Can stress cause acid reflux? Physical symptoms of stress

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated January 3, 2024by BetterHelp Editorial Team

If you’ve ever noticed your heartburn worsening when you feel under pressure, you might be experiencing stress-related acid reflux. 

Research has demonstrated that mental factors like stress and anxiety can worsen the symptoms of gastroesophageal reflux disease (GERD). Understanding the connection between heartburn and stress may aid you in coming up with a plan to cope with these symptoms independently or combined.

Getty/AnnaStills
Healthily managing stress may relieve reflux symptoms

Can stress put you at risk for acid reflux symptoms?

Chronic stress is a risk factor for GERD, a disease involving frequent bouts of painful acid reflux. Many population-based studies have found that people with high-stress levels are also more likely to report symptoms of acid reflux. 

Studies have also shown a direct association between mental pressure levels and GERD severity. A 2013 paper found that the higher participants scored on psychological assessments designed to measure stress, the worse their symptoms of GERD were.

Given these findings, psychological disorders associated with high stress also seem to increase the prevalence of acid reflux symptoms. A large cross-sectional study assessing more than 19,000 people found that those with anxiety or depression were more likely to have GERD.

Psychological effects of stress on GERD

Acid reflux occurs when stomach acid backs up into the esophagus. This process can cause various symptoms, including the following: 

  • Heartburn (burning pain traveling up from the stomach through the esophagus)
  • Regurgitation (bitter or sour taste produced by backed-up stomach fluid)
  • Bloating
  • Frequent burping
  • Hiccups
  • Nausea
  • Feelings of an object stuck in your throat 

GERD is a condition involving frequent episodes of acid reflux. If it persists for an extended period, the esophagus may be damaged by repeated exposure to stomach acid.

Does stress directly cause GERD? 

The connection between stress and stomach acid production was not widely understood until the 2010s. In the 1990s, many studies claimed that high stress was not associated with higher levels of acid exposure in the esophagus. However, 2022 studies have found that the stress response in the body can decrease gastric renewal, which leads to less blood flow to the stomach. In this case, the stomach can be more prone to acid production and hyperacid secretion. 

Stress and acid reflux

Other studies from 2019 also show that stress can cause inflammation in the gastrointestinal system, which may produce reactive bacteria that cause sensitivity in the stomach, potentially leading to acid reflux and the overall development of GERD. 

A few studies have reported that inducing stress seems to cause more frequent contractions in the esophagus. This effect could make it easier for acid to be transported up from the stomach, resulting in heartburn. 

Another paper reported that acute stress appeared to loosen the muscles that seal off the esophagus from the gut. If those effects also held true for chronic stress, it could make it easier for acid to make its way up from the stomach, as stress would be recurrent. 

Stress causes changes in the brain and body that can lead you to experience acid reflux symptoms more profoundly. Hormone-like substances called prostaglandins normally coat your stomach lining to safeguard it from acid.  Stress lowers the levels of these defensive substances. This may lead to more noticeable reflux symptoms. Stress also makes the pain receptors in your esophagus more active, which may amplify your experience of discomfort.  

Attempts to cope with stress sometimes lead to lifestyle changes that contribute to acid reflux. It can be tempting to reach for comfort foods or drink more alcohol to relax. However, drinking alcohol causes the lower esophageal sphincter to relax, which allows acid to come back up into the esophagus and cause a burning sensation. Sticking to healthy habits such as eating smaller meals, avoiding fatty foods, avoiding spicy foods, exercising regularly, and minimizing alcohol consumption may ease symptoms of acid reflux.

Can reducing stress reduce your acid reflux symptoms?

Reducing stress may reduce pain and discomfort associated with GERD. An experiment published in Gastroenterology found that when GERD patients were guided through a brief relaxation technique, they reported fewer symptoms afterward. They also showed reduced esophageal acid exposure, hinting there may have been some improvement in their digestive functioning.

Getty/AnnaStills

Techniques for reducing stress and GERD symptoms 

The following stress-reduction practices may help you feel more relaxed and decrease symptoms of GERD and stress in daily life. 

Deep breathing

Taking deep, slow breaths by fully expanding your diaphragm while inhaling can be one way to reduce stress. This technique may control your parasympathetic nervous system, which is responsible for feelings of relaxation and stress. Some studies have shown improvements in quality of life and symptom severity among GERD patients who practiced deep breathing regularly. 

Meditation

Mindfulness meditation combines deep breathing with sustained, relaxed attention. Sitting still, focusing on your breath, and noticing any thoughts that arise without judgment may help to bring about feelings of calm and well-being. One experiment found that people with acid reflux disease experience less distress and depression when they practice mindfulness meditation.

Exercise

Regular aerobic exercise may improve your mood, relieve stress, and combat symptoms of depression and anxiety. Engaging in exercise two days per week or more may be enough to reduce your stress levels substantially. The meditative exercise tai chi has been found to benefit both the body and the mind, and is gentle enough that older or obese people can enjoy this practice. People who begin to exercise regularly may also notice positive effects on their GERD symptoms because excessive body weight and a sedentary lifestyle are known risk factors for this disease. 

Reduced caffeine intake

Although some individuals drink tea, coffee, and caffeinated sodas daily, scientific evidence has found that caffeine can contribute to stress. However, stress levels may depend on your dosage of caffeine, as small amounts could have positive impacts. Try gradually reducing your caffeine intake and seeing if you can find a level that reduces anxiety symptoms, a racing heart, high blood pressure, or other co-occurring symptoms of stress. 

Social interaction

Many people may feel stressed when isolated or lonely. The demands placed on your time by your career or other responsibilities might leave less room for friends and family. However, social support may relieve the adverse effects of stress and is associated with physical and mental well-being. Consider walking with a friend or family or meeting someone on your lunch break at work. 

Spending time in nature 

A growing body of research has found that spending time in natural environments can reduce physical and mental signs of stress. If you’re able to take a few minutes to walk next to a river or through a grove of trees, you might notice a reduction in stress. If you live in an urban area, driving on the weekends to a zoo or natural park might be beneficial. Some states may also have national parks you can visit on a vacation or special weekend. 

Making peace with your stress

Though it might sound like a paradox, acknowledging and accepting that you’re stressed could reduce your distress. Fighting against challenging emotions or mental states may increase emotional strain. Stress can sometimes be positive, as it may motivate people to make essential life changes, work hard, and know when they need a break. If you’re feeling stressed, it could be a sign to look at what aspects of your life you might change to take the weight off.

Getty/VadymPastukh
Healthily managing stress may relieve reflux symptoms

Therapy

If you have chronic stress, anxiety, depression, or another mental health challenge, you’re not alone. Therapy may be beneficial to process these symptoms healthily with a professional. There are many therapeutic modalities, but cognitive-behavioral therapy has proven effective in reducing the symptoms of stress-related disorders. It may reduce anxiety, depression, and distress related to chronic fatigue, fibromyalgia, and irritable bowel syndrome. 

Consulting with a therapist might help you find better ways to manage your stress and reduce your symptoms of acid reflux. However, finding a therapist within one’s budget, location, or schedule can be stressful for many people. In these cases, online platforms like BetterHelp may enable you to connect with a provider from anywhere you have an internet connection. 

Though its popularity has increased in recent years, online therapy has been around for a while, and a substantial body of evidence shows its effectiveness. A 2008 meta-analysis looked at studies including more than 9,000 clients and found that therapy was as effective over the internet as it was in person. The researchers concluded that online counseling was also a legitimate and potentially cost-effective therapeutic option. 

Takeaway

Prolonged stress may exacerbate the symptoms of acid reflux and GERD, which might occur for various impacts on the gastrointestinal system. Practices like deep breathing, regular exercise, taking over the counter medication, consuming smaller meals, and reducing caffeine intake may effectively reduce discomfort and increase clients’ quality of life. However, consider contacting a therapist for guidance if you require further support. In addition, you might consult your primary care physician for treatment options for GERD.
Ease stress and mental exhaustion
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started