Authors
1 Department of Psychology, School of Literature and Humanities, University of Guilan, Rasht, Iran
2 Associate Professor, Department of Psychology, School of Literaturen and Humanities, University of Guilan, Rasht, Iran
3 Associate Professor, Gastroenterology and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
4 School of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
Abstract
Background & Aims: Considering the important role of stress in intensifying gastroesophageal reflux disease (GERD) symptoms, the aim of the present study was to determine the effectiveness of stress management training in reducing symptoms in patients with GERD. Methods: In the present semi-experimental study, a pre-test post-test design with control group was used. From among the patients who had refered to a gastroenterology specialist in Anzali, Iran, from January 2011 to July 2012 and were diagnosed with GERD, 38 women were selected based on the inclusion criteria. The subjects were randomly divided into experimental and control groups. After performing the pre-test using the Gastroesophageal Reflux Disease Symptom Assessment Scale (GSAS), 8 sessions of group stress management training were held for the experimental group along with applying routine medical treatments to both groups. At the end of the intervention, post-test was conducted on both groups. The obtained data were analyzed using one-way analysis of covariance, independent t-test, and paired t-test. Results: Stress management training reduced the dimensions of the frequency of each symptom (t = 0.01) and the discomfort or malaise associated with each symptom of the disease (P < 0.001) in the experimental group. However, it had no significant impact on the number ofsymptoms. Conclusion: Group stress management training can be effective in controlling GERD symptoms. It is, therefore, suggested that it be used alongside pharmaceutical treatments.
Keywords
- Eisen G. The epidemiology of gastroesophageal reflux disease: what we know and what we need to know. Am J Gastroenterol 2001; 96(8 Suppl): S16-S18.
- Terblanche AJ. Gastro-oesophageal reflux disease in paediatric patients. Prof Nurs Today 2011; 15(4): 37-9.
- El-Serag HB. Time trends of gastroesophageal reflux disease: a systematic review. Clin Gastroenterol Hepatol 2007; 5(1): 17-26.
- Fennerty MB, Castell D, Fendrick AM, Halpern M, Johnson D, Kahrilas PJ, et al. The diagnosis and treatment of gastroesophageal reflux disease in a managed care environment, Suggested disease management guidelines. Arch Intern Med 1996; 156(5): 477-84.
- Kamolz T, Pointner R. Gastroesophageal reflux disease. Heart-burn from a psychological view. Minerva Gastroenterol Dietol 2004; 50(3): 261-8.
- Pustorino S, Guerrisi O, Calipari G, Federico G, Ianni G, Scarpignato EM, et al. [Psycho-emotional distress and gastroesophageal reflux syndrome]. Minerva Gastroenterol Dietol 1991; 37(1): 1-9.
- Fass R, Naliboff BD, Fass SS, Peleg N, Wendel C, Malagon IB, et al. The effect of auditory stress on perception of intraesophageal acid in patients with gastroesophageal reflux disease. Gastroenterology 2008; 134(3): 696-705.
- Orzechowska A, Wysokinski A, Talarowska M, Zboralski K, Gruszczynski W. Psychological factors in the course of gastroesophageal reflux disease and irritable bowel syndrome. Gastroenterology 2008; 15(4): 213.
- Johnston BT, Lewis SA, Love AH. Psychological factors in gastro-oesophageal reflux disease. Gut 1995; 36(4): 481-2.
- Dent J. Long-term aims of treatment of reflux disease, and the role of non-drug measures. Digestion 1992; 51(Suppl 1): 30-4.
- Kamolz T, Pointner R, Velanovich V. The impact of gastroesophageal reflux disease on quality of life. Surgical Endoscopy and Other Interventional Techniques 2003; 17(8): 1193-9.
- Wang YK, Hsu WH, Wang S, Lu CY, Kuo F, Su Y, et al. Current pharmacological management of gastroesophageal reflux disease. Gastroenterology Research and Practice 2013; 2013: 12.
- Rubenstein JH, Nojkov B, Korsnes S, Adlis SA, Shaw MJ, Weinman B, et al. Oesophageal hypersensitivity is associated with features of psychiatric disorders and the irritable bowel syndrome. Aliment Pharmacol Ther 2007; 26(3): 443-52.
- Nojkov B, Rubenstein JH, Adlis SA, Shaw MJ, Saad R, Rai J, et al. The influence of co-morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2008; 27(6): 473-82.
- Shokohi Yekta M, Parand A, Shirazian H, Moaiedzadeh E. Stress management strategies. Tehran, Iran: Sepidbarg Publications; 2012. [In Persian].
- Antoni M, Ironson GH, Schneiderman N. Cognitive-behavioral stress management: Workbook. Oxford, UK: Oxford University Press; 2007.
- Kamolz T. Gastroesophageal reflux disease: A psychological perspective of interaction and therapeutic implications. In: Granderath FA, Kamolz T, Pointner R, Editors. Gastroesophageal reflux disease: principles of disease, diagnosis, and treatment. Berlin, Germany: Springer Science & Business Media; 2006. p. 309-18.
- Gordon A, Gordon E, Berelowitz M, Bremner CH, Bremner CG. Biofeedback improvement of lower esophageal sphincter pressures and reflux symptoms. J Clin Gastroenterol 1983; 5(3): 235-7.
- Shay SS, Johnson LF, Wong RK, Curtis DJ, Rosenthal R, Lamott JR, et al. Rumination, heartburn, and daytime gastroesophageal reflux. A case study with mechanisms defined and successfully treated with biofeedback therapy. J Clin Gastroenterol 1986; 8(2): 115-26.
- Klein KB, Spiegel D. Modulation of gastric acid secretion by hypnosis. Gastroenterology 1989; 96(6): 1383-7.
- McDonald-Haile J, Bradley LA, Bailey MA, Schan CA, Richter JE. Relaxation training reduces symptom reports and acid exposure in patients with gastroesophageal reflux disease. Gastroenterology 1994; 107(1): 61-9.
- Zargar Y, Dehghanizadeh Z, Mehrabizadeh Honarmand M, Kadkhodaei A. The effectiveness of stress management cognitive behavior on functional dyspepsia symptoms and quality of life in patients with functional dyspepsia. Govaresh 2012; 17(3): 148-55. [In Persian].
- Kamkar A, Golzary M, Farrokhi N, Aghaee S. The effectiveness of cognitive– behavioral stress management on symptoms of patients with irritable bowel syndrome. Armaghane-danesh 2011; 16(4): 300-10. [In Persian].
- Garcia-Vega E, Fernandez-Rodriguez C. A stress management programme for Crohn's disease. Behav Res Ther 2004; 42(4): 367-83.
- Han KS. The effect of an integrated stress management program on the psychologic and physiologic stress reactions of peptic ulcer in Korea. Int J Nurs Stud 2002; 39(5): 539-48.
- Richter JE, Bradley LC. Psychophysiological interactions in esophageal diseases. Semin Gastrointest Dis 1996; 7(4): 169-84.
- Mayer E. The neurobiology of stress and gastrointestinal disease. Gut 2000; 47(6): 861-9.
- Meining A, Classen M. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 2000; 95(10): 2692-7.
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