Skip to main content

Advertisement

SpringerLink
Log in

The effectiveness of mindfulness meditation in relief of symptoms of depression and quality of life in patients with gastroesophageal reflux disease

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

The role of psychological comorbidities in patients with gastroesophageal reflux disease (GERD), a common condition, still remains incompletely understood. Depression may intensify the symptoms and lower quality of life in these patients. In this study, we looked at the effectiveness of mindfulness-based stress reduction (MBSR) in relieving the symptoms of depression and the health-related quality of life of these patients.

Methods

A longitudinal, interventional open-label study was carried out on 60 patients with GERD and 60 controls. Zung Self-Rating Depression Scale (ZSDS) was used for assessing depression before and after the intervention. The GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire was used to assess the health-related quality of life and the Freiburg Mindfulness Inventory (FMI) to quantify the amount of mindfulness over the study period. The correlation between the above variables was analyzed.

Result

Compared with the group not receiving MBSR, the group receiving MBSR showed a greater decrease in the levels of depression indicated by changes in the ZSDS (p < 0.001). According to the GERD-HRQL questionnaire, mental health and social functioning significantly correlated with symptoms of depression and reduction in the levels of distress and in the improvement in health-related quality of life were greater in the group receiving MBSR (p < 0.001).

Conclusion

Depressive symptoms adversely influence GERD, reducing the overall quality of life. MBSR can be an effective modality in the alleviation of these symptoms and in reduction in the levels of distress in GERD patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–20.

    Article  PubMed  Google Scholar 

  2. Spechler SJ. Clinical manifestations and esophageal complications of GERD. Am J Med Sci. 2003;326:279–84.

    Article  PubMed  Google Scholar 

  3. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63:871–80.

    Article  PubMed  Google Scholar 

  4. Jeong ID. A review of diagnosis of GERD. Korean J Gastroenterol. 2017;69:96–101.

    Article  PubMed  Google Scholar 

  5. Bhatia SJ, Reddy DN, Ghoshal UC, et al. Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2011;30:118–27.

  6. Rai RR, Gangadhar A, Mayabhate MM. Clinical profiling of patients with acid peptic disorders (APD) in India: a cross-sectional survey of clinicians. Int J Basic Clin Pharmacol. 2016;6:194–202.

    Article  Google Scholar 

  7. Fass R, Tougas G. Functional heartburn: the stimulus, the pain, and the brain. Gut. 2002;51:885–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196:129–36.

    Article  CAS  PubMed  Google Scholar 

  9. Yang XJ, Jiang HM, Hou XH, Song J. Anxiety and depression in patients with gastroesophageal reflux disease and their effect on quality of life. World J Gastroenterol. 2015;21:4302–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Li YM, Du J, Zhang H, Yu CH. Epidemiological investigation in outpatients with symptomatic gastroesophageal reflux from the Department of Medicine in Zhejiang Province, east China. J Gastroenterol Hepatol. 2008;23:283–9.

    Article  PubMed  Google Scholar 

  11. Lee YC, Wang HP, Chiu HM, et al. Comparative analysis between psychological and endoscopic profiles in patients with gastroesophageal reflux disease: a prospective study based on screening endoscopy. J Gastroenterol Hepatol. 2006;21:798–804.

    Article  PubMed  Google Scholar 

  12. Jansson C, Nordenstedt H, Wallander M, et al. A population-based study showing an association between gastroesophageal reflux disease and sleep problems. Clin Gastroenterol Hepatol. 2009;7:960–5.

    Article  PubMed  Google Scholar 

  13. DeVault KR, Castell DO, American College of Gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005;100:190–200.

    Article  PubMed  Google Scholar 

  14. Fass R. Approach to refractory gastroesophageal reflux disease in adults; Topic 2239, Version 16.0; www.uptodate.com; topic last updated: Jun 07. 2016.

  15. El-Serag H, Becher A, Jones R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies. Aliment Pharmacol Ther. 2010;32:720–37.

    Article  CAS  PubMed  Google Scholar 

  16. Fass R, Shapiro M, Dekel R, Sewell J. Systematic review: proton-pump inhibitor failure in gastro-oesophageal reflux disease–where next? Aliment Pharmacol Ther. 2005;22:79–94.

    Article  CAS  PubMed  Google Scholar 

  17. Bhatia V, Tandon RK. Stress and the gastrointestinal tract. J Gastroenterol Hepatol. 2005;20:332–9.

    Article  PubMed  Google Scholar 

  18. Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011;62:591–9.

    CAS  PubMed  Google Scholar 

  19. Kamolz T, Pointner R. Gastroesophageal reflux disease. Minerva Gastroenterol Dietol. 2004;50:261–8.

    CAS  PubMed  Google Scholar 

  20. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol. 2010;78:169–83.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 2011;6:537–59.

    Article  PubMed  Google Scholar 

  22. Kabat-Zinn J, Hanh TN. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Delta Trade Paperbacks, 1990.

  23. Zung W. A rating instrument for anxiety disorders. Psychosomatics. 1971;12:371–9.

  24. Walach H, Buchheld N, Buttenmuller V, Kleinknecht N, Schmidt S. Measuring mindfulness--the Freiburg Mindfulness Inventory (FMI). Personal Individ Differ. 2006;40:1543–55.

    Article  Google Scholar 

  25. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33.

  26. Velanovich V. The development of the GERD-HRQL symptom severity instrument. Dis Esophagus. 2007;20:130–4.

    Article  CAS  PubMed  Google Scholar 

  27. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54:710–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Spechler SJ. Epidemiology and natural history of gastro-oesophageal reflux disease. Digestion. 1992;51 Suppl 1:24–9.

  29. Wienbeck M, Babnert J. Epidemiology of reflux disease and reflux esophagitis. Scand J Gastroenterol. 1989;24 Suppl 156:7–13.

  30. Stanghellini V. Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scand J Gastroenterol Suppl. 1999;231:20–8.

    Article  CAS  PubMed  Google Scholar 

  31. Locke GR, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997;112:448–56.

    Article  Google Scholar 

  32. Wiklund I, Carlsson R, Wiklund I, Carlsson R, Carlsson J, Glise H. Psychological factors as a predictor of treatment response in patients with heartburn: a pooled analysis of clinical trials. Scand J Gastroenterol. 2006;41:288–93.

    Article  PubMed  Google Scholar 

  33. Kessing BF, Bredenoord AJ, Saleh CM, Smout AJ. Effects of anxiety and depression in patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2015;13:1089–95.

    Article  PubMed  Google Scholar 

  34. Ronkainen J, Aro P, Storskrubb T, et al. Gastro-oesophageal reflux symptoms and health-related quality of life in the adult general population: the Kalixanda study. Aliment Pharmacol Ther. 2006;23:1725–33.

    Article  CAS  PubMed  Google Scholar 

  35. Garland EL, Gaylord SA, Palsson O, Faurot K, Douglas Mann J, Whitehead WE. Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med. 2012;35:591–602.

    Article  PubMed  Google Scholar 

  36. Labelle LE, Campbell TS, Carlson LE. Mindfulness-based stress reduction in oncology: evaluating mindfulness and rumination as mediators of change in depressive symptoms. Mindfulness. 2010;1:28–40.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore-Bangalore Road, Bannimantap, Mysuru, 570 015, India

    Suhas Chandran, Rajesh Raman & M. Kishor

  2. Department of Gastroenterology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore-Bangalore Road, Bannimantap, Mysuru, 570 015, India

    H. P. Nandeesh

Authors
  1. Suhas Chandran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rajesh Raman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Kishor
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. P. Nandeesh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Suhas Chandran.

Ethics declarations

Conflict of interest

SC, RR, MK, and HPN declare that they have no conflict of interest.

Ethical clearance

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com. Permission was obtained from the JSS Medical College and Hospital Ethics Committee.

Disclaimer

The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chandran, S., Raman, R., Kishor, M. et al. The effectiveness of mindfulness meditation in relief of symptoms of depression and quality of life in patients with gastroesophageal reflux disease. Indian J Gastroenterol 38, 29–38 (2019). https://doi.org/10.1007/s12664-019-00940-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-019-00940-z

Keywords

Search

Navigation