Gastroesophageal reflux disease (GERD) is a chronic condition in which stomach acid flows back up into your esophagus. It’s not uncommon to experience acid reflux on occasion, but acid reflux that occurs at least twice a week is considered GERD.
Anxiety is your body’s natural response to stress, but severe anxiety or anxiety that lasts a few months and interferes with your life may indicate an anxiety disorder.
The two may seem completely unrelated, but researchers believe there may be link between GERD and anxiety, though the nature of that link is unclear.
GERD is caused by frequent acid reflux, which occurs when stomach acid flows back up into your esophagus, irritating its lining and sometimes causing inflammation. There are certain conditions that can increase your risk of GERD, including:
Certain lifestyle factors may worsen acid reflux, including poor eating habits, such as eating large meals, lying down while — or shortly after — eating, or eating fried or fatty foods. Stress, which is closely linked to anxiety, is also known to worsen acid reflux.
A 2015 study found that anxiety and depression increase the risk of GERD, and other studies have found that GERD’s negative effect on quality of life increases anxiety and depression, creating a vicious cycle. Yet there is no scientific evidence that positively links anxiety to increased stomach acid.
A few studies, including a recent study published in the medical journal Gastroenterology, shows that many people with anxiety and GERD symptoms have normal esophageal acid levels.
However, several studies have found that anxiety seems to increase symptoms associated with GERD, such as heartburn and upper abdominal pain. It’s believed that anxiety may make you more sensitive to pain and other symptoms of GERD.
Anxiety and other psychological distress may also impact esophageal motility and the functioning of your lower esophageal sphincter. Esophageal motility refers to the contractions that occur in your esophagus to move food toward your stomach.
Your lower esophageal sphincter is a ring of muscle around your lower esophagus that relaxes to allow food and liquid into your stomach and closes to prevent the contents of your stomach from flowing back up.
GERD and anxiety can cause a number of different symptoms, though there are a few that both conditions seem to have in common.
GI issues, such as heartburn, nausea, and stomach pain are common symptoms of both conditions. Another symptom common in both is globus sensation, which is the painless feeling of a lump in your throat or a tightening or choking sensation.
People who experience globus sensation also often have hoarseness, a chronic cough, or a persistent need to clear their throat, which are also common symptoms caused by GERD and acid reflux.
Disrupted sleep is also a common symptom of both conditions. Acid reflux may be worse when lying down, which can cause you to wake up often. Anxiety affects your sleep pattern and can make it hard for you to fall asleep or stay asleep.
Other symptoms of GERD include:
- chest pain
- difficulty swallowing (dysphagia)
- regurgitation of sour liquid or food
Other symptoms of anxiety include:
- feeling restless or nervous
- a sense of impending doom or danger
- rapid heartrate
- difficulty controlling worry
- chest tightening or pain
Both conditions can cause chest pain and other symptoms that are also symptoms of a heart attack. Call 911 if you have chest pain, especially if it is accompanied by shortness of breath or arm or jaw pain.
Treating GERD and anxiety may require a combination of medications for both conditions, though acid-suppressing drugs commonly used to treat GERD have been found to be less effective in people whose symptoms are related to anxiety.
Home remedies for GERD and anxiety may also help reduce your symptoms.
Medical treatments and medication for GERD and anxiety
A doctor may recommend a combination of the following to treat GERD and anxiety:
- over-the-counter (OTC) antacids, such as Tums and Rolaids
- H-2-receptor blockers (H2 blockers), such as famotidine (Pepcid) and ranitidine (Zantac)
- proton pump inhibitors (PPIs), such as esomeprazole (Nexium) and rabeprazole (Aciphex)
- selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and citalopram (Celexa)
- benzodiazepines, such as alprazolam (Xanax) and lorazepam (Ativan)
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor)
- psychotherapy, such as cognitive behavioral therapy (CBT)
There are things that you can do at home that may help relieve symptoms of GERD and anxiety. A doctor may recommend that you try these before medication or in combination with medical treatment.
At-home remedies include:
- eat a healthy diet
- avoid foods that trigger acid reflux or heartburn
- get regular exercise, such as going for walks
- try relaxation techniques, such as yoga, tai chi, or meditation
- avoid caffeine and alcohol
Even though researchers don’t yet fully understand the connection between GERD and anxiety, it’s known that anxiety and stress can trigger or worsen symptoms related to GERD.
You may be able to relieve many of your symptoms of both conditions using at-home remedies, but both conditions do warrant a visit to a doctor. Treatments are available that can help you manage or prevent both conditions.
GERD and anxiety can both cause chest pain, which is also a symptom of a heart attack. Get emergency medical care for any new chest pain, especially if you also have shortness of breath, or arm or jaw pain.