Acid reflux and anxiety may share a close link. Some research suggests that anxiety might make acid reflux symptoms worse.
Anxiety and stress may also be contributing factors to acid reflux in some cases. Conversely, acid reflux can be stressful and may cause anxiety in some people.
People with troubling symptoms or symptoms that do not respond to home treatment should see a doctor.
Acid reflux occurs when acid from the stomach leaks back up into the food pipe, or esophagus. It is a common symptom of gastroesophageal reflux disease (GERD).
Stress can worsen acid reflux symptoms, and anxiety is a natural response to stress in the body. Paradoxically, experiencing anxiety can also in itself be stressful, which can continue the cycle.
There is some evidence to suggest that stress and anxiety may provoke acid reflux or make the symptoms worse.
For instance, a 2018 study involving more than 19,000 people found that those with anxiety were more likely to experience GERD symptoms.
The researchers suggested several possible physical reasons for this:
- Anxiety may reduce pressure in the lower esophageal sphincter, which is the band of muscle that keeps the stomach closed and prevents acid from leaking into the esophagus.
- Stress responses and anxiety may cause long lasting muscle tension. If this affects the muscles around the stomach, it could increase pressure in this organ and push the acid up.
- High anxiety levels may increase stomach acid production.
In some cases, people with anxiety who had the same number of acid reflux episodes as people without anxiety rated these episodes as more severe.
The authors of a study in Clinical Gastroenterology and Hepatology also found that among people with GERD, the symptoms — including pain and heartburn — were more severe in those who had higher levels of anxiety.
Scientists have also noted that GERD can be a major source of stress and anxiety for people.
In 2019, researchers noted that people with GERD who experienced chest pain had significantly higher levels of depression and anxiety that those who did not have pain in this part of the body.
The study authors also suggest that people may associate symptoms such as chest pain with other more serious conditions, increasing their anxiety about these symptoms.
The combination of these factors can allow a vicious cycle to develop. GERD may cause stress and anxiety, yet stress and anxiety levels also contribute to GERD. Finding both physical and psychological ways to treat these symptoms is vital to break the cycle and find relief.
Other factors that can lead to acid reflux include:
- eating meals just before bed
- eating large or fatty meals
- including spicy foods in meals
- having obesity
- consuming alcohol
Understanding the symptoms of GERD and anxiety may help a person distinguish between them.
Symptoms of GERD
GERD is a condition that causes regular acid reflux, as stomach acid often leaks back up into the esophagus. It causes a number of symptoms, the most common being heartburn.
Heartburn is a painful, burning feeling in the middle of the chest and, sometimes, in the throat. It occurs when the acid from the stomach irritates the esophagus.
Symptoms of GERD may include:
- nausea or stomach upset
- pain in the chest or abdomen
- painful swallowing
- bad breath
Symptoms of anxiety
Anxiety symptoms vary from person to person. Possible symptoms include:
- rapid heart rate
- nervousness or restlessness
- twitching muscles
- feeling very tense, both physically and mentally
- rapid breathing or hyperventilating
- a feeling of dread or constant impending doom
- difficulty focusing
- other digestive issues, such as gas, diarrhea, or constipation
- inability to sleep
Anxiety may also present as sudden, intense signs of distress called panic attacks. Panic attacks occur when severe symptoms come on very quickly. These can include extreme fear, drastic changes in heartbeat, and changes in breathing.
Many people deal with occasional acid reflux and feel anxious from time to time when they are facing a stressful situation.
When either or both symptoms become regular occurrences, it is important to take steps to treat or prevent them.
Additionally, as the symptoms of acid reflux and anxiety may make each other worse, taking quick action may help prevent this cycle from developing.
People may be able to relieve the symptoms of GERD using one or more methods, including:
- finding and eliminating foods that trigger symptoms
- avoiding large or very fatty meals
- eating their last meal no later than 2–3 hours before bed
- taking over-the-counter antacids, such as calcium carbonate (Tums) or bismuth subsalicylate (Pepto-Bismol)
- taking proton pump inhibitors, such as esomeprazole (Nexium)
- using H2 receptor blockers, such as famotidine (Pepcid)
Doctors may also recommend taking steps to reduce or prevent anxiety, including:
- attending regular cognitive behavioral therapy (CBT) sessions
- reducing the intake of caffeine
- avoiding recreational drug and alcohol use
- engaging in stress relief techniques, such as yoga, meditation, or tai chi
- taking prescription medications, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) or benzodiazepines
Always follow the doctor’s instructions when using drugs for anxiety, however, as some drugs can have severe adverse effects. With benzodiazepines, there is a high risk of dependence. Using them alongside alcohol or opioid drugs can produce life threatening effects.
In some cases, it is possible to manage the symptoms of both acid reflux and anxiety with home remedies.
However, anyone experiencing chronic anxiety or acid reflux should speak to a doctor.
Long-term anxiety can contribute to a range of physical and mental health complications.
The symptoms of both GERD and anxiety can appear similar to those of other conditions. Therefore, it is advisable to visit a doctor for a diagnosis.
Dealing with the combination of acid reflux and anxiety can be frustrating. In some cases, a person may not know whether they are experiencing acid reflux or the physical symptoms of anxiety.
Working with a doctor is important to ensure that the person gets the correct treatment.
Finding ways to manage anxiety and taking steps toward treating acid reflux may help end the cycle and help people control their symptoms.