Heartburn symptoms tied to psychological factors in some patients

Heartburn sufferers who don’t feel better with standard treatment, but who have no detectable reflux, tend to have greater distress and worse quality of life, according to a new study.

In contrast, symptoms in patients with confirmed gastroesophageal reflux disease (GERD) that didn’t respond to acid-suppressing drugs were associated with reflux severity, Dr. Rena Yadlapati of the University of Colorado Anschutz Medical Campus in Aurora and her colleagues found.

“Our results support the interplay between psychosocial factors and symptom generation for PPI non-responders with normal physiology,” the researchers write in American Journal of Gastroenterology.

 These results are important in understanding various types of PPI non-responders and formulating personalized management strategies, they add.

As many as half of people with symptoms of reflux don’t get better with proton pump inhibitors (PPIs), the researchers note. To better understand how patients who don’t respond to PPIs perceive their symptoms, they tested esophageal function in 192 patients who had persistent heartburn despite being on double-doses of the medications for at least eight weeks.

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