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There is a strong connection between acid reflux and anxiety. Acid reflux and anxiety can play off of each other creating a problematic cycle of mental and physical discomfort. It’s important to understand how the two are connected in order to stop heartburn generated by acid reflux and anxiety.
What Is Anxiety?
Anxiety is a normal phycological reaction to stress with feelings of worry, nervousness, or unease. Events of everyday life such as a test, important decision, presentation, or job interview can cause anxiousness.
Chronic anxiety is more pronounced interfering with one’s ability to live a normal life. Chronic anxiety includes nervous disorders such as generalized anxiety disorder, specific phobias, panic disorder, and social anxiety. Physical symptoms are more likely to be seen in those that have chronic anxiety.
What is Acid Reflux?
Most of us experience acid reflux on occasion. When we swallow food, it travels down the esophagus into the stomach where stomach acid helps break down food.
There is a ring of muscle at the base of the esophagus known as the lower esophageal sphincter (LES). The LES relaxes when we swallow food letting it pass into the stomach. It closes after the food passes to keep stomach acid out of the esophagus.
Unfortunately, the LES doesn’t always close tightly enough allowing acid to leak up into the esophagus. This backing up of stomach acid into the esophagus is acid reflux, and the pain from acid irritating the esophagus is known as heartburn.
Acid Reflux and Anxiety Connection
The connection between acid reflux and anxiety is obscured by its various causes and psychosomatic connection. The two can play off each other. Stress and other psychological traits of anxiety can increase acid reflux symptoms and acid reflux symptoms can cause anxiety to increase.
Heartburn is the most commonly recognized acid reflux symptom, but heartburn isn’t experienced by everyone who is anxious. Those most susceptible are those who have a gastrointestinal disorder such as gastroesophageal reflux disease (GERD).1,2
Anxiety Heartburn Causes
Is It Actually Heartburn?
- Hyperventilation is a common symptom of anxiety that can cause chest pain similar to heartburn.
- Anxiety sufferers may experience chest pain caused by muscle tension.
A bitter or sour taste is sometimes present during acid reflux. This could help differentiate between acid reflux and anxiety symptoms.
Muscle tension in the chest brought on by anxiety may increase abdominal pressure. Pressure on the abdomen can cause stomach contents to push up against the LES. This compromises the closure of the LES allowing acid to reflux into the esophagus leading to heartburn.
Stress and Hypervigilance
Stress causes the brain to turn up pain receptors. This greater sensitivity or awareness of the symptoms is known as hypervigilance. Hypervigilance causes heartburn pain to increase during times of anxiety, though actual acid exposure may not increase.
Chronic Acid Reflux
Those with gastrointestinal issues like chronic acid reflux are more susceptible to acid reflux issues and are more likely to experience an increase in heartburn during times of anxiety.
Excess Stomach Acid
Stress may cause an increase in stomach acid. As long as the LES closure keeps acids in place this may not be an issue but could lead to heightened acid levels in the esophagus if refluxed.
Changes in Digestion
Stress can cause a slowdown in digestion which can lead to additional abdominal pressure and an increase in stomach acid.
Diet and Lifestyle Behaviors
Many anxiety sufferers resort to poor diet and lifestyle choices for comfort. Many of these are heartburn triggers such as overeating, drinking alcohol, caffeine, and smoking more if they are smokers.
Psychiatric medications can cause the LES to relax and allow acid reflux.
Drop in Prostaglandins
Anxiety can cause a drop in prostaglandins. Drops in prostaglandins cause a drop in gastric mucus secretion which protects the digestive lining against acid. Drops in prostaglandins also cause an increase in stomach acid production. Without proper prostaglandins levels, there may be an increase in acid reflux symptoms.
Acid reflux symptoms can lead to further anxiety causing a cycle where acid reflux and anxiety feed off each other.
How to Prevent Acid Reflux and Anxiety
Without remedying both acid reflux and anxiety, either can provoke the occurrence of each other through a cyclical effect. The many acid reflux symptoms can lead to anxiety which can in-turn fuel acid reflux symptoms. Or anxiety can raise the pain of heartburn leading to more anxiousness and so on.
Acid Reflux Prevention: Lifestyle and dietary changes are the main ways to prevent acid reflux. Avoid heartburn triggers (i.e. tobacco, alcohol, and heartburn trigger foods), slow down while eating, do not overeat, avoid eating before bed, and sleep on an incline.
Anxiety Management: Normal events that trigger anxiety can’t be prevented, but they can be managed through:
- Soothing music
- Relaxing in the tub
- Time with friends or family
- Fun activities
If you suffer from chronic anxiety disorders such as generalized anxiety disorder, specific phobias, panic disorder, and social anxiety, the help of a medical professional will be required to overcome these disorders.
Treatment Options for Acid Reflux and Anxiety
Stress-related anxiety is common in our society and often unavoidable. Whether the stress comes from an external source or from internal pressures, anxiety can be managed through the coping mechanisms mentioned above.
If either anxiety or acid reflux is chronic, they should be treated by a health professional. Both acid reflux and anxiety can lead to other health issues if left untreated.
1) Bradley LA, Richter JE, Pulliam TJ, Haile JM, Scarinci IC, Schan CA, Dalton CB, & Salley AN. “The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors.” National Center for Biotechnology Information, U.S. National Library of Medicine, The American Journal of Gastroenterology, January 1993.
2) C. Jansson; H. Nordenstedt; M.-A. Wallander; S. Johansson; R. Johnsen; K. Hveem; & J. Lagergren. “Severe Gastro-oesophageal Reflux Symptoms in Relation to Anxiety, Depression and Coping in a Population-Based Study.” Medscape, Alimentary Pharmacology & Therapeutics, 2007.