arina widya, murni and Nasrul, Zubir and Julius, -
(2011)
PLASMA CORTISOL LEVELS IN DYSPEPSIA
WITH PSYCHOSOMATIC PATIENTS
Arina Widya Murni*, Nasrul Zubir**, **Julius
* Sub Division of Psychosomatic,
** Sub division of Gastroenterology
Department of Internal Medicine
Faculty of Medicine Andalas University Padang.
Masters thesis, Faculty of Medicine, Andalas University.
Abstract
Background:
The interaction between psychological factors with gastrointestinal disorders is believed through brain – gut – axis , including psycho- neuro- immune – endocrinology system, which is direct or indirect could influence on the acid secretion, motility, vascularitation and sensory of pain .
Excessive acid secretion may be caused by the stimulation on Hypothalamus-Pituitary-Adrenal axis pathway, starting with the release of Corticotrophins Releasing Hormone (CRH) and the end result is increasing cortisol secretion by adrenal cortex.
Objective: To find out the level of plasma cortisol in dyspepsia with psychosomatic patient.
Methods : This is an analytic descriptive, cross sectional study with non random consecutive sampling. After diagnosis of dyspepsia, depression, anxiety and both of depression – anxiety , all subjects were examine gastroscopy and plasma cortisol in the morning and evening .
Results: There were 40 patients with dyspepsia and psychosomatic disorders and 10 patients with dyspepsia without psychosomatic symptom as control group. Range of age was 20 – 40 years old, There was an increased cortisol level in the morning in sample with mean 322,33 ± 166,92 nmol/L compared to normal group 188,84 ± 103,14 nmol/L, and the difference was statistically significant (p < 0,05 ).
Level cortisol in the evening was higher in psychosomatic group with mean 163,09 ± SD 130,29 nmol/L comparing to normal group 112,69 ± 86,46, nmol/L but the differences was not significant.
Depression group had a significant higher morning cortisol with mean 328,92 ± 172,98 nmol/L comparing to normal 188,84 ± 103,14 nmol /L, (p< 0,05 ). There was no significant difference in cortisol level in anxiety and both of depression – anxiety group comparing to normal.
Conclusion: The level of morning plasma cortisol in dyspepsia with psychosomatic patients ( especially depression) was significantly higher than in dyspepsia without psychosomatic .
Key word : dyspepsia, cortisol plasma, psychosomatic disorders
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