Coping with stress and personality in patients with or without stress-related symptoms in gastroesophageal reflux disease

Background: Psychological aspects like stress, emotions or personality are known to affect the severity, of symptoms of gastroesophageal reflux diseas e (GERD). The aim of the present study was to evaluate differences in copin g with stress, structure of personality and also objective and subjective p arameters of patients with or without a stress-related perception of sympto ms in GERD. Methods: 100 patients which underwent laparoscopic antireflux surgery at ou r department of surgery were included in this study. All patients answered questionnaires to evaluate their coping with stress (SVF), structure of per sonality (FPI-R) and quality of life (GILQI) pre- and postoperatively, Also data of physiological parameters like manometry: 24-hours pH monitoring: e ndoscopy and clinical history were included. Patients were divided into two groups: one with and one without a stress-related perception of symptoms. Results: 46 out Of 100 patients declared stress-related symp toms of reflux (group 1) and 54 out of 100 had no influence of stress to their reflux dis ease (group two). Those two groups showed significant differences (p < .05) in some coping strategies and their personality: Coping with stress (SVF): Trial to control the situations (18.3 vs. 13.1), trial to control reactions (18.2 vs. 13.3), requirement of social support (9.7 vs. 14.8), tendency to escape (7.7 vs. 13.9) and aggression (13.1 vs. 7.6); structure of personal ity (FPI-R): Standard of performance (10.8 vs. 7.2), stress (9.8 vs. 4.7) a nd physical discomfort (7.6 vs. 4.6). We also found significant (p < .05) d ifferences in pre-and postoperative quality of life (GILQI: preoperative 86 .3 vs. 98.5 points: postoperative 117.9 vs. 128.2 points) and the day-time of reflux perception. There were no differences in physiological parameters . Conclusion: These findings point out that there are no physiological differ ences between the two groups with or without stress-related symptoms in GER D. But we found significant differences in psychological factors. Therefore Me suggest that preoperative psychological interventions may optimize the subjective outcome after antireflux surgery in patients with a stress-relat ed perception of symptoms.