The Effect of Auditory Stress on Perception of Intraesophageal Acid in Patients With Gastroesophageal Reflux Disease

Ronnie Fass, Bruce D. Naliboff, Shira S. Fass, Nitzan Peleg, Christopher S Wendel, Isaac B. Malagon, Emeran A. Mayer

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Background & Aims: Most patients with gastroesophageal reflux disease (GERD) report that stress exacerbates their symptoms, yet mechanisms underlying this association remain unknown. We sought to determine the effect of an acute laboratory stressor on perceptual and emotional responses to intraesophageal acid perfusion in healthy controls and patients with GERD. Methods: Forty-six patients with heartburn and 10 healthy controls underwent upper endoscopy and, if negative, pH monitoring. Assessment of psychologic factors and health-related quality of life was done by a questionnaire. Perceptual and emotional responses to intraesophageal acid at baseline, during auditory stress, and during an auditory control condition were determined using a randomized crossover design. Plasma levels of norepinephrine, adrenocorticotropic hormone, and cortisol were assessed. Results: Twenty-nine subjects were identified as nonerosive reflux disease and 17 as erosive esophagitis. Quality of life, psychologic profile, and personality assessment variables were similar among the 2 patient groups and the controls. There was a significant reduction in mean lag time to initial symptom perception and an increase in mean intensity rating and mean acid perfusion sensitivity score in the 2 patient groups during the stress period, which was not seen during the control condition. Healthy controls demonstrated lack of a significant change in all parameters of stimulus response functions to acid, regardless of condition. Conclusions: Acute auditory stress can exacerbate heartburn symptoms in GERD patients by enhancing perceptual response to intraesophageal acid exposure. This greater perceptual response is associated with greater emotional responses to the stressor.

Original languageEnglish (US)
Pages (from-to)696-705
Number of pages10
JournalGastroenterology
Volume134
Issue number3
DOIs
StatePublished - Mar 2008
Externally publishedYes

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Gastroesophageal Reflux
Acids
Heartburn
Perfusion
Quality of Life
Personality Assessment
Esophagitis
Adrenocorticotropic Hormone
Cross-Over Studies
Endoscopy
Hydrocortisone
Norepinephrine
Control Groups

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The Effect of Auditory Stress on Perception of Intraesophageal Acid in Patients With Gastroesophageal Reflux Disease. / Fass, Ronnie; Naliboff, Bruce D.; Fass, Shira S.; Peleg, Nitzan; Wendel, Christopher S; Malagon, Isaac B.; Mayer, Emeran A.

In: Gastroenterology, Vol. 134, No. 3, 03.2008, p. 696-705.

Research output: Contribution to journalArticle

Fass, Ronnie ; Naliboff, Bruce D. ; Fass, Shira S. ; Peleg, Nitzan ; Wendel, Christopher S ; Malagon, Isaac B. ; Mayer, Emeran A. / The Effect of Auditory Stress on Perception of Intraesophageal Acid in Patients With Gastroesophageal Reflux Disease. In: Gastroenterology. 2008 ; Vol. 134, No. 3. pp. 696-705.
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