Can Stress Cause Heartburn, Acid Reflux, And Gastroesophageal Reflux Disease (GERD)?

Medically reviewed by Julie Dodson, MA
Updated May 30, 2024by BetterHelp Editorial Team

In addition to the emotional and cognitive concerns it can cause, stress often produces a range of physical health concerns. One of the physiological reactions that can accompany stress is gastrointestinal distress, which encompasses several challenges, including heartburn. Heartburn—a painful burning sensation in the chest and throat—can lead to further physical health complications and worsening stress. But how exactly does stress create heartburn, and how can you avoid it? Below, we’re going to examine the connection between stress and heartburn and how to address both challenges. 

What is heartburn?

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Stress can lead to serious physical health concerns

Heartburn is discomfort that is caused by acid reflux, in which the stomach’s contents are forced partway back up into the esophagus, leading to an unpleasant burning feeling in the lower chest. Often, this is preceded by discomfort in the back of the throat, sometimes accompanied by painful belching. Other potential symptoms include a rising sense of pain that may reach as far up as your jaw. There might also be a foul, acrid taste in your mouth. 

There are several factors that may lead to an individual experiencing heartburn. It is thought to be caused by certain types of heartburn triggering foods, but it can also be the result of individual differences, such as smoking, pregnancy, and high levels of stress. While most people experience occasional heartburn, persistent and severe heartburn can be a sign of a physical health condition. 

Heartburn is most closely related to gastroesophageal reflux disease (GERD), a condition that may be implicated if you experience acid reflux more than twice a week. Heartburn is one of the more common symptoms of GERD, which is relatively prevalent in the adult population worldwide.

According to the American College of Gastroenterology, approximately 20% of Americans experience heartburn associated with GERD.

What is stress?

Stress is the body’s response to challenging situations. The stress response, also called the fight-or-flight response, produces a series of psychological and physiological changes in the body. These can help us take action and safegaurd ourselves, but these stress reactions can also cause mental and physical health complications, including gastrointestinal challenges

Symptoms of excessive stress can also include chest pain, fatigue, sweating, and irritability. If stress becomes persistent, it may lead to more serious negative effects. Sustained life stress can contribute to an increased risk of high blood pressure, depression, and anxiety. Additionally, research shows that stress can impact the pain receptors in the body, affecting our perception of pain. 

How stress can cause heartburn

As discussed above, stress can create several physiological changes in the body, including gastrointestinal (GI) distress. Stress can slow an individual’s digestion and increase acid production, which may increase the risk of heartburn. And because stress can cause us to perceive pain differently, it may lead to trouble coping with the discomfort of GI disturbances.  

Research shows that life stress can aggravate gastroesophageal reflux disease (GERD) and predict increased heartburn symptoms. Stress and gastrointestinal distress are thought to have a bidirectional relationship, meaning stress can lead to or exacerbate GI problems, and GI distress can cause or stress. Stress can also cause individuals to engage in behaviors that might lead to heartburn, such as drinking alcohol or smoking cigarettes. 

How to manage stress-related heartburn

There are several different treatment options for gastroesophageal reflux disease. A mental health or medical provider may prescribe a GERD medication—such as omeprazole or lansoprazole—and suggest specific lifestyle changes. Always consult with a healthcare professional prior to starting or stopping any medication.

Because of the close relationship between stress and GI issues, many stress-management strategies can also alleviate heartburn, and vice versa. The following are techniques that can help alleviate both stress and heartburn. 

Limit exposure to stressors

Stress in your life may arise out of a variety of situations. By addressing the sources of stress, you may prevent many of its physical effects. For example, if stress is related to low job satisfaction, consider speaking with a supervisor about adjusting responsibilities, looking for a more sustainable position, or transitioning to a less stress-inducing career. 

You can also limit stressors by making small changes. For example, if your commute contributes to stress, then you might find a new route or leave at a different time each day. Identifying what it is that's causing you stress can be vital to alleviating its negative impacts. 

Exercise

Some lifestyle factors are shown to reduce the risk of acid reflux. For example, exercise has proven benefits when it comes to stress, and many experts believe it can also improve GERD symptoms by facilitating proper digestion. However, it is thought that more strenuous forms of exercise may actually exacerbate heartburn. Consider participating in low-impact forms of exercise like yoga, tai chi, or pilates. 

Avoid heartburn-inducing foods

Several foods have been linked with GERD and heartburn, so making some tweaks to your diet may help with heartburn. Spicy and fatty foods have been linked to heartburn, as have foods that are high in fat and sodium. Black pepper, peppermints, garlic, onions, chocolate, citrus fruits and juices, and tomatoes or tomato derivatives like ketchup can also cause heartburn. 

Research shows that eating more fiber, which can help keep your bowel movements regular, can lead to fewer episodes of acid reflux and heartburn. High-fiber foods include legumes (e.g., lentils and beans), apples, avocados, broccoli, raspberries, and popcorn. Try to also drink plenty of water and be sure that you're consuming a lot of leafy green vegetables, fresh fruits, and raw nuts or seeds. You may want to also avoid processed foods and products that contain excess amounts of sodium and preservatives.

Avoid smoking 

Smoking can also lead to heartburn, as the act of inhaling and exhaling smoke relaxes the valve at the top of your stomach. This allows excess stomach acids to reflux back into your esophagus. If you are having trouble quitting, then talk to your doctor about some options. There are patches, nicotine gum, and several other options that exist now to help you try and make the adjustment.

Consider therapy

Psychotherapy is considered a first-line treatment for stress. In one study, researchers found that cognitive behavioral therapy and acceptance and commitment therapy—two common modalities—can help those who face occupational stress. A therapist can help you address the emotional symptoms of stress, develop useful coping strategies, and identify the sources of your feelings. 

Consult a specialist

You may also want to ask your primary care provider to refer you to a gastroenterologist or other gut health specialist. They can provide you with a thorough examination and identify the underlying causes of your gastrointestinal distress. They may also be able to prescribe medication and help you develop a nutritional plan that improves your symptoms. 

How online therapy can help

Research suggests that online therapy is an effective method of alleviating mental health concerns that may be related to physical health conditions. For example, in one study, researchers found that online therapy led to improvements in gastrointestinal symptoms, as well as depression and anxiety symptoms. Additionally, the study mentions the ability of online therapy to circumvent common barriers to mental health care, including cost, perceived stigma, and geographical limitations. 

Online therapy can be a convenient way for you to seek support in mitigating the effects of stress-induced heartburn. If your stress stems from a busy schedule, online therapy platforms like BetterHelp enable you to schedule appointments during times that are convenient for you. Online therapy is also an affordable option—BetterHelp starts at $65 to $100 per week (based on factors such as your location, referral source, preferences, therapist availability and any applicable discounts or promotions that might apply)—which may be helpful if your stress is related to finances. 

Takeaway

The connection between stress and heartburn is illustrative of the complex relationship between the mind and body. While excess stress can cause or make heartburn worse, both conditions can be managed so that their effects are limited. If you’d like support addressing the mental and physical concerns associated with stress or similar challenges, consider connecting with a licensed therapist online. With the right help, you can manage stress, reduce symptoms of heartburn, and foster emotional wellness. 
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