Links Between GERD and Anxiety

Woman experiencing heartburn.
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Many people believe that heartburn is related to anxiety. While you won't see anxiety listed as a usual risk factor for acid reflux, research suggests that a connection exists, although the precise reason why is unknown.

What Is GERD?

Gastroesophageal reflux disease (GERD), or acid reflux disease, occurs when acid from the stomach refluxes into the esophagus causing symptoms like heartburn, trouble swallowing, or a burning taste in your throat. While anyone may have an occasional bout of heartburn, if you have frequent heartburn it may be diagnosed as GERD. Getting diagnosed is important because GERD can be treated by lifestyle modifications, over-the-counter medications, and prescription drugs. If untreated, GERD may lead to complications like a chronic cough, erosive esophagitis, and even esophageal cancer.

What Causes GERD?

The structural cause of heartburn symptoms and GERD lies where your esophagus meets your stomach. The esophagus is a muscular tube that connects the mouth to the stomach. The lower esophageal sphincter (LES) is a ring of muscle that closes the stomach off from the esophagus when you are not eating. When you eat, this muscle relaxes, allowing food to pass smoothly from the esophagus to the stomach. The LES then closes again so that food in the stomach will not back up into the esophagus. But when the LES does not function properly, GERD may develop when stomach acid refluxes into the esophagus. The stomach acid irritates the lining of the esophagus and leads to the burning sensation known as heartburn.

Typical causes of GERD include increased abdominal pressure (such as with obesity or pregnancy), certain medications, smoking, and hiatal hernia. Heartburn may be triggered by overeating, eating too close to bedtime, drinking alcohol, or eating greasy or spicy foods.

Studies Showing a Link Between Anxiety and GERD

While anxiety is not listed as a cause of GERD, some studies have shown that the incidence of anxiety in people with GERD is higher than for those in the general population. Also, people with both GERD and anxiety may have more frequent symptoms and more severe symptoms, leading to a reduced quality of life. This suggests that anxiety may play a role in the development of GERD and in worsening of symptoms, although researchers aren't entirely clear how.

Some experts believe that a brain chemical called cholecystokinin (CCK), which has been linked to panic and gastrointestinal disorders, may play a role in the prevalence of GERD in people with anxiety disorders. There are theories that anxiety can slow digestion, increase stomach acid, or result in increased muscle tension that can put pressure on the stomach.

Another possibility or contributing factor may be that when people are anxious they tend to engage in behaviors that may trigger or worsen acid reflux, like smoking, drinking alcohol, or eating fatty or fried foods. These can be soothing behaviors that can then lead to the pain and discomfort of heartburn.

The reverse may also be true as your GERD symptoms, such as chest pain and trouble swallowing, can be worrisome and increase your anxiety or trigger a panic attack.

This being said, it's important to remember that a link does not imply causation. In other words, these studies are not suggesting that anxiety directly causes GERD or vice versa. Rather, a complex relationship has been found between the two health conditions.

A Word From Verywell

The big picture here is that if you suspect you have anxiety or GERD or both, be sure to see your healthcare professional for a proper diagnosis and treatment plan. The good news is that both can be effectively treated.

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