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This study is very comprehensive: Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8055252/ (2021).-----

Studies clearly suggest that psychosocial stress may have a significant relationship with reflux esophagitis and could play a potential role in symptom presentation and natural history. There is a close association between stress and reflux esophagitis, and a high likelihood that patients with refractory GERD may have comorbid psychosocial health problems. These stressors may include increased levels and frequency of esophageal acid exposure, inhibition of gastric acid emptying, or stress-induced hypersensitivity. A mindfulness-based intervention for anxiety symptom relief and quality of life in gastroesophageal reflux disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576549/ (2013).---

https://www.sciencedirect.com/science/article/abs/pii/S0016508507021713 (2008).---

https://gut.bmj.com/content/56/9/1191.short (2007)

https://mspsss.org.ua/index.php/journal/article/view/21 (2018).---

https://www.sciencedirect.com/science/article/pii/S2666149723000208 (2023).--

https://www.sciencedirect.com/science/article/pii/S2666149723000208 (2023).--

Various stressors Endogenous and exogenous factors disrupt gastrointestinal physiological functions and promote inflammation, tissue damage, ulceration, gastrointestinal bleeding, gastroesophageal reflux disease (GERD), irritable bowel disease (IBD), and gastritis.

http://www.melatonin-research.net/index.php/MR/article/view/120 (2021)

The protective role of melatonin on the gastric mucosa is due to the inhibition of gastric acid and pepsin secretion. Gastric acid and pepsin are two important invasive factors in the pathogenesis of gastric ulcers and are associated with stress-induced gastric mucosal lesions.

It has been observed that in animal models of chronic gastric fistula, melatonin reduced gastric acid and also increased plasma gastrin levels.

It is suggested that this inhibitory effect of melatonin is related to the central nervous system. Melatonin is also believed to control alkali secretion in the presence of acid in the lumen. Melatonin has been shown to protect the gastrointestinal mucosa by stimulating the production of mucosal HCO3- by inducing the release of intracellular Ca+2 in enterochromatic cells.

In the link ----1) Melatonin and mucosal protection and ulcer healing. ----2) Melatonin and Helicobacter pylori. ----3) Melatonin and stomach cancer. ----4) Melatonin and intestinal functions ----5) Melatonin’s effects on intestinal bacteria and the bacteria’s effects on the amount of melatonin. ----6) Melatonin and irritable bowel syndrome. ----7) Melatonin and inflammatory bowel disease. ----8) Melatonin and colorectal carcinoma. ----9) The role of melatonin in the liver. ----10) Melatonin and the pancreas. ----11) Melatonin and appetite.

https://www.mednews.care/wp-content/uploads/2024/02/therapeutic-applications-of-melatonin-in-disorders-related-to-the-gastrointestinal-tract-and-control-of-appetite.pdf (2024).-- Studies clearly suggest that psychosocial stress may have a significant relationship with reflux esophagitis and could play a potential role in the presentation of symptoms and natural history.

Acute auditory stress has been shown to exacerbate heartburn symptoms in GERD patients by enhancing the perceptual response to intraesophageal acid exposure.

https://www.sciencedirect.com/science/article/pii/S2666149723000208 (2023).--

https://www.sciencedirect.com/science/article/pii/S2666149723000208 (2023).--

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