Clinical and psychological characteristics of overlapping dyspepsia in patients with gastroesophageal reflux disease

Objective Overlap of dyspeptic symptoms often leads to poor response to therapy in gastroesophageal reflux disease (GERD) patients, which may be associated with psychological factors. This study is to study the clinical and psychological characteristics of overlapping dyspepsia in patients with GERD. Methods One hundred GERD patients with typical acid reflux and heartburn symptoms were collected from the second affiliated hospital of Anhui Medical University from January to November 2018. All participants were evaluated with Reflux Disease Questionnaire (RDQ) score, Patient Health Questionnaire-9 (PHQ-9), The Generalized Anxiety Disorder 7-item scale (GAD-7) and Pittsburgh Sleep Quality Index Scale (PSQI). The scores of overlapping dyspeptic symptoms including epigastric pain, post-prandial fullness, epigastric burning, early satiation, belching and nausea were recorded. All statistical analyses were performed using SPSS software (version 17.0). Results Among the 100 GERD patients, the prevalence of GERD overlapping dyspepsia was 37%. Patients with GERD overlapping dyspepsia had higher score of RDQ, GAD-7, PHQ-9 and PSQI than GERD alone and the difference was statistically significant(all P<0.05). In patients with GERD overlapping dyspepsia, the dyspeptic symptom score was positively correlated with the severity of RDQ score and the score of GAD-7, PHQ-9 and PSQI (all P<0.05). Among dyspepsia symptoms, epigastric pain and nausea were significantly related to the score of GAD-7, early satiation and nausea were significantly related to the score of PHQ-9 and PSQI (all P<0.05). Multivariate linear regression analysis also showed that early satiation and nausea were significantly related to the score of PHQ-9 and PSQI. Conclusions Patients with GERD overlapping dyspepsia have more obvious clinical symptoms, more anxiety and depression, and worse sleep quality. Epigastric pain, early satiation and nausea may be important symptoms of mental and psychological abnormalities in patients with GERD.