What to know about Acid reflux and anxiety

What to know about Acid reflux and anxiety

Acid reflux and anxiety may share a close connection. Some research suggests anxiety may aggravate the symptoms of acid reflux.

Anxiety and stress will also in some cases lead to the acid reflux. Conversely, acid reflux can be unpleasant in some individuals, and can cause anxiety.

Individuals with troubling symptoms or symptoms not leading to home therapy should see a doctor.

What’s the link between anxiety and acid reflux?

Acid reflux and anxiety may be closely related.
Acid reflux and anxiety may be closely related.

Acid reflux occurs when acid spills back into the food stream, or esophagus, from the stomach. It is a common symptom of GERD (Gastroesophageal Reflux Disorder).

Stress will aggravate the symptoms of acid reflux and anxiety is a natural response to body stress. Paradoxically, even feeling anxiety can be upsetting in itself which can start the process.

There is some evidence suggesting that stress and anxiety can cause acid reflux or aggravate the symptoms.

For example, a survey that included more than 19,000 people in 2018 showed that those with anxiety were more likely to experience GERD symptoms.

For this the researchers have proposed many possible physical reasons:

  • 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 episodes of acid reflux as people without anxiety classified these episodes as more serious.

The authors of a report for Clinical Gastroenterology and Hepatology have found that the symptoms— including pain and heartburn — were more severe in people with GERD in those with higher anxiety levels.

Researchers have also noticed that GERD can be a great source of people’s stress and anxiety.

Researchers noted in 2019 that people with GERD who have had chest pain have significantly higher levels of depression and anxiety than those who have had no pain in this part of the body.

The authors of the study also suggest that people may equate symptoms such as chest pain with other more severe conditions, raising their concern over those symptoms.

The combination of these factors may allow the creation of a vicious cycle. GERD can cause stress and anxiety but levels of stress and anxiety also lead to GERD. It is important to break the cycle and find relief to find both physical and psychological ways to treat those symptoms.

Other factors capable of causing acid reflux include:

  • eating meals just before bed
  • eating large or fatty meals
  • including spicy foods in meals
  • having obesity
  • consuming alcohol
  • smoking

Difference between symptoms

Learning GERD symptoms and anxiety may help a person differentiate between them.

Symptoms of GERD

GERD is a condition that causes frequent reflux of acid, because stomach acid also flows back into the esophagus. This causes many symptoms, the most common being heartburn.

Heartburn is a hot, burning sensation in the middle of the chest and in the throat, occasionally. It occurs when the gastric acid irritates the esophagus.

GERD symptoms could include:

  • heartburn
  • nausea or stomach upset
  • pain in the chest or abdomen
  • painful swallowing
  • vomiting
  • 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 manifest as unexpected, extreme symptoms of panic attacks called anxiety. If severe symptoms come on very fast, panic attacks occur. These can involve extreme fear, rapid rhythm changes and breathing changes.

Treatment and prevention

Most people deal with intermittent acid reflux and occasionally feel nervous when dealing with a stressful situation.

When either or both symptoms are regular occurrences, intervention to treat or avoid them is necessary.

Moreover, since the symptoms of acid reflux and anxiety can make each other worse, taking swift action will help prevent the development of this process.

People might be able to relieve GERD symptoms using one or more approaches, 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

When to see a doctor

In some cases, the effects of both acid reflux and anxiety can be treated using home remedies.

Anyone who has chronic anxiety or acid reflux should talk to a doctor, however.

Other complications, such as scar tissue in the esophagus, Barrett’s esophagus and, in rare cases, oesophageal cancer, can cause long-term acid reflux.

Long-term anxiety may lead to an array of problems in physical and mental health.

Both GERD and anxiety symptoms can seem close to those of other conditions. And seeing a doctor for a diagnosis is recommended.


It can be frustrating to deal with the combination of acid reflux and anxiety. In some cases, a person may not know whether he or she experiences acid reflux or the physical anxiety symptoms.

It’s important to work with a doctor to ensure the person gets the right care.

Learning ways to relieve anxiety and taking steps to alleviate acid reflux can help end the cycle and help control the symptoms of individuals.


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