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Several factors determine the nature and intensity of esophageal symptoms that are associated with gastroesophageal reflux disease. These include acidity, proximal extent, and volume of the esophageal refluxate; age of the patient; and presence of Barrett epithelium. Additionally, central mechanisms that control brain–gut interactions can modulate a patient’s perception of intraesophageal stimuli. Stress and anxiety also can heighten awareness of heartburn, presumably through the same central mechanisms (such as dilation of the esophageal intercellular spaces) that facilitate hypersensitivity.
In this animal study, researchers evaluated the effects of stress on permeability of the esophageal mucosa in Sprague Dawley rats. One group of rats w…