Some people report developing symptoms of GERD, such as heartburn, during or after having COVID-19. However, no studies have investigated the potential relationship between the two conditions.

Gastroesophageal reflux disease (GERD) occurs when stomach acid flows back into the esophagus, causing frequent heartburn, regurgitation, or pain. It is possible that COVID-19 may contribute to GERD because it can cause digestive symptoms. At present, though, it is unclear if there is any direct link.

However, scientists have discovered that some people genetically predisposed to developing acid reflux may be more vulnerable to COVID-19. People may also develop digestive symptoms due to long COVID.

This article explains what we currently know about COVID-19 and GERD, including whether there is a link, GERD and long COVID, and what doctors can do to help.

Coronavirus data

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.

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It is unclear if COVID-19 can directly trigger GERD. Digestive symptoms such as nausea, vomiting, and diarrhea are fairly common in COVID-19, but acid reflux and GERD do not appear much in the research.

However, there may be ways in which GERD raises the risk of COVID-19. A 2022 study found that people who were genetically predisposed to developing acid reflux might be more vulnerable to COVID-19.

The researchers calculated there was a 15% higher risk of severe illness, although they did not know why these genetic variations increased a person’s susceptibility.

Another way in which GERD could raise COVID-19 risk is through the medications some people take to reduce reflux.

Proton pump inhibitors (PPIs) reduce stomach acid production. A 2020 study with more than 53,000 participants found that people taking PPIs were significantly more likely to test positive for COVID-19 than those who were not.

Long COVID is a collection of symptoms that persist after COVID-19 is gone.

Besides the typical symptoms of fatigue, shortness of breath, headaches, and brain fog, people with long COVID can also develop digestive symptoms, including heartburn.

In a 2021 study with 749 respondents, almost 3 in 10 reported gastrointestinal symptoms 6 months after COVID-19. Of these, 16% reported heartburn.

This may mean that COVID-19 can cause new cases of heartburn or GERD. But there are several other ways the two conditions may interact.

For example, the conditions may share some of the same risk factors, making it more likely for them to occur at the same time. Obesity and smoking are two risk factors that GERD and COVID-19 share.

Long COVID can also take a toll on mental health, which in turn impacts the digestive system. The symptoms of long COVID can be severe, contributing to stress, anxiety, depression, and, in some cases, post-traumatic stress disorder (PTSD).

Anxiety and depression are more common in those with GERD, which may suggest mental health conditions can lead to its development. However, more research is necessary to fully understand the connection.

Some people report having GERD-like symptoms after receiving the COVID-19 vaccine. In a study of more than 1,000 healthcare workers, around 3% reported heartburn.

However, doctors are unsure if the COVID-19 vaccine directly causes heartburn. Many people experience heartburn occasionally, so it may be a coincidence or an uncommon side effect because not many people appear to report it.

There is no evidence suggesting that the COVID-19 vaccine causes long-term GERD.

Besides other COVID-19 symptoms, such as fever, cough, and fatigue, a person may experience digestive symptoms.

In a 2020 study of 204 people with COVID-19, more than 50% reported digestive symptoms, including:

  • lack of appetite
  • diarrhea
  • vomiting
  • abdominal pain

In 6 cases, digestive changes were the only symptoms, and as the severity of the infection increased, they became more pronounced. However, no one reported heartburn, reflux, or GERD.

People can use at-home tests to see if they have an active case of COVID-19. If it is a possibility, a person should follow local guidelines for getting a test. They should not visit a healthcare facility in person without calling ahead first.

For persistent heartburn or other GERD symptoms, a doctor will ask about a person’s symptoms and look at their medical history. This may be enough to confirm a diagnosis. If not, they may also order tests, including:

  • upper gastrointestinal (GI) endoscopy, which involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus and stomach
  • esophageal pH monitoring to measure acid levels in the esophagus
  • upper GI series, which uses X-rays and a chalky liquid to examine the esophagus, stomach, and small intestine

If a person does have COVID-19, and the heartburn is a direct symptom, it may go away on its own. Most people recover from COVID-19 without needing medical treatment.

If the symptoms do not go away, a person may have GERD or long COVID and GERD. There is no specific treatment for when these conditions occur together, but certain dietary and lifestyle changes may help to ease symptoms. These include:

  • quitting smoking
  • avoiding caffeine and alcohol
  • sitting up for at least 3 hours after eating meals, if possible
  • avoiding eating before going to bed
  • sleeping on the left side of the body with the head elevated

As body weight can increase pressure on the esophagus, it may also help to maintain a moderate weight. This can be more challenging for people with long COVID because fatigue may make it difficult to exercise without exacerbating symptoms.

If this is the case, it may be better for a person to focus on eating a balanced diet rather than on exercise. It may also help to:

  • eat smaller meals
  • avoid spicy, minty, or high-fat foods
  • avoid very acidic foods, such as citrus fruit

For more severe or persistent symptoms, a doctor may prescribe medications such as H2 blockers or PPIs to reduce stomach acid. They can also suggest surgery if GERD is severe and other treatments have not worked.

People with long COVID and GERD symptoms that do not get better should speak with a doctor.

A person should seek immediate medical care if they have any of the following symptoms:

  • chest pain or discomfort
  • difficulty swallowing
  • persistent vomiting or nausea
  • unexplained weight loss
  • black stool or vomit, which may indicate bleeding in the digestive tract

Some people report digestive symptoms with COVID-19. However, few studies have investigated whether heartburn, reflux, or GERD are among them.

Heartburn may be a symptom of long COVID, but there are other reasons why it can affect people with this condition, such as shared risk factors. More research is necessary to understand the potential link.

People with GERD or long COVID should contact a doctor for diagnosis and treatment, which may involve lifestyle changes or medications such as PPIs.