Gastroesophageal Reflux Disease and Its Associations with Depression, Other Psychiatric Disorders and Patient Quality of Life: A Literature Review
DOI:
https://doi.org/10.12775/QS.2025.43.61331Keywords
gastroesopageal reflux disease, depressive disorder, Quality of Life, mental healthAbstract
Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder whose incidence has been increasing in recent years. Due to its potential extraesophageal manifestations, diagnosing GERD can be challenging. Emerging evidence suggests that GERD may have significant implications not only in the digestive tract, including effects on mental health. This review investigates the potential associations between GERD and psychiatric disorders such as depression, anxiety, bipolar disorder and sleep disturbances, as well as its impact on quality of life and productivity. Relevant literature was found through databases including PubMed, ResearchGate and Google Scholar with a focus on meta-analyses and systematic reviews. The findings indicate that GERD is associated with a higher risk of mental health disorders, particularly depression and sleep disorders. These relationships may be bidirectional. Additionally, recent studies highlight promising non-pharmacological interventions that may alleviate GERD symptoms. Understanding the psychological consequences of GERD and integrating mental health screening into gastroenterological practice could potentially improve patient outcomes. However, further research is needed to clarify the mechanisms linking GERD and mental health.
References
Chen, D., Zhang, Y., Huang, T., & Jia, J. (2023). Depression and risk of gastrointestinal disorders: a comprehensive two-sample Mendelian randomization study of European ancestry. Psychological Medicine, 53(15), 7309–7321. https://doi.org/10.1017/S0033291723000867
Dai, F., Cai, Y., Chen, M., & Dai, Y. (2025). Global trends of depressive disorders among women of reproductive age from 1990 to 2021: a systematic analysis of burden, sociodemographic disparities, and health workforce correlations. BMC Psychiatry, 25(1), 263. https://doi.org/10.1186/s12888-025-06697-4
Eusebi, L. H., Ratnakumaran, R., Bazzoli, F., & Ford, A. C. (2018). Prevalence of Dyspepsia in Individuals With Gastroesophageal Reflux–Type Symptoms in the Community: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology, 16(1), 39-48.e1. https://doi.org/10.1016/j.cgh.2017.07.041
Eusebi, L. H., Ratnakumaran, R., Yuan, Y., Solaymani-Dodaran, M., Bazzoli, F., & Ford, A. C. (2018). Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut, 67(3), 430–440. https://doi.org/10.1136/gutjnl-2016-313589
Fuchs, K.-H., Musial, F., Eypasch, E., & Meining, A. (2022). Gastrointestinal Quality of Life in Gastroesophageal Reflux Disease: A Systematic Review. Digestion, 103(4), 253–260. https://doi.org/10.1159/000524766
Gao, L., & Gao, J. (2025). The Relationship of Sleep Duration, Chronotype and the Risk of Depression: A Systematic Review and Meta-analysis. International Journal of Education and Humanities, 19(2), 144–150. https://doi.org/10.54097/69ymgj60
Gisbert, J. P., Cooper, A., Karagiannis, D., Hatlebakk, J., Agréus, L., Jablonowski, H., & Nuevo, J. (2009). Impact of gastroesophageal reflux disease on work absenteeism, presenteeism and productivity in daily life: a European observational study. Health and Quality of Life Outcomes, 7(1), 90. https://doi.org/10.1186/1477-7525-7-90
Hajebi, A., Hajiabadi, I. Z., Fendereski, A., Ghodssighassemabadi, R., Zamani Hajiabadi, A., Hosseini, J., & Samadaee Gelehkolaee, K. (2025). Prevalence of major depressive disorder in Iranian men from 2011 to 2022; a systematic review and meta-analysis. BMC Psychiatry, 25(1), 189. https://doi.org/10.1186/s12888-025-06616-7
Halland, M., Bharucha, A. E., Crowell, M. D., Ravi, K., & Katzka, D. A. (2021). Effects of Diaphragmatic Breathing on the Pathophysiology and Treatment of Upright Gastroesophageal Reflux: A Randomized Controlled Trial. American Journal of Gastroenterology, 116(1), 86–94. https://doi.org/10.14309/ajg.0000000000000913
Islam, Md. M., Poly, T. N., Walther, B. A., Dubey, N. K., Anggraini Ningrum, D. N., Shabbir, S.-A., & (Jack) Li, Y.-C. (2018). Adverse outcomes of long-term use of proton pump inhibitors: a systematic review and meta-analysis. European Journal of Gastroenterology & Hepatology, 30(12), 1395–1405. https://doi.org/10.1097/MEG.0000000000001198
Kahrilas, P. J., Shaheen, N. J., & Vaezi, M. F. (2008). American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease. Gastroenterology, 135(4), 1383-1391.e5. https://doi.org/10.1053/j.gastro.2008.08.045
Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2022). ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. American Journal of Gastroenterology, 117(1), 27–56. https://doi.org/10.14309/ajg.0000000000001538
Li, L., Wu, C., Gan, Y., Qu, X., & Lu, Z. (2016). Insomnia and the risk of depression: a meta-analysis of prospective cohort studies. BMC Psychiatry, 16(1), 375. https://doi.org/10.1186/s12888-016-1075-3
Li, N., Yang, W.-L., Cai, M.-H., Chen, X., Zhao, R., Li, M.-T., Yan, X.-L., Xue, L.-W., Hong, L., & Tang, M.-Y. (2023). Burden of gastroesophageal reflux disease in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of disease study 2019. BMC Public Health, 23(1), 582. https://doi.org/10.1186/s12889-023-15272-z
Liu, J., Liu, Y., Ma, W., Tong, Y., & Zheng, J. (2024). Temporal and spatial trend analysis of all-cause depression burden based on Global Burden of Disease (GBD) 2019 study. Scientific Reports, 14(1), 12346. https://doi.org/10.1038/s41598-024-62381-9
Lynen, A., Schömitz, M., Vahle, M., Jäkel, A., Rütz, M., & Schwerla, F. (2022). Osteopathic treatment in addition to standard care in patients with Gastroesophageal Reflux Disease (GERD) – A pragmatic randomized controlled trial. Journal of Bodywork and Movement Therapies, 29, 223–231. https://doi.org/10.1016/j.jbmt.2021.09.017
Maideen, N. M. P. (2023). Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors. Chonnam Medical Journal, 59(2), 115. https://doi.org/10.4068/cmj.2023.59.2.115
Markar, S., Andreou, A., Bonavina, L., Florez, I. D., Huo, B., Kontouli, K., Low, D. E., Mavridis, D., Maynard, N., Moss, A., Pera, M., Savarino, E., Siersema, P., Sifrim, D., Watson, D. I., Zaninotto, G., & Antoniou, S. A. (2022). UEG and EAES rapid guideline: Update systematic review, network meta‐analysis, CINeMA and GRADE assessment, and evidence‐informed European recommendations on surgical management of GERD. United European Gastroenterology Journal, 10(9), 983–998. https://doi.org/10.1002/ueg2.12318
McKinley, S. K., Dirks, R. C., Walsh, D., Hollands, C., Arthur, L. E., Rodriguez, N., Jhang, J., Abou-Setta, A., Pryor, A., Stefanidis, D., & Slater, B. J. (2021). Surgical treatment of GERD: systematic review and meta-analysis. Surgical Endoscopy, 35(8), 4095–4123. https://doi.org/10.1007/s00464-021-08358-5
Nirwan, J. S., Hasan, S. S., Babar, Z.-U.-D., Conway, B. R., & Ghori, M. U. (2020). Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis. Scientific Reports, 10(1), 5814. https://doi.org/10.1038/s41598-020-62795-1
Nurita, R., Faturohman, A., Santoso, F. M., Magdalena, B., & Ilyas, M. F. (2025). Bidirectional Association between Gastroesophageal Reflux Disease and Bipolar Disorder: A Systematic Review and Meta-analysis of Longitudinal Studies. Middle East Journal of Digestive Diseases, 17(1), 68–75. https://doi.org/10.34172/mejdd.2025.411
Phyo, A. Z. Z., Freak-Poli, R., Craig, H., Gasevic, D., Stocks, N. P., Gonzalez-Chica, D. A., & Ryan, J. (2020). Quality of life and mortality in the general population: a systematic review and meta-analysis. BMC Public Health, 20(1), 1596. https://doi.org/10.1186/s12889-020-09639-9
Qiu, K., Wang, J., Chen, B., Wang, H., & Ma, C. (2020). The effect of breathing exercises on patients with GERD: a meta-analysis. Annals of Palliative Medicine, 9(2), 405–413. https://doi.org/10.21037/apm.2020.02.35
San, L., & Arranz, B. (2024). The Night and Day Challenge of Sleep Disorders and Insomnia: A Narrative Review. Actas Espanolas de Psiquiatria, 52(1), 45–56.
Sidhwa, F., Moore, A., Alligood, E., & Fisichella, P. M. (2017). Diagnosis and Treatment of the Extraesophageal Manifestations of Gastroesophageal Reflux Disease. Annals of Surgery, 265(1), 63–67. https://doi.org/10.1097/SLA.0000000000001907
Simadibrata, D. M., Ngadiono, E., Sinuraya, F. A. G., Damara, I., Fass, R., & Simadibrata, M. (2023). Diagnostic accuracy of gastroesophageal reflux disease questionnaire for gastroesophageal reflux disease: A systematic review and meta‐analysis. Neurogastroenterology & Motility, 35(12). https://doi.org/10.1111/nmo.14619
Tack, J., & Pandolfino, J. E. (2018). Pathophysiology of Gastroesophageal Reflux Disease. Gastroenterology, 154(2), 277–288. https://doi.org/10.1053/j.gastro.2017.09.047
Tan, X., Wang, S., Wu, F., & Zhu, J. (2024). Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis. PeerJ, 12, e17202. https://doi.org/10.7717/peerj.17202
Touré, M., Kouakou, C. R. C., & Poder, T. G. (2021). Dimensions Used in Instruments for QALY Calculation: A Systematic Review. International Journal of Environmental Research and Public Health, 18(9), 4428. https://doi.org/10.3390/ijerph18094428
Velanovich, V. (2007). The development of the GERD-HRQL symptom severity instrument. Diseases of the Esophagus, 20(2), 130–134. https://doi.org/10.1111/j.1442-2050.2007.00658.x
Wiklund, I. (2004). Review of the Quality of Life and Burden of Illness in Gastroesophageal Reflux Disease. Digestive Diseases, 22(2), 108–114. https://doi.org/10.1159/000080308
Zamani, M., Alizadeh-Tabari, S., Chan, W. W., & Talley, N. J. (2023). Association Between Anxiety/Depression and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis. American Journal of Gastroenterology, 118(12), 2133–2143. https://doi.org/10.14309/ajg.0000000000002411
Zhang, C., Kwong, J. S. W., Yuan, R.-X., Chen, H., Xu, C., Wang, Y.-P., Yang, G.-L., Yan, J.-Z., Peng, L., Zeng, X.-T., Weng, H., Luo, J., & Niu, Y.-M. (2017). Effectiveness and Tolerability of Different Recommended Doses of PPIs and H2RAs in GERD: Network Meta-Analysis and GRADE system. Scientific Reports, 7(1), 41021. https://doi.org/10.1038/srep41021
Zhang, H., Yang, Z., Ni, Z., & Shi, Y. (2017). A Meta-Analysis and Systematic Review of the Efficacy of Twice Daily PPIs versus Once Daily for Treatment of Gastroesophageal Reflux Disease. Gastroenterology Research and Practice, 2017, 1–8. https://doi.org/10.1155/2017/9865963
Zhang, M., Pandolfino, J. E., Zhou, X., Tan, N., Li, Y., Chen, M., & Xiao, Y. (2019). Assessing different diagnostic tests for gastroesophageal reflux disease: a systematic review and network meta-analysis. Therapeutic Advances in Gastroenterology, 12. https://doi.org/10.1177/1756284819890537
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jan Szerocki, Katarzyna Milewska-Plis, Alicja Winkowska, Alina Grudina, Igor Kłak, Joanna Grodzicka , Katarzyna Bartnik, Mariola Herian, Monika Karalus, Weronika Curyło
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 353
Number of citations: 0
