[The effect of antianxiety and anti-depressive agents for the acid-related gastrointestinal diseases].

Abstract The first-line drug for acid-related gastrointestinal diseases is acid-suppressive agents (proton pump inhibitor(PPI), H2 receptor antagonist, etc.). However, among them, there are pathophysiological conditions that cannot be cured by acid-suppressive agents. These conditions are related to the complexity of the pathophysiology, and so called "PPI-resistant gastro-esophageal reflux disease (GERD)" is one of such conditions. In these pathophysiological conditions, hypersensitive esophagus to either acid, weakly acid and non-acid, and functional heartburn are included. Esophageal hypersensitivity is associated with psychiatric disorders and anxiety changes the esophageal sensitivity. Therefore, anti-anxiety agents might be effective. However, there has been no evidence. Hypersensitive esophagus, functional heartburn, and non-cardiac chest pain can be the candidates of the use of anti-depressive agents. The evidence of antianxiety and anti-depressive agents on PPI resistant GERD is not enough and further studies are warranted.