Psychological Factors in Patients with Refractory Heartburn and Reflux

Psychological factors are thought to be associated with symptoms attributed to gastroesophageal reflux disease (GERD). To explore this relation, researchers at a tertiary referral center in Belgium have published two reports that involved 393 consecutive adult patients who were evaluated for refractory heartburn or regurgitation (i.e., persistent symptoms despite taking a proton-pump inhibitor twice daily for 12 weeks). Patients underwent upper endoscopy and 24-hour pH-impedance monitoring and ultimately were classified into four groups: true GERD (98 patients), borderline GERD (85), reflux hypersensitivity (77), and functional heartburn (133).

All patients completed several questionnaires to assess symptom severity and psychosocial function…