Skip to main content

Advertisement

SpringerLink
Log in

Psychoemotional factors and their influence on the quality of life in patients with GERD

  • 2020 SAGES Poster
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Patient-reported outcomes (PROs) are integral to determining the success of foregut surgical interventions and psychoemotional factors have been hypothesized to impact the quality of life of patients. This study evaluates the correlation between PROs—specifically the Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) and the Laryngopharangeal Reflux Symptom Index (LPR-RSI)—and the recently validated Esophageal Hypervigilance Anxiety Scale (EHAS). We hypothesize that patients with higher EHAS scores have significantly elevated GERD-HRQL LPR-RSI compared to those with normal scores. EHAS has been developed and validated in chronic esophageal disorders, but clinical impact is unknown. In this retrospective study, 197 patients (38% men, average age 56 ± 16) completed the following surveys:(1) EHAS, (2) GERD-HRQL, and (3) LPR-RSI. All patients referred for surgical evaluation of GERD completed the surveys as part of their pre-operative workup and post-operative follow-up In bivariate analysis, EHAS correlated with both GERD-HRQL (r 0.53, P = <0.001) and LPR-RSI (r 0.36, P = 0.009). Accounting for potential confounding with sex and age in multivariable linear regression models, a higher GERD-HRQL score (β 0.38; 95% CI 0.29 to 0.48; P = <0.001; Semipartial R2 0.20) and a higher LPR-RSI score (β 0.21; 95% CI 0.13 to 0.29; P = <0.001; Semipartial R2 0.08) were independently associated with higher EHAS. The observed relationship between mental health and GERD symptom intensity is consistent with the biopsychosocial paradigm of illness. Future studies focused on post-surgical outcomes following the incorporation of EHAS into perioperative care is needed to evaluate its effectiveness as a clinical decision support tool in ARS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gong EJ, Choi KD, Jung HK et al (2017) Quality of life, patient satisfaction, and disease burden in patients with gastroesophageal reflux disease with or without laryngopharyngeal reflux symptoms. J Gastroenterol Hepatol 32(7):1336–1340

    Article  Google Scholar 

  2. Ness-Jensen E, Hveem K, El-Serag H, Lagergren J (2016) Lifestyle intervention in gastroesophageal reflux disease. Clin Gastroenterol Hepatol 14(2):175–182 e3

    Article  Google Scholar 

  3. Maret-Ouda J, Wahlin K, El-Serag HB, Lagergren J (2017) Association between laparoscopic antireflux surgery and recurrence of gastroesophageal reflux. Jama 318(10):939–946

    Article  Google Scholar 

  4. Wiklund I (2004) Review of the quality of life and burden of illness in gastroesophageal reflux disease. Dig Dis 22(2):108–114

    Article  Google Scholar 

  5. Tack J, Becher A, Mulligan C, Johnson DA (2012) Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther 35(11):1257–1266. https://doi.org/10.1111/j.1365-2036.2012.05086.x

    Article  CAS  PubMed  Google Scholar 

  6. Spechler SJ, Hunter JG, Jones KM et al (2019) Randomized trial of medical versus surgical treatment for refractory heartburn. N Engl J Med 381(16):1513–1523

    Article  Google Scholar 

  7. Emken B-EG, Lundell LR, Wallin L et al (2017) Effects of omeprazole or anti-reflux surgery on lower oesophageal sphincter characteristics and oesophageal acid exposure over 10 years. Scand J Gastroenterol 52(1):11–17

    Article  CAS  Google Scholar 

  8. Vakil NB, Halling K, Becher A, Ryden A (2013) Systematic review of patient-reported outcome instruments for gastroesophageal reflux disease symptoms. Eur J Gastroenterol Hepatol 25(1):2–14

    Article  Google Scholar 

  9. Francis DO, Patel DA, Sharda R et al (2016) Patient-reported outcome measures related to laryngopharyngeal reflux: a systematic review of instrument development and validation. Otolaryngol Head Neck Surg 155(6):923–935

    Article  Google Scholar 

  10. Tack J, Becher A, Mulligan C, Johnson D (2012) Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther 35(11):1257–1266

    Article  CAS  Google Scholar 

  11. Velanovich V (2003) The effect of chronic pain syndromes and psychoemotional disorders on symptomatic and quality-of-life outcomes of antireflux surgery. J Gastrointest Surg 7(1):53–58. https://doi.org/10.1016/s1091-255x(02)00136-1

    Article  PubMed  Google Scholar 

  12. Kamolz T, Granderath FA, Pointner R (Jan 2003) Does major depression in patients with gastroesophageal reflux disease affect the outcome of laparoscopic antireflux surgery? Surg Endosc 17(1):55–60. https://doi.org/10.1007/s00464-002-8504-8

    Article  CAS  PubMed  Google Scholar 

  13. Taft TH, Triggs J, Carlson DA et al (2018) Validation of the oesophageal hypervigilance and anxiety scale for chronic oesophageal disease. Aliment Pharmacol Ther 47(9):1270–1277

    Article  CAS  Google Scholar 

  14. Osheroff JA (2012) Improving outcomes with clinical decision support: an implementer’s guide. Himss

  15. McCoy AB, Melton GB, Wright A, Sittig DF (2013) Clinical decision support for colon and rectal surgery: an overview. Clin Colon Rectal Surg 26(01):023–030

    Article  Google Scholar 

  16. McKinley B, Sailors R, Glorsky S et al (2001) Computer directed resuscitation of major torso trauma: 137. Shock 15:46

    Article  Google Scholar 

  17. Moore LJ, Turner KL, Todd SR, McKinley B, Moore FA (2010) Computerized clinical decision support improves mortality in intra abdominal surgical sepsis. Am J Surg 200(6):839–844

    Article  Google Scholar 

  18. Moore FA, McKinley BA, Moore EE (2004) The next generation in shock resuscitation. Lancet 363(9425):1988–1996

    Article  Google Scholar 

  19. Thomsen GE, Pope D, East TD et al (1993) Clinical performance of a rule-based decision support system for mechanical ventilation of ARDS patients. Am Med Infor Assoc 339

  20. Francis DO, Patel DA, Sharda R et al (2016) Patient-reported outcome measures related to laryngopharyngeal reflux: a systematic review of instrument development and validation. Otolaryngol Head Neck Surg 155(6):923–935. https://doi.org/10.1177/0194599816664330

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gong EJ, Choi KD, Jung HK et al (2017) Quality of life, patient satisfaction, and disease burden in patients with gastroesophageal reflux disease with or without laryngopharyngeal reflux symptoms. J Gastroenterol Hepatol 32(7):1336–1340. https://doi.org/10.1111/jgh.13716

    Article  PubMed  Google Scholar 

  22. Bradley LA, Richter JE, Pulliam TJ et al (1993) The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol 88(1)

  23. Roman S, Keefer L, Imam H et al (2015) Majority of symptoms in esophageal reflux PPI non-responders are not related to reflux. Neurogastroenterol Motility 27(11):1667–1674

    Article  CAS  Google Scholar 

  24. Haug TT, Mykletun A, Dahl AA (2002) Are anxiety and depression related to gastrointestinal symptoms in the general population? Scand J Gastroenterol 37(3):294–298. https://doi.org/10.1080/003655202317284192

    Article  PubMed  Google Scholar 

  25. Hu WHC, Wong WM, Lam CLK et al (2002) Anxiety but not depression determines health care-seeking behaviour in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study. Aliment Pharmacol Ther 16(12):2081–2088. https://doi.org/10.1046/j.1365-2036.2002.01377.x

    Article  CAS  PubMed  Google Scholar 

  26. Jansson C, Nordenstedt H, Wallander MA et al (2007) Severe gastro-oesophageal reflux symptoms in relation to anxiety, depression and coping in a population-based study. Aliment Pharmacol Ther 26(5):683–691. https://doi.org/10.1111/j.1365-2036.2007.03411.x

    Article  CAS  PubMed  Google Scholar 

  27. Aro P, Talley NJ, Ronkainen J et al (2009) Anxiety is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. Gastroenterology 137(1):94–100

    Article  Google Scholar 

  28. Kamolz T, Velanovich V (2002) Psychological and emotional aspects of gastroesophageal reflux disease. Dis Esophagus 15(3):199–203

    Article  CAS  Google Scholar 

  29. Kamolz T, Bammer T, Granderath FA, Pointner R (2001) Laparoscopic antireflux surgery in gastro-oesophageal reflux disease patients with concomitant anxiety disorders. Dig Liver Dis 33(8):659–664. https://doi.org/10.1016/s1590-8658(01)80041-4

    Article  CAS  PubMed  Google Scholar 

  30. Kamolz T, Granderath FA, Bammer T, Pasiut M, Pointner R (2001) Psychological intervention influences the outcome of laparoscopic antireflux surgery in patients with stress-related symptoms of gastroesophageal reflux disease. Scand J Gastroenterol 36(8):800–805. https://doi.org/10.1080/003655201750313306

    Article  CAS  PubMed  Google Scholar 

  31. Velanovich V, Karmy-Jones R (2001) Psychiatric disorders affect outcomes of antireflux operations for gastroesophageal reflux disease. Surg Endosc 15(2):171–175. https://doi.org/10.1007/s004640000318

    Article  CAS  PubMed  Google Scholar 

  32. Lord RV, Kaminski A, Öberg S et al (2002) Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication. J Gastrointest Surg 6(1):3–10

    Article  Google Scholar 

  33. Khajanchee YS, O'Rourke RW, Lockhart B, Patterson EJ, Hansen PD, Swanstrom LL (2002) Postoperative symptoms and failure after antireflux surgery. Arch Surg 137(9):1008–1014

    Article  Google Scholar 

  34. Lindau ST, Laumann EO, Levinson W, Waite LJ (2003) Synthesis of scientific disciplines in pursuit of health: the interactive biopsychosocial model. Perspect Biol Med 46(3 Suppl):S74

    Article  Google Scholar 

  35. Ayers DC, Franklin PD, Ring DC (2013) The role of emotional health in functional outcomes after orthopaedic surgery: extending the biopsychosocial model to orthopaedics: AOA critical issues. J Bone Joint Surg Am 95(21)

  36. Berliner JL, Brodke DJ, Chan V, SooHoo NF, Bozic KJ (2017) Can preoperative patient-reported outcome measures be used to predict meaningful improvement in function after TKA? Clin Orthop Relat Res 475(1):149–157

    Article  Google Scholar 

  37. Lundell L, Miettinen P, Myrvold H et al (2001) Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 192(2):172–179

    Article  CAS  Google Scholar 

  38. Epstein D, Bojke L, Sculpher MJ (2009) Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: cost effectiveness study. Bmj. 339:b2576

    Article  Google Scholar 

  39. Anvari M, Allen C, Marshall J et al (2011) A randomized controlled trial of laparoscopic Nissen fundoplication versus proton pump inhibitors for the treatment of patients with chronic gastroesophageal reflux disease (GERD): 3-year outcomes. Surg Endosc 25(8):2547–2554

    Article  Google Scholar 

  40. Grant A, Boachie C, Cotton S et al (2013) Clinical and economic evaluation of laparoscopic surgery compared with medical management for gastro-oesophageal reflux disease: 5-year follow-up of multicentre randomised trial (the REFLUX trial). Health Technol Assessment (Winchester, England) 17(22):1

    CAS  Google Scholar 

  41. Hatlebakk JG, Zerbib F, des Varannes SB et al (2016) Gastroesophageal acid reflux control 5 years after antireflux surgery, compared with long-term esomeprazole therapy. Clin Gastroenterol Hepatol 14(5):678–685 e3

    Article  Google Scholar 

  42. Kellokumpu I, Voutilainen M, Haglund C, Färkkilä M, Roberts PJ, Kautiainen H (2013) Quality of life following laparoscopic Nissen fundoplication: assessing short-term and long-term outcomes. World J Gastroenterol: WJG 19(24):3810

    Article  Google Scholar 

  43. Hamdy E, El Nakeeb A, Hamed H, El Hemaly M, ElHak NG (2014) Outcome of laparoscopic Nissen fundoplication for gastroesophageal reflux disease in non-responders to proton pump inhibitors. J Gastrointest Surg 18(9):1557–1562

    Article  Google Scholar 

  44. Zhang C, Hu Z-W, Yan C et al (2017) Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale. World J Gastroenterol 23(19):3546

    Article  Google Scholar 

  45. Swoger J, Ponsky J, Hicks DM et al (2006) Surgical fundoplication in laryngopharyngeal reflux unresponsive to aggressive acid suppression: a controlled study. Clin Gastroenterol Hepatol 4(4):433 e1

    Article  Google Scholar 

  46. Ayazi S, Zheng P, Zaidi AH et al (2020) Clinical outcome and predictors of favorable result after laparoscopic magnetic sphincter augmentation: single institution experience with over 500 patients. J Am Coll Surg

  47. Francis DO, Goutte M, Slaughter JC et al (2011) Traditional reflux parameters and not impedance monitoring predict outcome after fundoplication in extraesophageal reflux. Laryngoscope 121(9):1902–1909

    Article  Google Scholar 

  48. Ayers DC, Franklin PD, Trief PM, Ploutz-Snyder R, Freund D (2004) Psychological attributes of preoperative total joint replacement patients: implications for optimal physical outcome. J Arthroplast 19(7):125–130

    Article  Google Scholar 

  49. Ring D, Leopold SS (2015) Measuring satisfaction: can it be done? Springer

Download references

Author information

Authors and Affiliations

  1. Department of Surgery and Perioperative Care, University of Texas at Austin, Austin, TX, USA

    Charles Hill, Elisa Furay, Stephanie Doggett & F. P. Buckley

  2. Department of Orthopaedic Surgery, University of Texas at Austin, Austin, TX, USA

    Yvonne Versluijs & David Ring

  3. Dell Medical School, University of Texas at Austin, Austin, TX, USA

    Deonna Reese-White, Cole Holan & Jeremiah Alexander

Authors
  1. Charles Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yvonne Versluijs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elisa Furay
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deonna Reese-White
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cole Holan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jeremiah Alexander
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephanie Doggett
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David Ring
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. F. P. Buckley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles Hill.

Ethics declarations

Disclosures

Drs. Hill, Versluijs, Furay, Ring, Buckley, Mr. Holan, and Alexander, Mrs. Reese-White, and Ms. Doggett have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hill, C., Versluijs, Y., Furay, E. et al. Psychoemotional factors and their influence on the quality of life in patients with GERD. Surg Endosc 35, 7219–7226 (2021). https://doi.org/10.1007/s00464-020-08145-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-08145-8

Keywords

Search

Navigation