Hypervigilance, Anxiety Linked to Poor Treatment Outcomes in Esophageal Disorder - News Center

"Increased esophageal hypervigilance and anxiety were associated with worse post-treatment symptoms and poor quality of life in patients with achalasia, a rare esophageal motility disorder, according to a recent Northwestern Medicine study. The findings, published in Gastroenterology, demonstrate how psychological processes are associated with physiological processes that occur alongside poor treatment outcomes. Achalasia is a rare swallowing disorder in which damaged nerves in the esophagus prevent food and liquid from moving through the esophagus to the stomach."

"Symptoms can include food impaction, difficulty swallowing, or dysphagia, and chest pain. While there is no cure, endoscopic and surgical treatments can help patients manage their symptoms. However, a subset of patients will continue to experience symptoms and poor quality of life despite treatment. Previous work suggests that esophageal hypervigilance - having a heightened focus on sensations in the esophagus - and anxiety caused by symptoms may be associated with symptom severity and quality of life in patients with achalasia."

""Esophageal hypervigilance is when you focus attention on the esophagus in response to a perceived threat, so you anticipate pain is going to come or you anticipate something is going to be harmful in your esophagus. Esophageal-specific anxiety is the worry of esophageal symptoms, as well as their perceived consequences," said Livia Guadagnoli, '20 PhD, research assistant professor of Medicine in the Division of Gastroenterology and Hepatology and lead author of the study."

Increased esophageal hypervigilance and anxiety were associated with worse post-treatment symptoms and poorer quality of life in patients treated for achalasia. Achalasia is a rare swallowing disorder caused by damaged esophageal nerves that impair passage of food and liquid to the stomach, and symptoms include food impaction, dysphagia, and chest pain. Endoscopic and surgical interventions can reduce symptoms, but a subset of patients remain symptomatic and experience reduced quality of life despite treatment. A dataset of more than 90 treated patients, average age 55, was analyzed to assess whether esophageal-specific hypervigilance and anxiety predicted post-treatment symptom severity and quality-of-life outcomes.

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