Anxiety disorders are the most prevalent psychiatric disorders in the general population. The relationship between dyspepsia and particularly gastroesophageal reflux disease (GERD) and psychiatric comorbidity such as anxiety is poorly defined. However, GERD was noted to be strongly associated and often coincident in onset with generalized anxiety disorder in the community. In this paper, we report the case of an adult man who presented with severe weight loss and underlying GERD, and was later found to have an anxiety disorder as the cause of both.

Background
There are many reports that obesity could be associated with gastoesophageal refl ux disease (GERD) but the outcomes are controversial and the studies on correlation between endoscopic severity of GERD and obesity are rare. Therefore, we investigated the association between endoscopic severity of GERD and indexes of obesity. Methods: Among the subjects who visited a health promotion center of a general hospital from January 2007 to March 2008, a total of 527 subjects with typical symptoms of GERD who underwent esophagogastroduodenoscopy and analysis of body composition were enrolled. The endoscopic severity of GERD was classifi ed depending on LA grading classifi cation system. Results: Among 527 subjects, 125 subjects were classifi ed with Non-erosive refl ux disease (NERD) while 254, 105, and 43 subjects were classifi ed as LA grade A, B, and C group, respectively. Men and frequent alcohol drinkers (≥ 5 times/week) were likely to be in higher endoscopic severity group (OR, 2.065 and 2.394, respectively; P < 0.05). If the subject was obese by BMI and waist circumference, it showed a higher possibility of belonging to the higher endoscopic severity group (OR, 2.319 and 2.596, respectively; P < 0.001). In the case of %body fat, the obesity group was more likely to be in the higher endoscopic severity group only in men (OR, 1.906; P < 0.001). Conclusion: Indexes of obesity such as BMI, %body fat (only in men), and waist circumference were related with endoscopic severity of GERD and this relationship is more apparent in men and alcohol drinkers (≥ 5 times/week).

Background
: Gastroesophageal reflux disease (GERD) is common in Western civilization and comprises 75% of esophageal diseases. However, there are only few studies of GERD in Korea. The aim of the study was to evaluate the clinical symptoms of GERD in Koreans and the effect of Rabeprazole on the symptoms.

Methods : The study subjects were included 353 patients who were diagnosed endoscopically with reflux esophagitis (316) or non-erosive reflux disease who have complained of intermittent heartburn during the past 3 months or more. All patients received Rabeprazole 20 mg daily for 8 weeks. Symptoms according to 8 symptom categories of GERD were evaluated. Patients recorded the severity of GERD associated symptoms at baseline, 4 weeks and 8 weeks after treatment. Presenting symptoms in Korean, frequency and severity of each symptom was evaluated. Efficacy of Rabeprazole treatment was analyzed.

Results : The most common symptoms of GERD were regurgitation (60.9%), heartburn (52.7%), epigastric pain/ soreness (49.6%) and other epigastric discomfort (47.0%). Symptom severity was rated in order of epigastric pain/ soreness, epigastric discomfort, and heartburn. The proportion of all symptoms, except for heart burn and cough, increased in relation to the severity of endoscopic grading, but the severity of symptoms was not significantly different between subgroups according to endoscopic findings. Symptoms, except for hoarseness, globus sensation and cough, significantly improved in 4 weeks after treatment. Cough did not improve after 4 weeks irrespective of smoking status, All symptoms significantly improved after 8 weeks.

Conclusion : Regurgitation was more common, and epigastric symptoms were more severe than heartburn in Koreans. The 8-week Rabeprazole treatment was effective on all symptoms associated with GERD.