The study find that the Gastroesophageal reflux (GERD) is associated with chronic, painful temporomandibular disorder pain in the temporomandibular joint and anxiety and poor sleep contribute to this association, according to a study in CMAJ (Canadian Medical Association Journal). Because Pain from temporomandibular disorder (TMD) affects about 13% of Canada’s population. But Reflux is an uncomfortable condition in which stomach contents are regurgitate into the throat. Evidence indicates that anxiety, somatization and depression are link to GERD.

The Gastroesophageal reflux

Researchers from China and the United States looked at data on 1522 patients with chronic TMD; of whom 69% (1048) were women, to understand the relationship between chronic TMD and GERD and to determine if anxiety; somatization and depression influence the association. They found symptomatic GERD was a risk factor for TMD; and people with a longer history of GERD had a higher risk of TMD than those with a shorter history.

“The interactions between chronic musculoskeletal diseases, gastrointestinal diseases; mental disorders and sleep problems are complicate,” writes Dr. Jihua Chen, The Dental College of Georgia; Augusta, Georgia, and The Fourth Military Medical University, Xi’an, China, with coauthors. Therefore “There is evidence to support the bidirectional nature of the associations among these comorbidities; and patients may be stuck in a cycle in which undermined sleep, somatization and anxiety exacerbate the pain, with the pain also leading to sleep problems and mental disorders.”

The bidirectional nature

The authors suggest physicians need to be aware of the association and consider multidisciplinary management programs to help patients with TMD and chronic pain. Chronic pain is define as pain that persists longer than the temporal course of natural healing; but associated with a particular type of injury or disease process. The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage; or described in terms of such damage.”

Pain is subjective in nature and is define by the person experiencing it, and the medical community’s understanding of chronic pain now includes the impact that the mind has in processing and interpreting pain signals. Because “Physicians and patients may overlook the association between chronic musculoskeletal disease and gastrointestinal symptoms;” write the authors. “Patients with both chronic TMD and reflux symptoms may be under diagnosed, resulting in deferred effective treatment and a prolonged disease course.”

Psychological or behavioral pattern

“Associations among gastroesophageal reflux disease, mental disorders, sleep and chronic temporomandibular disorder: a case-control study” is publish. A mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expect as part of normal development or culture. The recognition and understanding of mental disorders has changed over time and across cultures. Definitions, assessments; and classifications of mental disorders can vary; but guideline criteria listed in the ICD, DSM and other manuals are widely accept by mental health professionals.