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Oesophagus
Could one in ten members of the public possibly have anxiety and depression due to reflux? a snapshot of 348 ‘healthy’ volunteers
  1. S M Barratt *,
  2. J S Leeds,
  3. D S Sanders
  1. The GI & Liver Unit, Sheffield Teaching Hospitals, Sheffield, UK

Abstract

Introduction This study aimed to chart the prevalence and character of reflux symptoms in members of the public accompanying family and friends to a large medical out-patient department and determine how such symptoms are associated with quality of life (QoL), and the likelihood of anxiety and depression.

Methods 348 non-health seeking members of the public (self-identifying as ‘healthy') (13% 18–25 years, 9% 26–35 years, 12% 36–45 years, 19% 46–55 years, 21% 56–65 years, 26% >66 years) of which 36% were male completed a reflux symptom screen. This included the type (heartburn, regurgitation, retrosternal pain, belching, dysphagia), frequency (<2 days/week, 3–5 days/week, >5 days/week) and severity (mild, moderate, severe) of reflux symptoms in the previous twenty-eight days. QoL was measured by the Short-Form 36-Item Health Survey (SF-36) and psychological wellbeing by The Hospital Anxiety and Depression Scale (HADS).

Results Age and sex were not confounding factors. 50% (n=176) were reflux symptom free. 35% (n=124) reported heartburn, 8% (n=30) regurgitation, 19% (n=69) belching, 4% (n=17) dysphagia and 11% (n=41) retrosternal pain. 33% (n=114) reported mild reflux, 13% (n=45) moderate and 3% (n=13) severe reflux. 34% (n=121) experienced reflux <2 days/week, 10% (n=36) 3–5 days/week and 5% (n=19) >5 days/week. Stepwise reductions in the SF-36 subscales of general health, physical functioning, bodily pain and role-physical were associated with increasing reflux severity (p=0.001). Moderate reflux was associated with possible anxiety (HADS-A score >8, p=<0.0001) and possible depression (HADS-D score >8, p=0.002).

Conclusion Based on our findings 50% of self-identifying healthy individuals experience reflux symptoms, most likely heartburn, in a 28 day period. In the majority, these symptoms are of mild intensity and relatively infrequent. However, we have observed that increasing reflux severity is associated with reductions in QoL. Furthermore, over one in ten participants report moderate reflux, which is associated with possible and anxiety and depression when rated by a popular, valid and reliable instrument. Applied to a wider population our findings suggest that one in ten members of the public possibly experience psychological distress as a consequence of untreated reflux.

  • Anxiety
  • Depression
  • Quality of Life
  • Reflux

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Footnotes

  • Competing interests None.

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