Reflux Esophagitis and Fatigue: Are They Related?

Abstract Background: Gastroesophageal reflux disease (GERD) is a chronic, recurrent disease. Reflux esophagitis can interfere with sleep via acid reflux, which could cause daytime sleepiness or fatigue. However, little is known about the association between reflux esophagitis and fatigue Objectives : We evaluated the association between fatigue and reflux esophagitis in subjects seen at health check-ups. Methods : Consecutive patients who were scheduled for screening endoscopy were enrolled prospectively at the Comprehensive Medical Examination Center of St. Vincent Hospital and Eunpyeong St. Mary's Hospital, Korea. Three validated questionnaires were used to assess fatigue, daytime hypersomnolence, anxiety, and depression: the Multidimensional Fatigue Inventory-Korean version (MFI-K), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS). Results : We investigated 497 consecutive eligible subjects. The reflux esophagitis and symptomatic GERD groups comprised 103 (20.7%) and 92 (18.5%) subjects, respectively. The MFI-K total, ESS, HADS-anxiety, and HADS-depression scores did not differ between the esophagitis and non-esophagitis groups (50.0±11.5 vs . 49.7±10.9, P =0.769; 6.2±2.8 vs . 6.1±3.1, P =0.819; 5.8±3.1 vs . 5.2±3.2, P =0.069; 6.2±3.6 vs . 6.0±3.3, P =0.527). However, the MFI-K total, ESS, HADS-anxiety, and HADS-depression scores were higher in the symptomatic group than in the non-symptomatic group (54.7±12.7 vs . 48.6±10.3, P <0.001; 7.1±3.5 vs . 5.9±2.9, P =0.002; 6.4±3.3 vs . 5.1±3.1, P <0.001; 7.5±4.0 vs . 5.7±3.1, P <0.001). In addition, HADS-depression was correlated with the MFI-K score ( P <0.001). Conclusion : There was no statistically significant association in which reflux esophagitis could cause daytime sleepiness, fatigue, anxiety, or depression, but GERD symptoms were associated with all of these. Depression was also associated with fatigue. Further studies should clarify the association between fatigue and reflux esophagitis.