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Gold standard treatment includes cognitive behavioral therapies (CBT) that incorporate exposure to traumatic memories to facilitate extinction

I get all these people asking me stuff, he says

Back pain and co-occurring conditions: findings from a nationally representative sample

Disrupted peripheral neurogenic signaling pathways between the liver and the brain axis, coupled with perturbed central neurotransmission within the brain, in tandem with disease-related or disease-associated factors, such as complications, treatments, and severity, as well as alcohol use, metabolic syndrome, and malignancy, collectively contribute toward clinical fatigue (10)

This dual mechanism may enhance outcomes for GERD specifically compared to purely systemic delivery