Psychological factors have a greater impact on the severity of symptoms in esophageal diseases than objective evaluations, such as acid reflux and esophageal motility function. Although there are questionnaires that assess general psychological states in Japan, there were none that were specific to esophageal symptoms. In the United States, meanwhile, the Esophageal Hypervigilance and Anxiety Scale (EHAS) questionnaire that evaluates symptom-specific hypervigilance and anxiety for esophageal symptoms was developed in 2018.

In an effort to expand the use of EHAS, Dr. Akinari Sawada’s research group at Osaka Metropolitan University’s Graduate School of Medicine developed a Japanese version of EHAS in cooperation with the original developers. To determine the reliability of the Japanese EHAS, survey results of 432 patients who had undergone esophageal manometry at six facilities in Japan were examined. Though minor adjustments were made to account for cultural differences, the questionnaire demonstrated validity comparative to standardized mental and physical health surveys.

The team also examined the correlation between the results of the EHAS and the severity of symptoms in 113 patients with esophageal achalasia, a condition that causes difficulty passing food to the stomach, and similar diseases. It was found that the higher the EHAS score, the more intense the symptoms were perceived.

“By using the EHAS to better determine esophageal symptoms that are affected by psychological factors, we hope that this will lead to appropriate treatment,” said Dr. Sawada.

The findings were published in the Journal of Gastroenterology.

Conflict of interests
Akinari Sawada: Bristol Myers Squibb (grant), Daniel Sifrim: Jinshan (speaking, grant, trips), Reckitt Benckiser (speaking, grant, trips), Tiffany H. Taft: Ayble Health (scientific advisory board), Oak Park Behavioral Medicine LLC (ownership), John Erik Pandolfino: Medtronic (speaking, consulting, patent, license), Sandhill Scientific/Diversatek (grant), Takeda (speaking), Astra Zeneca (speaking), Torax/Ethicon (speaking, consulting), EndoGastric Solutions (advisory board), Phathom (speaking, consulting), Yasuhiro Fujiwara: Takeda (speaking), Astra Zeneca (speaking), Astellas (speaking), Daiichi Sankyo (speaking), Otsuka (speaking), EA Pharma (speaking). The remaining authors declare no conflicts of interest in this study.

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