Autonomic dysfunction and psychosomatic changes in patients after cholecystectomy and gastroesophageal reflux disease
DOI:
https://doi.org/10.32782/2415-8127.2023.68.43Keywords:
cholecystectomy, gastroesophageal reflux disease, autonomic dysfunction, neuropsychometric tests, psychosomatic stateAbstract
Introduction. Psychosomatic conditions that occur in a gastroenterology clinic are an urgent problem today. The purpose of the study: to determine the features of autonomic dysfunction (AD) and neuropsychometric changes in patients after cholecystectomy (CE) and gastroesophageal reflux disease (GERD). Object and research methods. There were examined 62 patients after CE and GERD. The patients were divided into two groups: the first group was included the patients after CE with typical esophageal manifestations of GERD (n=38); the II group was consisted of patients after CE with atypical extra-esophageal manifestations of GERD (n=24). All examined patients were undertaken general clinical examinations, as well as determination of vegetative status and neuropsychometric testing. Research results and their discussion. AD was diagnosed in both groups of patients after CE and GERD. The overwhelming majority of patients in both study groups often complained of mood lability, increased irritability, emotional stress, anxiety, sleep disturbances, headache, fatigue, palpitations, and heart failure. More pronounced manifestations of AD were diagnosed in patients of group II. The state of the emotional sphere and its severity in the examined patients after CE and GERD were characterized using neuropsychometric tests. The data on the Spielberg-Hanin self-assessment scale indicate severe situational anxiety in the examined patients of both groups (55.3–54.2% of patients, respectively – p<0.01). Determination of the emotional sphere according to the BDI scale indicates moderate and severe depression in patients of group II (41.7% (p<0.05) and 33.3% (p<0.01) of patients, respectively). According to the Zung scale, moderate depression was also more often diagnosed among patients in group II (54.2% of patients – p<0.05). Conclusions. 1. Autonomic dysfunction was found in patients after CE, especially among those with atypical clinical course of GERD. 2. Neuropsychometric testing indicates manifestations of moderate and severe depression in patients after CE, mainly with atypical course of GERD according to the Spielberg-Hanin scale, BDI, Zung, and the Toronto alexithymic scale.
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