Can stress cause heartburn, acid reflux, and gastroesophageal reflux disease (GERD)?
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?
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.
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
Can stress and anxiety cause heartburn?
Feeling stressed or anxious may cause a variety of digestive problems including heartburn and irritable bowl syndrome (IBS). It is important to note that stress and anxiety do not directly cause heartburn, however, when you feel stressed or anxious you are more likely to engage in behaviors that cause heartburn. Some of these include overeating, eating unhealthy foods that cause acid reflux, or drinking alcohol.
Working with a therapist or mental health professional may be beneficial when learning to cope with stress in new ways. A therapist may teach you strategies for managing stress in real-time in ways that do not cause heartburn.
How do you get rid of heartburn from stress?
The key to avoiding heartburn in general, including stress-related heartburn, is to avoid behaviors that cause heartburn in the first place. Some things that you can do to reduce heartburn include:
- Avoiding certain foods (spicy foods, alcohol, tomatoes, garlic, etc.)
- Avoiding carbonation which makes you burp
- Do not exercise after eating
- Eat slower and smaller portions
- Sleep with your upper body propped up
- Don’t smoke
- Maintain a healthy weight
Another way to reduce heartburn related to stress is to reduce stress in your life. You can do this by:
- Exercising regularly (yoga, tai chi, and taking walks are all good options)
- Practice deep breathing techniques
- Meditation
- Practice self-care
- Laugh more
- Be mindful
- Keep a journal
- Practice good sleep hygiene
Why does stress cause heartburn?
While stress does not cause heartburn directly, habits that arise from stress may contribute to heartburn. These include things like overeating while stressed, drinking, or smoking.
It is also thought that stress may make existing heartburn symptoms worse by increasing stomach acid production. This is a major problem for individuals with gastroesophageal reflux disease, or GERD. With GERD, the lower esophageal sphincter, which separates the stomach from the esophagus, doesn’t close correctly which allows stomach acid to more freely enter the esophagus. In combination with high acid production from stress, this may increase heartburn.
What emotions cause heartburn?
There is evidence that emotions such as anxiety, worry, stress, and anger may cause heartburn. In a study, researchers found that feelings of anxiety or occupational stress led to high rates of GERD and heartburn. Other research has confirmed that emotions and psychological factors play a large role in increased heartburn symptoms and the severity of GERD.
There is a natural and biological reason why we experience increased stomach pain or heartburn when we feel emotions of worry or stress. The brain and digestive system are connected. In nature, the causes of stress or worry may center around survival, worrying about predators, dangerous weather, or other life-threatening factors. When we experience stress, the mind signals the body that a potentially dangerous situation is unfolded and we enter fight or flight mode. This causes digestion in the stomach to slow down to conserve energy, as the food sits in the stomach for a long time it may cause heartburn or general stomach discomfort.
Can lack of sleep cause heartburn?
Yes, lack of sleep can contribute to the development or exacerbation of heartburn, though it might not be the direct cause. Several factors come into play:
- Stress and Anxiety: Lack of sleep can lead to increased stress and anxiety levels, which are known to trigger heartburn or make existing symptoms worse.
- Diet and Eating Habits: Sleep deprivation can disrupt your eating patterns and food choices. People who are sleep-deprived may be more likely to consume unhealthy foods or eat irregularly, both of which can contribute to heartburn.
- Digestive System Function: Sleep plays a role in maintaining various body functions, including the digestive system. When you don't get enough rest, it can affect the functioning of the gastrointestinal system and potentially lead to heartburn.
- Relaxation of Lower Esophageal Sphincter (LES): The LES is a ring of muscle that separates the stomach from the esophagus. It acts as a barrier to prevent stomach acid from flowing back up into the esophagus. Sleep deprivation and stress can relax the LES, increasing the likelihood of acid reflux and heartburn.
- Increased Gastric Acid Production: Poor sleep and increased stress may lead to the overproduction of stomach acid, which can contribute to heartburn.
Is it GERD or anxiety?
Determining whether your symptoms are related to gastroesophageal reflux disease (GERD) or anxiety can be challenging because they can often present with similar symptoms. Both conditions can cause heartburn, chest discomfort, and a feeling of tightness in the throat, making it difficult to differentiate between the two based solely on symptoms. However, by seeing a healthcare professional, you can get a determination on whether your symptoms are caused by anxiety or GERD.
What naturally fights heartburn?
There are many ways to fight heartburn, including many over-the-counter medications designed for those who have GERD or repeated acid reflux. Although there are medications available, there are also different ways to fight heartburn naturally including:
- Changing dietary habits - eating smaller portions, avoiding foods to which you are sensitive and chewing more thoroughly may help reduce acid reflux.
- Exercise and maintain a healthy weight - overweight individuals are more likely to have heartburn due to an increase in abdominal weight.
- Avoid alcohol and caffeine - Both alcohol and caffeine can trigger heartburn in some individuals. Reducing or eliminating their consumption may be helpful.
- Add in herbal teas - some teas, such as chamomile and ginger may help with digestion
- Manage stress - implementing stress management techniques or seeing a therapist to help with lowering stress can reduce stress-related heartburn.
How long does heartburn last?
The length of a heartburn episode can vary depending on its underlying cause and the individual. In many cases, heartburn is a temporary and short-lived discomfort that may last for a few minutes to a couple of hours. It often occurs after eating a large meal or consuming trigger foods.
However, if heartburn is caused by gastroesophageal reflux disease (GERD) or other underlying conditions, it can persist for extended periods. In such cases, heartburn may occur regularly or even become chronic, lasting months or years if not properly managed.
Why does my chest burn when I feel anxious?
When you feel anxious, your body undergoes a series of physiological responses, often referred to as the "fight-or-flight" response. During this response, your body releases stress hormones like adrenaline and cortisol, which trigger various changes to prepare you to cope with a perceived threat.
Some of these changes occur in the stomach and include slowed digestion and increased acid production. These may cause the stomach acid to more readily enter the esophagus causing a burning sensation in the chest area, which we call heartburn.
Is acid reflux the same as heartburn?
Acid reflux and heartburn are related but not the same. They are often used interchangeably, but they refer to different aspects of the same problem. Generally speaking, heartburn is a symptom of acid reflux while acid reflux is a condition where a sphincter in the stomach isn’t working properly, which allows acid to flow from the stomach to the esophagus.
Not everyone who has acid reflux will have heartburn as a symptom, in some cases, they have no symptoms at all. Other symptoms of acid reflux can include regurgitation (a sour or bitter taste in the mouth), difficulty swallowing, a sensation of a lump in the throat, and coughing or wheezing, especially at night.
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