Parameters of the functional and morphological status of the upper digestive tract in alcohol-dependent male patients with depression and alexithymia in the context of autonomic nervous system activity and nitric oxide plasma level

Psychosomatic factors play an important role in the pathogenesis of many diseases. The aim of this study was to compare the results of upper digestive tract examinations in alcoholics with depression and/or alexithymia diagnosed with atypical chest pain. In 52 alcohol dependent male patients with atypical chest pain we performed gastroduodenoscopy, esophageal and gastric pH-metry, 24-h esophageal manometry, treadmill stress test, Holter monitoring, and blood sampling. Depression was diagnosed using the Beck Depression Inventory (BDI), and alexithymia according to the Toronto Alexithymia Scale (TAS). Depression and/or alexithymia were diagnosed in 37 patients (71%). Depressive and alexithymic patients, in comparison to subjects with lower BDI and TAS scores, had less intensive Helicobacter pylori antral colonization, higher values of gastro-esophageal acid reflux parameters in 24h pH-metry, higher mean amplitude of contraction, longer mean contraction duration, higher percentage of hypertensive contractions, and a greater percentage of effective peristalsis, in spite of a similar percentage of peristaltic and simultaneous contractions. The patient groups did not differ in relation to gastric pH-metry parameters or factors potentially connecting mental status and esophageal function regulation, such as plasma nitric oxide metabolite concentration and heart rate variability (HRV), which correlate with autonomic nervous system activity. In alcoholic patients with depression and alexithymia there is a tendency to greater functional disturbances in the upper digestive tract. The observed differences between groups were not related to changes in ANS activity and nitric oxide metabolism.