To explore the effect of anxiety during proton pump inhibitor (PPI) treatment on the curative effect of gastroesophageal reflux disease (GERD).

This study was a prospective cohort study. From January 2018 to December 2021, 503 patients who were diagnosed as GERD by gastroscopy and needed PPI treatment were collected. The main end point was effective treatment with proton pump inhibitor (PPI), and the follow-up time was 4 weeks. The patients were followed up by outpatient service, telephone and hospital medical records, and the occurrence of end point events and the detection of various indicators were counted. Patients were divided into two groups according to whether they were anxious or not, including 179 patients in anxiety group and 49 patients in non-anxiety group. Draw Kaplan-Meier survival curve to clarify the difference of effective rate after PPI treatment in different anxiety States, and use single-factor Cox regression model and multi-factor Cox regression model to clarify the relationship between anxiety and effective rate respectively, and at the same time use trend test to clarify the similarities and differences of different levels of anxiety on effective rate.

425 patients with GERD were finally included in this study. After 4-week follow-up, among 425 patients with GERD, 297 (69.88%) were effective after PPI treatment, and 128 (30.12%) were ineffective. Among 246 patients with anxiety, 160 patients (65.04%) were effective after PPI treatment, and 86 patients (34.96%) were ineffective. Among 179 patients without anxiety, 137 (76.54%) were effective after treatment, and 42 (23.46%) were ineffective. Patients without anxiety have a higher remission rate. The results of univariate and multivariate Cox regression analysis showed that no matter univariate analysis (HR=1.05,95%CI: 1.02-1.07; P<0.05) or multivariate analysis (HR=1.05,95%CI: 1.02-1.07; P<0.05), anxiety is a risk factor for reducing the curative effect of PPI; The trend test showed that with the increase of anxiety, the effective rate after PPI treatment decreased significantly (P for trend<0.05).

Anxiety is a risk factor for refractory gastroesophageal reflux disease. Anxiety reduces the therapeutic effect of PPIs on GERD symptoms. Therefore, it is necessary to pay attention to detect the anxiety state of patients with GERD symptoms in order to treat patients appropriately and optimize the treatment results.