn.

METHODS

Sixty subjects with current heartburn symptoms were recruited by community advertisement and assessed for presence of stressful life events retrospectively over the preceding 6 months and prospectively for 4 months. Symptom severity by daily diary, quality of life, and psychological symptoms of anxiety, depression, and vital exhaustion were also measured.

RESULTS

The presence of a severe, sustained life stress during the previous 6 months significantly predicted increased heartburn symptoms during the following 4 months. In addition, symptoms showed a strong, independent correlation with vital exhaustion. Affective and subjective stress ratings were not strongly related to heartburn severity; however, anxiety showed the strongest relationship to impaired quality of life and depression to heartburn medication use.

CONCLUSIONS

As with other chronic conditions such as irritable bowel syndrome (IBS), heartburn severity appears to be most responsive to major life events and not an accumulation of more minor stressors or fluctuations in mood. In addition, vital exhaustion, which may in part result from sustained stress, may represent the psychophysiological symptom complex most closely associated with heartburn exacerbation. Potential mechanisms for these results include increased level and frequency of esophageal acid exposure, inhibition of gastric emptying of acid, or stress-induced hypersensitivity.

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  • Authors+Show Affiliations

    ,

    Center for Neurovisceral Sciences & Women's Health, Department of Medicine, UCLA, Los Angeles, CA, USA. naliboff@ucla.edu

    , , , , ,

    Source

    Psychosomatic medicine 66:3 pg 426-34

    MeSH

    Adult
    Aged
    Anxiety Disorders
    Chronic Disease
    Depressive Disorder
    Fatigue
    Female
    Gastroesophageal Reflux
    Heartburn
    Humans
    Life Change Events
    Male
    Middle Aged
    Personality Inventory
    Quality of Life
    Retrospective Studies
    Severity of Illness Index
    Stress, Psychological

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15184707

    Citation

    Naliboff, Bruce D., et al. "The Effect of Life Stress On Symptoms of Heartburn." Psychosomatic Medicine, vol. 66, no. 3, 2004, pp. 426-34.
    Naliboff BD, Mayer M, Fass R, et al. The effect of life stress on symptoms of heartburn. Psychosom Med. 2004;66(3):426-34.
    Naliboff, B. D., Mayer, M., Fass, R., Fitzgerald, L. Z., Chang, L., Bolus, R., & Mayer, E. A. (2004). The effect of life stress on symptoms of heartburn. Psychosomatic Medicine, 66(3), pp. 426-34.
    Naliboff BD, et al. The Effect of Life Stress On Symptoms of Heartburn. Psychosom Med. 2004;66(3):426-34. PubMed PMID: 15184707.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of life stress on symptoms of heartburn. AU - Naliboff,Bruce D, AU - Mayer,Minou, AU - Fass,Ronnie, AU - Fitzgerald,Leah Z, AU - Chang,Lin, AU - Bolus,Roger, AU - Mayer,Emeran A, PY - 2004/6/9/pubmed PY - 2004/7/20/medline PY - 2004/6/9/entrez SP - 426 EP - 34 JF - Psychosomatic medicine JO - Psychosom Med VL - 66 IS - 3 N2 - OBJECTIVE: Psychosocial stressors have been associated with exacerbations of symptoms in functional and inflammatory disorders of the gastrointestinal tract. The present longitudinal study tests the general hypothesis that life stressors can exacerbate symptoms in patients with chronic heartburn. METHODS: Sixty subjects with current heartburn symptoms were recruited by community advertisement and assessed for presence of stressful life events retrospectively over the preceding 6 months and prospectively for 4 months. Symptom severity by daily diary, quality of life, and psychological symptoms of anxiety, depression, and vital exhaustion were also measured. RESULTS: The presence of a severe, sustained life stress during the previous 6 months significantly predicted increased heartburn symptoms during the following 4 months. In addition, symptoms showed a strong, independent correlation with vital exhaustion. Affective and subjective stress ratings were not strongly related to heartburn severity; however, anxiety showed the strongest relationship to impaired quality of life and depression to heartburn medication use. CONCLUSIONS: As with other chronic conditions such as irritable bowel syndrome (IBS), heartburn severity appears to be most responsive to major life events and not an accumulation of more minor stressors or fluctuations in mood. In addition, vital exhaustion, which may in part result from sustained stress, may represent the psychophysiological symptom complex most closely associated with heartburn exacerbation. Potential mechanisms for these results include increased level and frequency of esophageal acid exposure, inhibition of gastric emptying of acid, or stress-induced hypersensitivity. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/15184707/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=15184707 DB - PRIME DP - Unbound Medicine ER -