Reflux Esophagitis and Fatigue: Are They Related?

Sung-Goo Kang; Hyun Jee Hwang; Youngwoo Kim; Junseak Lee; Jung Hwan Oh; Jinsu Kim; Chul-Hyun Lim; Seung Bae Youn; Sung Hoon Jung

doi:10.3390/jcm10081588

Reflux Esophagitis and Fatigue: Are They Related?

J Clin Med. 2021 Apr 9;10(8):1588. doi: 10.3390/jcm10081588.

Authors

Sung-Goo Kang¹, Hyun Jee Hwang², Youngwoo Kim², Junseak Lee², Jung Hwan Oh², Jinsu Kim², Chul-Hyun Lim², Seung Bae Youn², Sung Hoon Jung²

Affiliations

¹ Department of Family Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Korea.
² Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea.

Abstract

Gastroesophageal reflux disease (GERD) is a chronic, recurrent disease. Reflux esophagitis can interfere with sleep via acid reflux, which can 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 endoscopies 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 = 0.661; 6.2 ± 2.8 vs. 6.1 ± 3.1, p = 0.987; 5.8 ± 3.1 vs. 5.2 ± 3.2, p = 0.060; 6.2 ± 3.6 vs. 6.0 ± 3.3, p = 0.561). 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). Multiple regression analysis showed that the MFI-K total was correlated with GERD symptoms (p = 0.021), women (p = 0.001), anxiety (p < 0.001), and depression (p < 0.001).

Conclusion: There was no statistically significant association in which reflux esophagitis could cause daytime sleepiness, fatigue, anxiety, or depression. However, fatigue was associated with GERD symptoms, women, anxiety, and depression. Further studies should clarify the association between fatigue and reflux esophagitis.

Keywords: depression; esophagus; fatigue; gastroesophageal reflux disease; reflux esophagitis.